DEPARTMENT OF INSURANCE

Affiliations

Name	Douglas, Ann C	DOIID	302172	NAIC NPN	7156621

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Property	8/15/2000		4/30/2026
Active	Resident	Agent	Casualty	8/15/2000		4/30/2026
Inactive	Resident	Agent	General Lines	7/1/1999	8/15/2000
Denied	Resident	Apprentice Adjuster	Not Applicable
Active	Resident	Staff Adjuster	Property & Casualty	7/21/2021		4/30/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Family Home Insurance Company	301817	Agent - Casualty	4/7/2015	11/14/2021
Inactive	American Family Home Insurance Company	301817	Agent - Property	4/7/2015	11/14/2021
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	4/7/2015	11/14/2021
Inactive	American Modern Home Insurance Company	300791	Agent - Property	4/7/2015	11/14/2021
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	10/5/2018
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	10/5/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	4/7/2015	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	4/7/2015	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	4/7/2015	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	4/7/2015	11/14/2021
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	1/15/2015	5/25/2022
Inactive	Bristol West Insurance Company	301655	Agent - Property	1/15/2015	5/25/2022
Inactive	FB Insurance Company (The)	301763	Agent - Casualty	8/15/2000	9/7/2022
Inactive	FB Insurance Company (The)	301763	Agent - General Lines	7/1/1999	8/15/2000
Inactive	FB Insurance Company (The)	301763	Agent - Property	8/15/2000	9/7/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/15/2015	5/25/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/15/2015	5/25/2022
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	8/15/2000	9/7/2022
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - General Lines	7/1/1999	8/15/2000
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	8/15/2000	9/7/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Jack R. Allen Insurance, Inc.	520704	Agent - Property	2/17/2004	3/31/2017
Inactive	Jack R. Allen Insurance, Inc.	520704	Agent - Casualty	2/17/2004	3/31/2017
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Staff Adjuster - Property & Casualty	10/27/2021