DEPARTMENT OF INSURANCE

Affiliations

Name	Tillett, Shelly Jean	DOIID	303576	NAIC NPN	7157267

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	5/27/2014		6/30/2025
Active	Resident	Agent	Health	9/30/2014		6/30/2025
Active	Resident	Agent	Life	9/26/2014		6/30/2025
Active	Resident	Agent	Property	5/27/2014		6/30/2025
Inactive	Resident	Agent	General Lines	6/28/1999	8/15/2000
Inactive	Resident	Agent	Assessment Chapter 299	8/24/1999	12/1/2000
Inactive	Resident	Agent	Limited Line Credit	5/2/2011	6/30/2013
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2025	06/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allstate Indemnity Company	300778	Agent - General Lines	3/15/2000	8/15/2000
Inactive	Allstate Insurance Company	300773	Agent - General Lines	3/15/2000	8/15/2000
Active	American Economy Insurance Company	300315	Agent - Casualty	5/31/2022
Active	American Economy Insurance Company	300315	Agent - Property	5/31/2022
Inactive	American Health and Life Insurance Company	300844	Agent - Limited Line Credit	5/2/2011	12/5/2012
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	7/3/2019
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	7/3/2019
Active	Ansur America Insurance Company	520667	Agent - Casualty	8/14/2019
Active	Ansur America Insurance Company	520667	Agent - Property	8/14/2019
Active	Anthem Life Insurance Company	301209	Agent - Health	11/24/2014
Active	Anthem Life Insurance Company	301209	Agent - Life	11/24/2014
Active	Auto-Owners Insurance Company	301480	Agent - Casualty	4/27/2022
Active	Auto-Owners Insurance Company	301480	Agent - Property	4/27/2022
Active	Auto-Owners Life Insurance Company	301368	Agent - Life	4/27/2022
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	6/13/2014	6/10/2020
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	6/13/2014	6/10/2020
Inactive	Baptist Health Plan, Inc.	300157	Agent - Life	12/9/2014	3/31/2019
Active	Cincinnati Casualty Company (The)	300308	Agent - Casualty	2/27/2019
Active	Cincinnati Casualty Company (The)	300308	Agent - Property	2/27/2019
Active	Cincinnati Indemnity Company (The)	301566	Agent - Casualty	2/27/2019
Active	Cincinnati Indemnity Company (The)	301566	Agent - Property	2/27/2019
Active	Cincinnati Insurance Company	301298	Agent - Casualty	2/27/2019
Active	Cincinnati Insurance Company	301298	Agent - Property	2/27/2019
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	3/19/2015	12/15/2015
Inactive	Dairyland Insurance Company	301370	Agent - Property	3/19/2015	12/15/2015
Inactive	First Mutual Insurance Company	301258	Agent - Assessment Chapter 299	8/24/1999	12/1/2000
Active	Frankenmuth Insurance Company	301481	Agent - Casualty	8/14/2019
Active	Frankenmuth Insurance Company	301481	Agent - Property	8/14/2019
Inactive	Golden Rule Insurance Company	301943	Agent - Health	11/3/2014	10/22/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Life	11/3/2014	10/22/2017
Inactive	Hartford Accident and Indemnity Company	301917	Agent - General Lines	5/8/2000	8/15/2000
Inactive	Hartford Casualty Insurance Company	301332	Agent - General Lines	5/8/2000	8/15/2000
Inactive	Hartford Fire Insurance Company	300628	Agent - General Lines	5/8/2000	8/15/2000
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - General Lines	5/8/2000	8/15/2000
Inactive	Hartford Underwriters Insurance Company	301064	Agent - General Lines	5/22/2000	8/15/2000
Active	Kentucky Home Life Insurance Company	300477	Agent - Health	11/3/2016
Active	Kentucky Home Life Insurance Company	300477	Agent - Life	11/3/2016
Active	Kentucky National Insurance Company	301625	Agent - Casualty	4/27/2020
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	6/28/1999	8/15/2000
Active	Kentucky National Insurance Company	301625	Agent - Property	4/27/2020
Active	Milbank Insurance Company	925185	Agent - Casualty	5/22/2019
Active	Milbank Insurance Company	925185	Agent - Property	5/22/2019
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	12/15/2022
Active	Ohio Casualty Insurance Company	301492	Agent - Property	12/15/2022
Active	Ohio Security Insurance Company	300622	Agent - Casualty	7/20/2020
Active	Ohio Security Insurance Company	300622	Agent - Property	7/20/2020
Inactive	Old Guard Insurance Company	533854	Agent - Casualty	6/4/2021	6/15/2021
Inactive	Old Guard Insurance Company	533854	Agent - Property	6/4/2021	6/15/2021
Active	Owners Insurance Company	300796	Agent - Casualty	4/27/2022
Active	Owners Insurance Company	300796	Agent - Property	4/27/2022
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	1/15/2020
Active	SAFECO Insurance Company of America	300159	Agent - Property	1/15/2020
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	5/31/2022
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	5/31/2022
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	6/13/2014	6/10/2020
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	6/13/2014	6/10/2020
Active	State Automobile Mutual Insurance Company	301824	Agent - Casualty	12/30/2019
Active	State Automobile Mutual Insurance Company	301824	Agent - Property	12/30/2019
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	6/13/2014	6/10/2020
Inactive	The Phoenix Insurance Company	301502	Agent - Property	6/13/2014	6/10/2020
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	6/13/2014	6/10/2020
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	6/13/2014	6/10/2020
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	6/13/2014	6/10/2020
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	6/13/2014	6/10/2020
Inactive	Triton Insurance Company	300654	Agent - Limited Line Credit	5/2/2011	12/5/2012
Inactive	Twin City Fire Insurance Company	300721	Agent - General Lines	5/8/2000	8/15/2000
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	1/15/2015	12/2/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	1/15/2015	12/2/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	1/15/2015	8/30/2019
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	1/15/2015	4/30/2018
Inactive	Unitrin Auto and Home Insurance Company	301538	Agent - Casualty	8/21/2014	10/23/2024
Inactive	Unitrin Auto and Home Insurance Company	301538	Agent - Property	8/21/2014	10/23/2024
Inactive	Westfield Champion Insurance Company	1054839	Agent - Casualty	6/4/2021	6/15/2021
Inactive	Westfield Champion Insurance Company	1054839	Agent - Property	6/4/2021	6/15/2021
Active	Westfield Insurance Company	301950	Agent - Casualty	10/22/2020
Active	Westfield Insurance Company	301950	Agent - Property	10/22/2020
Inactive	Westfield Premier Insurance Company	1055055	Agent - Casualty	6/4/2021	6/15/2021
Inactive	Westfield Premier Insurance Company	1055055	Agent - Property	6/4/2021	6/15/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Casualty	6/4/2021	6/15/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Property	6/4/2021	6/15/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Casualty	6/4/2021	6/15/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Property	6/4/2021	6/15/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Designated Agent Company Inc.	681257	Agent - Life	11/24/2014
Active	Designated Agent Company Inc.	681257	Agent - Health	11/24/2014
Inactive	Forsythe & Associates Inc.	400718	Agent - General Lines	10/23/1999	8/15/2000
Active	Jessie Insurance Danville LLC	1026513	Agent - Casualty	3/11/2019
Active	Jessie Insurance Danville LLC	1026513	Agent - Property	3/11/2019
Active	Jessie Insurance Danville LLC	1026513	Agent - Life	3/11/2019
Active	Jessie Insurance Danville LLC	1026513	Agent - Health	3/11/2019
Active	Johnson-Pohlmann Inc.	399739	Agent - Casualty	3/20/2015
Active	Johnson-Pohlmann Inc.	399739	Agent - Property	3/20/2015
Active	Johnson-Pohlmann Inc.	399739	Agent - Life	3/20/2015
Active	Johnson-Pohlmann Inc.	399739	Agent - Health	3/20/2015
Active	Keystone Ins & Benefits Group LLC	716920	Agent - Life	11/3/2014
Active	Keystone Ins & Benefits Group LLC	716920	Agent - Health	11/3/2014
Denied	Warman Insurance, LLC	578291	Agent - Casualty
Denied	Warman Insurance, LLC	578291	Agent - Property