DEPARTMENT OF INSURANCE

Affiliations

Name	Roberts, Gavin Clayton	DOIID	304441	NAIC NPN	7157610

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	5/31/2001		8/31/2026
Active	Resident	Agent	Property	3/26/2001		8/31/2026
Active	Resident	Agent	Life	5/31/2001		8/31/2026
Active	Resident	Agent	Health	5/31/2001		8/31/2026
Inactive	Resident	Apprentice Adjuster	Not Applicable	10/7/1999	6/28/2000
* 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 Agricultural Insurance Company	300215	Agent - Property	10/9/2015	6/16/2021
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	2/7/2019	4/14/2023
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	2/7/2019	4/14/2023
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	4/5/2004	6/23/2008
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	4/5/2004	6/23/2008
Active	American Modern Home Insurance Company	300791	Agent - Casualty	1/26/2023
Active	American Modern Home Insurance Company	300791	Agent - Property	1/26/2023
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	10/9/2018
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	10/9/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	10/11/2016	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	10/11/2016	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	6/19/2017	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	6/19/2017	11/14/2021
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	4/30/2023
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/26/2021	12/19/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	3/5/2015	12/5/2017
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	3/5/2015	12/5/2017
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	2/11/2008	12/20/2024
Inactive	Bristol West Insurance Company	301655	Agent - Property	2/11/2008	12/20/2024
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/16/2021
Active	Dairyland Insurance Company	301370	Agent - Casualty	5/31/2001
Active	FB Insurance Company (The)	301763	Agent - Casualty	5/31/2001
Active	FB Insurance Company (The)	301763	Agent - Property	3/26/2001
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	7/16/2004
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	7/16/2004
Active	Illinois Mutual Life Insurance Company	301479	Agent - Health	1/23/2018
Active	Illinois Mutual Life Insurance Company	301479	Agent - Life	1/23/2018
Inactive	Independence American Insurance Company	524747	Agent - Health	10/9/2020	12/30/2022
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	11/1/2005	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	11/1/2005	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	9/19/2008	3/19/2017
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	9/19/2008	3/19/2017
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	5/31/2001
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	3/26/2001
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	8/18/2016	9/20/2018
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	7/26/2018	3/30/2020
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	5/31/2001
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	5/31/2001
Inactive	Standard Insurance Company	300185	Agent - Health	3/3/2014	12/5/2022
Inactive	Standard Insurance Company	300185	Agent - Life	3/3/2014	12/5/2022
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	8/26/2016	12/27/2018
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	8/26/2016	12/27/2018
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	5/4/2011	6/26/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	5/4/2011	6/26/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	11/9/2009	1/9/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/12/2013	10/5/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/12/2013	10/5/2021
Active	Gavin C. Roberts Insurance Agency, Inc.	680772	Agent - Life	5/15/2008
Active	Gavin C. Roberts Insurance Agency, Inc.	680772	Agent - Health	5/15/2008
Active	Gavin C. Roberts Insurance Agency, Inc.	680772	Agent - Property	5/15/2008
Active	Gavin C. Roberts Insurance Agency, Inc.	680772	Agent - Casualty	5/15/2008
Inactive	Gavin C. Roberts Insurance, LLC	624432	Agent - Life	1/20/2006	6/2/2008
Inactive	Gavin C. Roberts Insurance, LLC	624432	Agent - Health	1/20/2006	6/2/2008
Inactive	Gavin C. Roberts Insurance, LLC	624432	Agent - Property	1/20/2006	6/2/2008
Inactive	Gavin C. Roberts Insurance, LLC	624432	Agent - Casualty	1/20/2006	6/2/2008
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	4/16/2001
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	4/16/2001
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	4/16/2001
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	4/16/2001
Active	Planchoice Inc.	400482	Agent - Health	4/17/2014
Inactive	Southern Capital Brokerage Co LLC	577403	Agent - Life	9/7/2004	3/31/2007
Active	Southern Capital Brokerage Co LLC	577403	Agent - Health	2/5/2019