DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Rose, Jerry David	DOIID	311337	NAIC NPN	7160767

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	4/9/1998	12/1/2000
Inactive	Resident	Agent	Life	10/27/1998	12/1/2000
Inactive	Resident	Apprentice Adjuster	Not Applicable	2/9/2011	2/25/2011
Active	Resident	Staff Adjuster	Property & Casualty	2/25/2011		7/31/2026
* 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
Staff Adjuster	05/15/2024	07/31/2024	06/20/2024	06/20/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Combined Insurance Company of America	301472	Agent - Health	4/9/1998	7/23/1998
Inactive	Life Insurance Company of Alabama	301439	Agent - Health	3/16/1999	12/1/2000
Inactive	Life Insurance Company of Alabama	301439	Agent - Life	10/27/1998	12/1/2000
Inactive	Southwestern Life Insurance Company	301343	Agent - Health	2/22/1999	12/1/2000
Inactive	Southwestern Life Insurance Company	301343	Agent - Life	2/22/1999	12/1/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Staff Adjuster - Property & Casualty	3/9/2011

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Youngblood, Gregory Doyle	385919	Apprentice Adjuster - Not Applicable	2/9/2011	2/25/2011