DEPARTMENT OF INSURANCE

Affiliations

Name	Tiller, William Todd	DOIID	333718	NAIC NPN	3044010

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	8/19/2002		6/30/2026
Active	Resident	Agent	Casualty	8/19/2002		6/30/2026
Active	Resident	Agent	Property	8/19/2002		6/30/2026
Active	Resident	Agent	Health	8/19/2002		6/30/2026
Inactive	Resident	Agent	General Lines	12/27/1993	8/15/2000
* 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	Agri General Insurance Company	300914	Agent - General Lines	3/23/1994	12/3/1998
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	10/5/2018
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	10/5/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	4/6/2016	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	4/6/2016	11/14/2021
Active	Anthem Life Insurance Company	301209	Agent - Health	4/13/2023
Active	Anthem Life Insurance Company	301209	Agent - Life	4/13/2023
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
Inactive	C.M. Life Insurance Company	301335	Agent - Health	4/19/2006	11/8/2012
Inactive	C.M. Life Insurance Company	301335	Agent - Life	4/19/2006	11/8/2012
Active	Dairyland Insurance Company	301370	Agent - Casualty	1/9/2012
Inactive	Dairyland Insurance Company	301370	Agent - General Lines	7/2/1999	8/15/2000
Active	Dairyland Insurance Company	301370	Agent - Property	1/9/2012
Active	FB Insurance Company (The)	301763	Agent - Casualty	8/19/2002
Inactive	FB Insurance Company (The)	301763	Agent - General Lines	12/27/1993	8/15/2000
Active	FB Insurance Company (The)	301763	Agent - Property	8/19/2002
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	7/9/2004
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	7/9/2004
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	5/14/2010	11/7/2011
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	5/14/2010	11/7/2011
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	1/10/2006	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	1/10/2006	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	9/19/2008	4/11/2012
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	9/19/2008	4/11/2012
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	8/19/2002
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - General Lines	12/27/1993	8/15/2000
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	8/19/2002
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	4/19/2006	11/8/2012
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	4/19/2006	11/8/2012
Inactive	Protective Life Insurance Company	300638	Agent - Life	1/1/2007	12/20/2010
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	8/19/2002
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	8/19/2002
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	5/5/2011	6/26/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	5/5/2011	6/26/2017
Inactive		300277	Agent - Life	5/24/2006	1/1/2007

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	3/17/2004	11/8/2013
Active	Designated Agent Company Inc.	681257	Agent - Life	12/3/2013
Active	Designated Agent Company Inc.	681257	Agent - Health	12/3/2013
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - General Lines	2/15/1994	8/15/2000
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	8/30/2002
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	8/30/2002
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	8/30/2002
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	8/29/2002
Active	Todd Tiller Insurance Inc	551750	Agent - Life	8/16/2002
Active	Todd Tiller Insurance Inc	551750	Agent - Health	8/16/2002
Active	Todd Tiller Insurance Inc	551750	Agent - Property	8/16/2002
Active	Todd Tiller Insurance Inc	551750	Agent - Casualty	8/16/2002