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	Health	8/19/2002		6/30/2026
Active	Resident	Agent	Casualty	8/19/2002		6/30/2026
Active	Resident	Agent	Life	8/19/2002		6/30/2026
Active	Resident	Agent	Property	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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2024	06/30/2024	01/23/2024	01/23/2024	Yes

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
Active	Bristol West Insurance Company	301655	Agent - Casualty	2/11/2008
Active	Bristol West Insurance Company	301655	Agent - Property	2/11/2008
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