DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Collins, Jerry Wayne	DOIID	359482	NAIC NPN	7195631

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Casualty	5/7/2008	11/30/2020
Inactive	Resident	Agent	Property	5/7/2008	11/30/2020
Inactive	Resident	Agent	Health	6/11/2008	11/30/2020
Inactive	Resident	Agent	Limited Line Credit	2/14/2005	4/3/2007
Inactive	Resident	Agent	Life	6/11/2008	11/30/2020
Inactive	Resident	Temporary Agent	Ordinary Life (Temporary Life)	7/7/1999	10/5/1999
* 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 Heritage Life Insurance Company	300272	Agent - Health	9/30/2008	1/4/2013
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	9/30/2008	1/4/2013
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	7/24/2008	11/3/2009
Inactive	Dairyland Insurance Company	301370	Agent - Property	7/24/2008	11/3/2009
Inactive	FB Insurance Company (The)	301763	Agent - Casualty	5/7/2008	4/22/2020
Inactive	FB Insurance Company (The)	301763	Agent - Health	6/11/2008	4/22/2020
Inactive	FB Insurance Company (The)	301763	Agent - Property	5/7/2008	4/22/2020
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	7/9/2008	4/20/2009
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	7/9/2008	4/20/2009
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	5/7/2008	4/22/2020
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	6/11/2008	4/22/2020
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	5/7/2008	4/22/2020
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	6/11/2008	3/31/2009
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	6/11/2008	3/31/2009
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	2/14/2005	4/3/2007
Inactive	Transamerica Premier Life Insurance Company	300558	Temporary Agent - Ordinary Life (Temporary Life)	7/7/1999	10/5/1999
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	5/25/2011	6/23/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	5/25/2011	6/23/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	7/7/2008	3/31/2009
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	7/7/2008	3/31/2009
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	7/7/2008	3/31/2009
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	7/7/2008	3/31/2009