DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Montgomery, Jerry Wayne	DOIID	370783	NAIC NPN	7200513

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	2/3/2003	3/31/2010
Inactive	Non Resident	Adjuster	Public	11/24/1997	3/31/2002
Inactive	Non Resident	Apprentice Adjuster	Not Applicable	9/17/1996	9/17/1997
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Brentwood Serv Administrators Inc	397924	Adjuster - Independent	7/9/2008	11/11/2008

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Vanhandle, William Russell	339780	Apprentice Adjuster - Not Applicable	9/17/1996	9/17/1997