DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Stacy, Jeremy Scott	DOIID	383350	NAIC NPN	7206040

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Credit Life & Health	7/20/1995	8/12/1996
Inactive	Resident	Agent	Limited Line Credit	7/2/2014	12/31/2015
* 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	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	4/13/2001	8/16/2004
Inactive	Protective Life Insurance Company	300638	Agent - Limited Line Credit	7/7/2014	12/31/2015
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Credit Life & Health	7/20/1995	8/12/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Don Moore Automotive Inc.	399266	Agent - Limited Line Credit	3/15/2007	12/31/2013
Inactive	Riverview Motors Inc	400101	Agent - Limited Line Credit	9/17/2014	12/31/2015
Inactive	Stacy Chrysler Inc.	398280	Agent - Credit Life & Health	4/26/1996	8/12/1996
Inactive	Stacy Chrysler Inc.	398280	Agent - Limited Line Credit	4/15/2004	8/16/2004