DEPARTMENT OF INSURANCE

Affiliations

Name	Davis, Tracy Michelle	DOIID	387876	NAIC NPN	3567561

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Adjuster	Independent	10/8/1999	9/12/2006
Active	Resident	Agent	Health	5/21/2003		9/30/2024
Active	Resident	Agent	Property	5/21/2003		9/30/2024
Active	Resident	Agent	Casualty	5/21/2003		9/30/2024
Active	Resident	Agent	Life	6/20/2003		9/30/2024
Active	Resident	Agent	Variable Life and Variable Annuities	10/15/2004		9/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	07/15/2024	09/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Pet Insurance Company, Inc.	301240	Agent - Casualty	11/20/2020
Active	American Pet Insurance Company, Inc.	301240	Agent - Property	11/20/2020
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/16/2014	5/12/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/10/2006	9/27/2014
Inactive	Humana Insurance Company	301104	Agent - Health	10/16/2014	5/12/2016
Inactive	Humana Insurance Company	301104	Agent - Life	1/10/2006	9/27/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/9/2005	9/27/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/9/2005	9/27/2014
Active	Jackson National Life Insurance Company	300486	Agent - Life	1/29/2020
Active	Jackson National Life Insurance Company	300486	Agent - Variable Life and Variable Annuities	1/29/2020
Inactive	Nassau Life Insurance Company	301406	Agent - Life	7/18/2007	12/15/2010
Inactive	Nassau Life Insurance Company	301406	Agent - Variable Life and Variable Annuities	7/18/2007	12/15/2010
Inactive	PHL Variable Insurance Company	300525	Agent - Life	10/2/2006	1/31/2013
Inactive	PHL Variable Insurance Company	300525	Agent - Variable Life and Variable Annuities	10/2/2006	1/31/2013
Active	State Farm Fire and Casualty Company	301809	Agent - Casualty	5/21/2003
Active	State Farm Fire and Casualty Company	301809	Agent - Property	5/21/2003
Inactive	State Farm General Insurance Company	301122	Agent - Casualty	5/21/2003	11/22/2010
Inactive	State Farm General Insurance Company	301122	Agent - Property	5/21/2003	11/22/2010
Active	State Farm Life Insurance Company	301810	Agent - Life	6/20/2003
Active	State Farm Life Insurance Company	301810	Agent - Variable Life and Variable Annuities	10/15/2004
Active	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	5/21/2003
Active	State Farm Mutual Automobile Insurance Company	301732	Agent - Health	5/21/2003
Inactive	Time Insurance Company	300683	Agent - Health	6/27/2005	8/8/2016
Inactive	Time Insurance Company	300683	Agent - Life	6/27/2005	8/8/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	State Farm Mutual Automobile Insurance Company	301732	Adjuster - Independent	10/8/1999	9/12/2006
Active	Tracy Davis Insurance Agcy Inc	827505	Agent - Casualty	11/14/2013
Active	Tracy Davis Insurance Agcy Inc	827505	Agent - Property	11/14/2013
Active	Tracy Davis Insurance Agcy Inc	827505	Agent - Health	11/14/2013
Active	Tracy Davis Insurance Agcy Inc	827505	Agent - Life	11/14/2013
Denied	Tracy Davis Insurance Agcy Inc	827505	Agent - Variable Life and Variable Annuities