DEPARTMENT OF INSURANCE

Affiliations

Name	Stacy Insurance Inc.	DOIID	398813	NAIC NPN	7221182

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Limited Line Credit	2/27/2024		3/31/2027
Inactive	Resident	Agent	Health	4/26/2002	8/1/2016
Inactive	Resident	Agent	Credit Life & Health	8/3/1994	8/7/2000
Inactive	Resident	Agent	Life	4/26/2002	8/1/2016
* 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	01/15/2027	03/31/2027

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	9/21/1993	2/13/1996
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	9/21/1993	2/13/1996
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	9/16/2009	3/9/2015
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	9/16/2009	3/9/2015
Inactive	Fresenius Health Plans Insurance Company	300180	Agent - Health	6/7/1993	3/31/1999
Inactive	Fresenius Health Plans Insurance Company	300180	Agent - Life	6/7/1993	3/31/1999
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Health	4/17/2007	2/26/2016
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	4/17/2007	2/26/2016
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Credit Life & Health	11/24/1998	8/7/2000
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Health	8/24/2009	8/1/2016
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	8/24/2009	8/1/2016
Active	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	2/12/2025
Inactive	MedAmerica Insurance Company	301568	Agent - Health	7/13/2004	3/9/2009
Inactive	MedAmerica Insurance Company	301568	Agent - Life	7/13/2004	4/6/2016
Inactive	NGL Insurance Company	300596	Agent - Credit Life & Health	8/3/1994	12/1/1998

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arnett, Janice Rae	369901	Agent - Credit Life & Health	8/3/1994	2/7/2000
Inactive	Cantrell, Christopher Harlow	560833	Agent - Limited Line Credit	2/26/2004	1/22/2009
Inactive	Cole, Christopher Todd	553077	Agent - Casualty	11/23/2010	12/1/2015
Inactive	Cole, Christopher Todd	553077	Agent - Health	11/23/2010	12/1/2015
Inactive	Cole, Christopher Todd	553077	Agent - Life	11/23/2010	12/1/2015
Inactive	Cole, Christopher Todd	553077	Agent - Limited Line Credit	12/20/2022	3/31/2023
Inactive	Cole, Christopher Todd	553077	Agent - Property	11/23/2010	12/1/2015
Inactive	Cole, Tammy Irene	638451	Agent - Limited Line Credit	1/19/2007	1/22/2009
Inactive	Collett, Roy	304950	Agent - Limited Line Credit	2/26/2004	2/28/2011
Inactive	Collins, Alden W	382523	Agent - Credit Life & Health	8/3/1994	8/7/2000
Inactive	Collins, Alden W	382523	Agent - Limited Line Credit	8/7/2000	2/28/2007
Inactive	Engle, Zachary Ray	866547	Agent - Limited Line Credit	6/9/2015	3/31/2021
Inactive	Ennis, Quentin	1146915	Agent - Limited Line Credit	12/20/2022	3/31/2023
Inactive	Evans, Brandon Curtis	638474	Agent - Limited Line Credit	1/19/2007	12/31/2015
Denied	Evans, Dexter Blake	1383121	Agent - Limited Line Credit
Inactive	Gevedon, Jeffrey E	351626	Agent - Limited Line Credit	12/20/2022	3/31/2023
Inactive	Hopkins, Jerry	500627	Agent - Limited Line Credit	5/12/2016	3/31/2021
Inactive	Hornbuckle, James William	324816	Agent - Credit Life & Health	8/3/1994	8/7/2000
Inactive	Hornbuckle, James William	324816	Agent - Limited Line Credit	8/7/2000	6/30/2012
Inactive	Ratliff, Adam	1013279	Agent - Limited Line Credit	10/29/2018	10/31/2020
Inactive	Salyer, Alan Reid	329033	Agent - Limited Line Credit	2/26/2004	4/30/2004
Inactive	Scalf, Brian Joel	627383	Agent - Health	10/7/2013	6/1/2016
Inactive	Scalf, Brian Joel	627383	Agent - Life	10/7/2013	6/1/2016
Inactive	Scalf, Brian Joel	627383	Agent - Limited Line Credit	1/22/2009	5/31/2016
Inactive	Stacy, Cortis Kash	340437	Agent - Credit Life & Health	8/3/1994	8/7/2000
Denied	Stacy, Cortis Kash	340437	Agent - Health
Denied	Stacy, Cortis Kash	340437	Agent - Life
Inactive	Stacy, Cortis Kash	340437	Agent - Limited Line Credit	8/7/2000	8/6/2007
Active	Stacy, Jodi Kash	954261	Agent - Limited Line Credit	2/27/2024
Inactive	Stacy, Joe D	351205	Agent - Health	11/22/1988	12/1/2000
Inactive	Stacy, Joe D	351205	Agent - Life	11/22/1988	12/1/2000
Inactive	Stacy, Jonathan Travis	542733	Agent - Limited Line Credit	2/26/2004	3/31/2021