DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Stacy, Annette Lynn	DOIID	501617	NAIC NPN	7009872

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	1/8/2001	7/1/2010
Inactive	Non Resident	Apprentice Adjuster	Not Applicable	1/12/2000	1/12/2000
Active	Non Resident	Staff Adjuster	Property & Casualty	7/1/2010		4/30/2027
* 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
Staff Adjuster	02/15/2025	04/30/2025	03/10/2025	03/10/2025	Yes

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	SAFECO Insurance Company of America	300159	Adjuster - Independent	1/8/2001	7/1/2010
Active	SAFECO Insurance Company of America	300159	Staff Adjuster - Property & Casualty	7/1/2010

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Long, Douglas James	387044	Apprentice Adjuster - Not Applicable	1/12/2000	1/12/2000