DEPARTMENT OF INSURANCE

Affiliations

Name	Williams, David M	DOIID	574431	NAIC NPN	7824970

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Property	9/23/2003	2/28/2025
Active	Resident	Agent	Life	9/9/2003	2/28/2025
Active	Resident	Agent	Health	9/9/2003	2/28/2025
Active	Resident	Agent	Casualty	9/23/2003	2/28/2025
* 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	12/15/2024	02/28/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Agricultural Insurance Company	300215	Agent - Property	9/23/2016
Active	American Modern Home Insurance Company	300791	Agent - Casualty	1/26/2023
Active	American Modern Home Insurance Company	300791	Agent - Property	1/26/2023
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	10/12/2018
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	10/12/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	10/20/2017	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	10/20/2017	11/14/2021
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	1/21/2004	3/7/2005
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	1/21/2004	3/7/2005
Active	Bristol West Insurance Company	301655	Agent - Casualty	2/11/2008
Active	Bristol West Insurance Company	301655	Agent - Property	2/11/2008
Active	Dairyland Insurance Company	301370	Agent - Casualty	10/21/2003
Active	FB Insurance Company (The)	301763	Agent - Casualty	9/23/2003
Active	FB Insurance Company (The)	301763	Agent - Property	9/23/2003
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	2/1/2013
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	2/1/2013
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	1/21/2004	3/7/2005
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	1/21/2004	3/7/2005
Active	Illinois Mutual Life Insurance Company	301479	Agent - Health	3/15/2018
Active	Illinois Mutual Life Insurance Company	301479	Agent - Life	3/15/2018
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	11/7/2005	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	11/7/2005	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	9/19/2008	6/8/2011
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	9/19/2008	6/8/2011
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	9/23/2003
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	9/23/2003
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	9/25/2015	11/3/2017
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	9/9/2003
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	9/9/2003
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	5/5/2011	6/26/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	5/5/2011	6/26/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	David M. Williams II, Insurance Agency, LLC	861689	Agent - Health	11/22/2014
Active	David M. Williams II, Insurance Agency, LLC	861689	Agent - Life	11/22/2014
Active	David M. Williams II, Insurance Agency, LLC	861689	Agent - Casualty	11/22/2014
Active	David M. Williams II, Insurance Agency, LLC	861689	Agent - Property	11/22/2014
Active	Designated Agent Company Inc.	681257	Agent - Health	12/11/2013
Active	Designated Agent Company Inc.	681257	Agent - Life	12/11/2013
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	10/8/2003
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	10/8/2003
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	10/8/2003
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	10/8/2003
Inactive	Southern Capital Brokerage Co LLC	577403	Agent - Health	9/7/2004	3/31/2007
Inactive	Southern Capital Brokerage Co LLC	577403	Agent - Life	9/7/2004	3/31/2007