DEPARTMENT OF INSURANCE

Affiliations

Name	Heritage Insurance USA	DOIID	704116	NAIC NPN	13707506

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Property	4/20/2009	5/25/2021
Inactive	Resident	Agent	Life	4/20/2009	5/25/2021
Inactive	Resident	Agent	Casualty	4/20/2009	5/25/2021
* 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	Grange Indemnity Insurance Company	300793	Agent - Casualty	5/13/2009	5/25/2021
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	5/13/2009	5/25/2021
Inactive	Grange Insurance Company	300234	Agent - Casualty	7/27/2009	5/25/2021
Inactive	Grange Insurance Company	300234	Agent - Property	7/27/2009	5/25/2021
Inactive	Grange Life Insurance Company	300128	Agent - Life	7/27/2009	5/25/2021
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	7/27/2009	5/25/2021
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	7/27/2009	5/25/2021
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	9/25/2013	5/25/2021
Inactive	Kentucky National Insurance Company	301625	Agent - Casualty	7/6/2009	5/25/2021
Inactive	Kentucky National Insurance Company	301625	Agent - Property	7/6/2009	5/25/2021
Inactive	Motorists Mutual Insurance Company	300963	Agent - Casualty	3/26/2010	5/25/2021
Inactive	Motorists Mutual Insurance Company	300963	Agent - Property	3/26/2010	5/25/2021
Inactive	Sagamore Insurance Company	300942	Agent - Casualty	5/12/2010	12/3/2015
Inactive	Sagamore Insurance Company	300942	Agent - Property	5/12/2010	12/3/2015
Inactive	Star Casualty Insurance Company	681448	Agent - Casualty	7/27/2009	12/30/2013
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	3/2/2010	5/25/2021
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	7/27/2009	5/25/2021
Inactive	Trustgard Insurance Company	300104	Agent - Property	7/27/2009	5/25/2021

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Black, Kerry Clayton	707005	Agent - Casualty	9/16/2009	9/30/2012
Inactive	Black, Kerry Clayton	707005	Agent - Property	9/16/2009	9/30/2012
Inactive	Blackwell, Paul Burgess	648316	Agent - Casualty	7/20/2009	11/1/2011
Inactive	Blackwell, Paul Burgess	648316	Agent - Property	7/20/2009	11/1/2011
Inactive	Bradley, Gena M	335642	Agent - Casualty	9/16/2009	5/25/2021
Inactive	Bradley, Gena M	335642	Agent - Life	9/16/2009	5/25/2021
Inactive	Bradley, Gena M	335642	Agent - Property	9/16/2009	5/25/2021
Inactive	Campbell, Michael Vane	700768	Agent - Casualty	7/20/2009	3/8/2017
Inactive	Campbell, Michael Vane	700768	Agent - Property	7/20/2009	3/8/2017
Inactive	Cummins, Jonathan Glen	653253	Agent - Casualty	7/20/2009	5/25/2021
Inactive	Cummins, Jonathan Glen	653253	Agent - Property	7/20/2009	5/25/2021
Inactive	Fackler, Catherine Allison	631626	Agent - Casualty	9/16/2009	3/23/2010
Inactive	Fackler, Catherine Allison	631626	Agent - Life	9/16/2009	3/23/2010
Inactive	Fackler, Catherine Allison	631626	Agent - Property	9/16/2009	3/23/2010
Inactive	Griffin, Michelle Leigh	596944	Agent - Casualty	9/16/2009	3/23/2010
Inactive	Griffin, Michelle Leigh	596944	Agent - Property	9/16/2009	3/23/2010
Inactive	Hall, Jeffery C	321498	Agent - Casualty	1/31/2016	4/1/2016
Inactive	Hall, Jeffery C	321498	Agent - Life	12/9/2015	4/1/2016
Inactive	Hall, Jeffery C	321498	Agent - Property	1/31/2016	4/1/2016
Inactive	Hayes, Tammy Renee	653897	Agent - Casualty	9/16/2009	5/25/2021
Inactive	Hayes, Tammy Renee	653897	Agent - Property	9/16/2009	5/25/2021
Inactive	Hinton, Suzanne Nicole	596945	Agent - Casualty	9/16/2009	5/25/2021
Inactive	Hinton, Suzanne Nicole	596945	Agent - Property	9/16/2009	5/25/2021
Inactive	Hook, Kevin W	723670	Agent - Casualty	1/19/2015	5/25/2021
Inactive	Hook, Kevin W	723670	Agent - Life	1/19/2015	5/25/2021
Inactive	Hook, Kevin W	723670	Agent - Property	1/19/2015	5/25/2021
Inactive	Huerta, Mary C	663887	Agent - Casualty	7/20/2009	11/5/2009
Inactive	Huerta, Mary C	663887	Agent - Property	7/20/2009	11/5/2009
Inactive	Huerta, Travis L	640960	Agent - Casualty	7/20/2009	6/30/2012
Inactive	Huerta, Travis L	640960	Agent - Property	7/20/2009	6/30/2012
Inactive	Jenson, William Tyler	677106	Agent - Casualty	7/20/2009	10/31/2009
Inactive	Jenson, William Tyler	677106	Agent - Property	7/20/2009	10/31/2009
Inactive	Kirkwood, Donna Lynn	653352	Agent - Casualty	9/16/2009	5/25/2021
Inactive	Kirkwood, Donna Lynn	653352	Agent - Property	9/16/2009	5/25/2021
Inactive	Lafferty, Thomas D	393492	Agent - Casualty	9/28/2009	9/30/2012
Inactive	Lafferty, Thomas D	393492	Agent - Property	9/28/2009	9/30/2012
Inactive	Ledford, Frances Colleen	374730	Agent - Casualty	9/16/2009	5/25/2021
Inactive	Ledford, Frances Colleen	374730	Agent - Property	9/16/2009	5/25/2021
Inactive	Letcher, Patrick Keith	620168	Agent - Casualty	11/12/2009	4/20/2015
Inactive	Letcher, Patrick Keith	620168	Agent - Life	11/12/2009	2/19/2016
Inactive	Letcher, Patrick Keith	620168	Agent - Property	11/12/2009	4/20/2015
Inactive	Mitchell, William Clark	729086	Agent - Casualty	9/13/2010	1/31/2013
Inactive	Mitchell, William Clark	729086	Agent - Property	9/13/2010	1/31/2013
Inactive	Phillips, Tammy Jo	542124	Agent - Casualty	9/16/2009	5/25/2021
Inactive	Phillips, Tammy Jo	542124	Agent - Property	9/16/2009	5/25/2021
Inactive	Swain, Renee	698494	Agent - Casualty	7/20/2009	11/30/2013
Inactive	Swain, Renee	698494	Agent - Property	7/20/2009	11/30/2013
Inactive	Turner, Blake Curtis	591747	Agent - Casualty	2/28/2014	5/25/2021
Inactive	Turner, Blake Curtis	591747	Agent - Property	2/28/2014	5/25/2021
Inactive	Turner, Matthew Steven	589769	Agent - Casualty	7/20/2009	3/5/2019
Inactive	Turner, Matthew Steven	589769	Agent - Property	7/20/2009	3/5/2019
Inactive	Turner, Steven Lee	355237	Agent - Casualty	4/20/2009	5/25/2021
Inactive	Turner, Steven Lee	355237	Agent - Life	4/20/2009	5/25/2021
Inactive	Turner, Steven Lee	355237	Agent - Property	4/20/2009	5/25/2021
Inactive	Wasiewicz Rivera, Deborah Ann	695608	Agent - Casualty	7/20/2009	2/21/2011
Inactive	Wasiewicz Rivera, Deborah Ann	695608	Agent - Property	7/20/2009	2/21/2011