DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Burgess, Deborah A	DOIID	727465	NAIC NPN	15748740

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	7/27/2022		11/30/2026
Active	Non Resident	Agent	Casualty	7/27/2022		11/30/2026
* 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	09/15/2026	11/30/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Ohio Indemnity Company	301745	Agent - Casualty	8/1/2022
Active	Ohio Indemnity Company	301745	Agent - Property	8/1/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Kubota Tractor Acceptance Corporation	643991	Agent - Casualty	8/25/2022
Active	Kubota Tractor Acceptance Corporation	643991	Agent - Property	8/25/2022