DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Kirby, Justin Carlisle	DOIID	780635	NAIC NPN	10523504

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Preneed Funeral	3/6/2024		4/30/2026
Inactive	Non Resident	Agent	Life	5/1/2012	4/30/2014
* 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	02/15/2026	04/30/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Kentucky Funeral Directors Life Insurance Company	532905	Agent - Preneed Funeral	3/18/2024
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	5/25/2012	4/30/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Todd County Funeral Home	714859	Agent - Life	5/25/2012	3/31/2014