DEPARTMENT OF INSURANCE

Affiliations

Name	Lee, Jeremy S	DOIID	812202	NAIC NPN	16983340

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	6/19/2013	8/1/2016
Inactive	Resident	Agent	Property	6/25/2013	8/1/2016
Inactive	Resident	Agent	Life	6/18/2013	8/1/2016
Inactive	Resident	Agent	Casualty	6/25/2013	8/1/2016
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	9/5/2014	9/14/2015
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/5/2014	9/14/2015
Inactive	Auto Club Property-Casualty Insurance Company	650781	Agent - Casualty	10/31/2014	3/7/2016
Inactive	Auto Club Property-Casualty Insurance Company	650781	Agent - Property	10/31/2014	3/7/2016
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	7/9/2013	8/1/2016
Inactive	Bristol West Insurance Company	301655	Agent - Property	7/9/2013	8/1/2016
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	6/17/2014	12/8/2015
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	7/9/2013	6/26/2014
Inactive	Dairyland Insurance Company	301370	Agent - Property	7/9/2013	6/26/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	6/17/2014	12/8/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	7/9/2013	8/1/2016
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	7/9/2013	8/1/2016
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	7/11/2014	3/12/2015
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	7/11/2014	3/12/2015
Inactive	Grange Insurance Company	300234	Agent - Casualty	7/11/2014	3/12/2015
Inactive	Grange Insurance Company	300234	Agent - Property	7/11/2014	3/12/2015
Inactive	Grange Life Insurance Company	300128	Agent - Health	7/22/2014	3/12/2015
Inactive	Grange Life Insurance Company	300128	Agent - Life	7/22/2014	3/12/2015
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	7/11/2014	3/12/2015
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	7/11/2014	3/12/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	6/17/2014	12/8/2015
Inactive	Humana Insurance Company	301104	Agent - Health	6/17/2014	4/16/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	6/17/2014	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	6/17/2014	12/8/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	6/17/2014	11/3/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	6/17/2014	11/3/2015
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	7/3/2013	6/9/2014
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	7/3/2013	6/9/2014
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	7/3/2013	6/9/2014
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	7/24/2014	1/15/2015
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	7/24/2014	1/15/2015
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	7/24/2014	1/15/2015
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	7/24/2014	1/15/2015
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	7/3/2013	6/9/2014
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	7/3/2013	6/9/2014
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	7/11/2014	3/12/2015
Inactive	Trustgard Insurance Company	300104	Agent - Property	7/11/2014	3/12/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/17/2013	6/3/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/17/2013	6/3/2014
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	7/3/2013	6/2/2014
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	7/3/2013	6/2/2014
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	7/3/2013	6/2/2014
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	7/3/2013	6/2/2014
Inactive	Lee Insurance, Inc.	841960	Agent - Health	5/30/2014	3/31/2016
Inactive	Lee Insurance, Inc.	841960	Agent - Casualty	5/30/2014	3/31/2016
Inactive	Lee Insurance, Inc.	841960	Agent - Life	5/30/2014	3/31/2016
Inactive	Lee Insurance, Inc.	841960	Agent - Property	5/30/2014	3/31/2016