DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Southern Risk Insurance Group	DOIID	822414	NAIC NPN	17072670

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	1/28/2014		3/31/2027
Active	Non Resident	Agent	Property	9/27/2013		3/31/2027
Active	Non Resident	Agent	Health	1/28/2014		3/31/2027
Active	Non Resident	Agent	Casualty	9/27/2013		3/31/2027
* 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	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Agri-Business Insurance Company	634731	Agent - Casualty	12/28/2020	11/17/2022
Inactive	American Agri-Business Insurance Company	634731	Agent - Property	12/28/2020	11/17/2022
Inactive	CGB Insurance Company	559048	Agent - Casualty	10/11/2017	12/28/2020
Inactive	CGB Insurance Company	559048	Agent - Property	10/11/2017	12/28/2020
Inactive	Great American Alliance Insurance Company	301247	Agent - Casualty	1/2/2024	1/14/2026
Inactive	Great American Alliance Insurance Company	301247	Agent - Property	1/2/2024	1/14/2026
Inactive	Great American Insurance Company	301586	Agent - Casualty	1/2/2024	1/14/2026
Inactive	Great American Insurance Company	301586	Agent - Property	1/2/2024	1/14/2026
Active	Palomar Specialty Insurance Company	841441	Agent - Casualty	3/9/2023
Active	Palomar Specialty Insurance Company	841441	Agent - Health	3/9/2023
Active	Producers Agriculture Insurance Company	595288	Agent - Property	9/3/2021
Active	Rural Community Insurance Company	301891	Agent - Casualty	10/12/2017
Active	Rural Community Insurance Company	301891	Agent - Property	10/12/2017

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Banks, Aleshia G	819077	Agent - Casualty	11/27/2013	1/7/2014
Inactive	Banks, Aleshia G	819077	Agent - Property	11/27/2013	1/7/2014
Inactive	Campbell, Terry Lynn	661790	Agent - Casualty	10/1/2013	6/6/2022
Denied	Campbell, Terry Lynn	661790	Agent - Health
Denied	Campbell, Terry Lynn	661790	Agent - Life
Active	Campbell, Terry Lynn	661790	Agent - Property	10/1/2013
Active	Lewis, Leslie Jill	630666	Agent - Casualty	9/24/2014
Active	Lewis, Leslie Jill	630666	Agent - Health	1/28/2014
Active	Lewis, Leslie Jill	630666	Agent - Life	1/28/2014
Active	Lewis, Leslie Jill	630666	Agent - Property	9/24/2014