DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bass, Debra Ann	DOIID	865056	NAIC NPN	17469548

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	2/20/2018		1/31/2025
Active	Resident	Agent	Life	2/16/2018		1/31/2025
Active	Resident	Agent	Property	1/15/2015		1/31/2025
Active	Resident	Agent	Casualty	1/15/2015		1/31/2025
* 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	11/15/2024	01/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Modern Home Insurance Company	300791	Agent - Casualty	1/26/2023
Active	American Modern Home Insurance Company	300791	Agent - Property	1/26/2023
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	12/6/2018
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	12/6/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	5/18/2018	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	5/18/2018	11/14/2021
Active	Bristol West Insurance Company	301655	Agent - Casualty	3/12/2018
Active	Bristol West Insurance Company	301655	Agent - Property	3/12/2018
Active	Dairyland Insurance Company	301370	Agent - Casualty	3/16/2018
Active	Dairyland Insurance Company	301370	Agent - Property	3/16/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	3/12/2018	12/20/2023
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	3/12/2018	12/20/2023
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	2/4/2015
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	3/5/2018
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	2/4/2015
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	3/5/2018
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	3/5/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Debra A Bass LLC	1102672	Agent - Property	10/5/2020
Active	Debra A Bass LLC	1102672	Agent - Casualty	10/5/2020
Active	Debra A Bass LLC	1102672	Agent - Health	10/5/2020
Active	Debra A Bass LLC	1102672	Agent - Life	10/5/2020
Active	Designated Agent Company Inc.	681257	Agent - Health	3/13/2018
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	3/1/2018
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	3/1/2018
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	3/5/2018
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	3/5/2018