DEPARTMENT OF INSURANCE

Affiliations

Name	Frederick, Mitchell Thomas	DOIID	909967	NAIC NPN	17884358

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	3/25/2016	11/30/2020
Inactive	Resident	Agent	Casualty	4/6/2016	11/30/2020
Inactive	Resident	Agent	Property	4/1/2016	11/30/2020
Inactive	Resident	Agent	Health	4/4/2016	11/30/2020
* 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 Modern Select Insurance Company	581481	Agent - Casualty	5/5/2016	11/30/2020
Inactive	American Modern Select Insurance Company	581481	Agent - Property	5/5/2016	11/30/2020
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	10/26/2017	9/30/2019
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	4/21/2016	1/26/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	4/21/2016	1/26/2017
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	4/22/2016	2/1/2017
Inactive	Dairyland Insurance Company	301370	Agent - Property	4/22/2016	2/1/2017
Inactive	Erie Family Life Insurance Company	301400	Agent - Life	1/11/2017	12/16/2019
Inactive	Erie Insurance Company	300230	Agent - Casualty	1/11/2017	12/16/2019
Inactive	Erie Insurance Company	300230	Agent - Property	1/11/2017	12/16/2019
Inactive	Erie Insurance Company of New York	789916	Agent - Casualty	1/11/2017	12/16/2019
Inactive	Erie Insurance Company of New York	789916	Agent - Property	1/11/2017	12/16/2019
Inactive	Erie Insurance Exchange	300789	Agent - Casualty	1/11/2017	12/16/2019
Inactive	Erie Insurance Exchange	300789	Agent - Property	1/11/2017	12/16/2019
Inactive	Erie Insurance Property & Casualty Company	789942	Agent - Casualty	1/11/2017	12/16/2019
Inactive	Erie Insurance Property & Casualty Company	789942	Agent - Property	1/11/2017	12/16/2019
Inactive	Farmington Casualty Company	301137	Agent - Casualty	2/16/2017	10/11/2017
Inactive	Farmington Casualty Company	301137	Agent - Property	2/16/2017	10/11/2017
Inactive	Flagship City Insurance Company	789965	Agent - Casualty	1/11/2017	12/16/2019
Inactive	Flagship City Insurance Company	789965	Agent - Property	1/11/2017	12/16/2019
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/24/2018	11/30/2020
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/24/2018	11/30/2020
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	4/11/2016	11/17/2016
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	4/11/2016	11/17/2016
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	4/11/2016	11/17/2016
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	3/27/2018	11/30/2020
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	3/27/2018	11/30/2020
Inactive	Royal Neighbors of America	301646	Agent - Life	1/21/2019	11/30/2020
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	4/11/2016	11/17/2016
Inactive	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	4/11/2016	11/17/2016
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	10/25/2017	2/11/2019
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	10/25/2017	2/11/2019
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	10/25/2017	2/11/2019
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	10/25/2017	2/11/2019
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	2/16/2017	10/11/2017
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	2/16/2017	10/11/2017
Inactive	United Financial Casualty Company	301886	Agent - Casualty	3/27/2018	11/30/2020
Inactive	United Financial Casualty Company	301886	Agent - Property	3/27/2018	11/30/2020

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	4/15/2016	8/12/2016
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	4/11/2016	11/14/2016
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	4/11/2016	11/14/2016
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	4/11/2016	11/14/2016
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	4/11/2016	11/14/2016