DEPARTMENT OF INSURANCE

Affiliations

Name	Brown, Chase Michael	DOIID	915243	NAIC NPN	17937954

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Health	5/31/2016	7/31/2026
Active	Resident	Agent	Casualty	5/24/2016	7/31/2026
Active	Resident	Agent	Property	5/25/2016	7/31/2026
Active	Resident	Agent	Life	5/31/2016	7/31/2026
* 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	05/15/2024	07/31/2024	04/08/2024	04/08/2024	Yes

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	1/13/2022
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	1/13/2022
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	8/30/2016	11/2/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	8/30/2016	11/2/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	9/16/2016	11/2/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	9/16/2016	11/2/2021
Active	Bristol West Insurance Company	301655	Agent - Casualty	1/18/2022
Active	Bristol West Insurance Company	301655	Agent - Property	1/18/2022
Active	Dairyland Insurance Company	301370	Agent - Casualty	1/14/2022
Active	Dairyland Insurance Company	301370	Agent - Property	1/14/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/18/2022	12/20/2023
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/18/2022	12/20/2023
Active	Illinois Mutual Life Insurance Company	301479	Agent - Health	2/21/2019
Active	Illinois Mutual Life Insurance Company	301479	Agent - Life	2/21/2019
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	6/8/2016
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	6/8/2016
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	6/8/2016
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	6/8/2016
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	6/8/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Chase Brown Insurance Llc	1143392	Agent - Life	7/6/2021
Active	Chase Brown Insurance Llc	1143392	Agent - Health	7/6/2021
Active	Chase Brown Insurance Llc	1143392	Agent - Casualty	7/6/2021
Active	Chase Brown Insurance Llc	1143392	Agent - Property	7/6/2021
Active	Designated Agent Company Inc.	681257	Agent - Life	6/9/2016
Active	Designated Agent Company Inc.	681257	Agent - Health	6/9/2016
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	6/8/2016
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	6/8/2016
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	6/8/2016
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	6/8/2016