DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Chase Smith Insurance Inc	DOIID	947774	NAIC NPN	18351335

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Property	3/15/2017		3/31/2027
Active	Resident	Agent	Health	3/15/2017		3/31/2027
Active	Resident	Agent	Casualty	3/15/2017		3/31/2027
Active	Resident	Agent	Life	3/15/2017		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
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	3/27/2017
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	3/27/2017
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	3/27/2017
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	3/27/2017
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	3/27/2017

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Smith, Donald Chase	862302	Agent - Casualty	3/15/2017
Active	Smith, Donald Chase	862302	Agent - Health	3/15/2017
Active	Smith, Donald Chase	862302	Agent - Life	3/15/2017
Active	Smith, Donald Chase	862302	Agent - Property	3/15/2017