DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Dennis, Clint S	DOIID	977571	NAIC NPN	18614252

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	1/2/2018		9/30/2026
Active	Resident	Agent	Life	1/3/2018		9/30/2026
Active	Resident	Agent	Property	12/5/2017		9/30/2026
Active	Resident	Agent	Casualty	12/5/2017		9/30/2026
* 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	07/15/2024	09/30/2024	07/15/2024	07/15/2024	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	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021
Active	Bristol West Insurance Company	301655	Agent - Casualty	3/13/2018
Active	Bristol West Insurance Company	301655	Agent - Property	3/13/2018
Active	Dairyland Insurance Company	301370	Agent - Casualty	3/16/2018
Active	Dairyland Insurance Company	301370	Agent - Property	3/16/2018
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	3/13/2018
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	3/13/2018
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	1/8/2018
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Health	1/8/2018
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	1/8/2018
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	1/8/2018
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	1/8/2018
Active	United Financial Casualty Company	301886	Agent - Casualty	3/14/2018
Active	United Financial Casualty Company	301886	Agent - Property	3/14/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Designated Agent Company Inc.	681257	Agent - Health	1/9/2018
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	1/8/2018
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	1/8/2018
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	1/8/2018
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	1/8/2018