DEPARTMENT OF INSURANCE

Name	Rose, Jerry David	DOIID	311337	NAIC NPN	7160767

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	4/9/1998	12/1/2000
Inactive	Resident	Agent	Life	10/27/1998	12/1/2000
Inactive	Resident	Apprentice Adjuster	Not Applicable	2/9/2011	2/25/2011
Active	Resident	Staff Adjuster	Property & Casualty	2/25/2011		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
Staff Adjuster	05/15/2024	07/31/2024	06/20/2024	06/20/2024	Yes

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Mailing	2001 Eagle Dr Morehead, KY 40351
Residence	Not Public Information
Business / Home Office	Kentucky Farm Bureau 506 Sunset Drive P O Box 890Morehead, KY 40351

Internet Information

Type	Address
Business Email	dave.rose@kyfb.com

Phone Information

Type	Phone
Business / Home Office	(606) 784-7536