DEPARTMENT OF INSURANCE

Name	Chaffin, Thomas Grant	DOIID	357096	NAIC NPN	1722613

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	General Lines	4/4/1979	8/15/2000
Inactive	Resident	Agent	Property	8/15/2000	2/1/2015
Inactive	Resident	Agent	Casualty	8/15/2000	2/1/2015
Inactive	Resident	Surplus Lines Broker	Not Applicable	9/8/1994	6/6/2012

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

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
Residence	Not Public Information
Business / Home Office	200 Oxcart Road Ashland, KY 41101

Phone Information

Type	Phone
Business / Home Office	(606) 920-4477