DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Defouw, Michelle	DOIID	1122102	NAIC NPN	9274390

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	2/25/2021		12/31/2026
Active	Non Resident	Agent	Property	2/25/2021		12/31/2026
* 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	10/15/2026	12/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	State National Insurance Company, Inc.	300888	Agent - Casualty	6/24/2022
Active	State National Insurance Company, Inc.	300888	Agent - Property	6/24/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dimension Insurance Agency Inc	1128986	Agent - Casualty	4/12/2021
Active	Dimension Insurance Agency Inc	1128986	Agent - Property	4/12/2021
Active	Fortress Policy And Insurance Services, Inc.	1289797	Agent - Casualty	9/7/2023
Active	Fortress Policy And Insurance Services, Inc.	1289797	Agent - Property	9/7/2023