DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Chisum, Jessica M	DOIID	1043170	NAIC NPN	17747612

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	6/7/2019		10/31/2026
Active	Non Resident	Agent	Life	6/7/2019		10/31/2026
Active	Non Resident	Agent	Health	6/7/2019		10/31/2026
Active	Non Resident	Agent	Property	6/7/2019		10/31/2026
* 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	08/15/2024	10/31/2024	09/25/2024	09/25/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Bristol West Insurance Company	301655	Agent - Casualty	9/11/2020
Active	Bristol West Insurance Company	301655	Agent - Property	9/11/2020
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	10/6/2021
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Property	10/6/2021
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/11/2020
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/11/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aca Club Insurance Agency, Inc.	1033550	Agent - Casualty	9/11/2020
Denied	Aca Club Insurance Agency, Inc.	1033550	Agent - Life
Denied	Aca Club Insurance Agency, Inc.	1033550	Agent - Health
Active	Aca Club Insurance Agency, Inc.	1033550	Agent - Property	9/11/2020