DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	First Citizens National Bank Insurance LLC	DOIID	1073586	NAIC NPN	19417322

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	2/7/2020		3/31/2026
Active	Non Resident	Agent	Health	2/7/2020		3/31/2026
Active	Non Resident	Agent	Casualty	2/7/2020		3/31/2026
Active	Non Resident	Agent	Life	2/7/2020		3/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	5/21/2020
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	5/21/2020
Active	Progressive Casualty Insurance Company	300696	Agent - Casualty	4/3/2020
Active	Progressive Casualty Insurance Company	300696	Agent - Property	4/3/2020
Active	United Financial Casualty Company	301886	Agent - Casualty	4/3/2020
Active	United Financial Casualty Company	301886	Agent - Property	4/3/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Chesky, Jeffrey Carl	692036	Agent - Casualty	2/7/2020
Active	Chesky, Jeffrey Carl	692036	Agent - Health	2/7/2020
Active	Chesky, Jeffrey Carl	692036	Agent - Life	2/7/2020
Active	Chesky, Jeffrey Carl	692036	Agent - Property	2/7/2020