DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gossett, Clinton J	DOIID	1083506	NAIC NPN	19489093

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	6/30/2020		8/31/2024
Active	Resident	Agent	Property	6/29/2020		8/31/2024
Inactive	Resident	Temporary Agent	Property	6/10/2020	6/30/2020
Inactive	Resident	Temporary Agent	Casualty	6/10/2020	6/30/2020
* 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	06/15/2024	08/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Church Mutual Insurance Company, S.I.	301554	Agent - Casualty	6/30/2020
Active	Church Mutual Insurance Company, S.I.	301554	Agent - Property	6/29/2020
Inactive	Church Mutual Insurance Company, S.I.	301554	Temporary Agent - Casualty	6/10/2020	6/30/2020
Inactive	Church Mutual Insurance Company, S.I.	301554	Temporary Agent - Property	6/10/2020	6/30/2020
Active	ClearPath Insurance Company	979815	Agent - Casualty	10/17/2023
Active	MGT Insurance Company	970661	Agent - Casualty	7/13/2020
Active	MGT Insurance Company	970661	Agent - Property	7/13/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	C M I C Specialty Services Inc	645077	Agent - Casualty	6/7/2022
Active	C M I C Specialty Services Inc	645077	Agent - Property	6/7/2022