DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Cornelisse, Jayde	DOIID	1131776	NAIC NPN	19877018

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Personal Lines	4/28/2021	9/30/2023
* 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
Inactive	Bristol West Insurance Company	301655	Agent - Personal Lines	4/30/2021	6/2/2021
Inactive	Farmers Insurance Exchange	300336	Agent - Personal Lines	4/30/2021	6/4/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fx Insurance Agency, LLC	646184	Agent - Personal Lines	4/30/2021	6/4/2021