DEPARTMENT OF INSURANCE

Affiliations

Name	Stephens, Jack Wayne	DOIID	343648	NAIC NPN	7188649

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	5/8/1991	4/15/2002
Inactive	Resident	Agent	Casualty	8/15/2000	3/31/2012
Inactive	Resident	Agent	Life	5/8/1991	3/31/2012
Inactive	Resident	Agent	Property	8/15/2000	3/31/2012
Inactive	Resident	Agent	General Lines	6/7/1976	8/15/2000
* 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	ACE Property and Casualty Insurance Company	300520	Agent - General Lines	3/12/1982	3/31/1996
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Casualty	8/15/2000	11/3/2005
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - General Lines	1/6/2000	8/15/2000
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Property	8/15/2000	11/3/2005
Inactive	American Fire and Casualty Company	300567	Agent - General Lines	4/1/1980	3/31/1996
Inactive	American Select Insurance Company	301229	Agent - Casualty	3/8/2004	9/23/2009
Inactive	American Select Insurance Company	301229	Agent - Property	3/8/2004	9/23/2009
Inactive	Auto Club Property-Casualty Insurance Company	650781	Agent - Casualty	12/31/2009	8/26/2010
Inactive	Auto Club Property-Casualty Insurance Company	650781	Agent - Property	12/31/2009	8/26/2010
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	9/12/2002	9/29/2010
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	8/20/2004	3/31/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	8/20/2004	3/31/2012
Inactive	Great American Insurance Company	301586	Agent - Casualty	8/15/2000	5/19/2005
Inactive	Great American Insurance Company	301586	Agent - General Lines	6/3/1997	8/15/2000
Inactive	Great American Insurance Company	301586	Agent - Property	8/15/2000	5/19/2005
Inactive	Great American Insurance Company of New York	301897	Agent - Casualty	8/15/2000	5/19/2005
Inactive	Great American Insurance Company of New York	301897	Agent - General Lines	8/10/1998	8/15/2000
Inactive	Great American Insurance Company of New York	301897	Agent - Property	8/15/2000	5/19/2005
Inactive	Guarantee Life Insurance Company	301560	Agent - Health	5/4/1998	4/17/2000
Inactive	Guarantee Life Insurance Company	301560	Agent - Life	5/4/1998	4/17/2000
Inactive	GuideOne Elite Insurance Company	300490	Agent - Casualty	11/21/2008	12/17/2010
Inactive	GuideOne Elite Insurance Company	300490	Agent - Property	11/21/2008	12/17/2010
Inactive	GuideOne Insurance Company	301794	Agent - Casualty	11/21/2008	12/17/2010
Inactive	GuideOne Insurance Company	301794	Agent - Property	11/21/2008	12/17/2010
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Casualty	11/21/2008	12/17/2010
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Property	11/21/2008	12/17/2010
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	8/15/2000	12/30/2005
Inactive	Hartford Accident and Indemnity Company	301917	Agent - General Lines	12/15/1977	8/15/2000
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	8/15/2000	12/30/2005
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	8/15/2000	12/30/2005
Inactive	Hartford Casualty Insurance Company	301332	Agent - General Lines	12/15/1977	8/15/2000
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	8/15/2000	12/30/2005
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	8/15/2000	12/30/2005
Inactive	Hartford Fire Insurance Company	300628	Agent - General Lines	12/15/1977	8/15/2000
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	8/15/2000	12/30/2005
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	8/15/2000	12/30/2005
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - General Lines	10/10/1986	8/15/2000
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	8/15/2000	12/30/2005
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	8/15/2000	12/30/2005
Inactive	Hartford Underwriters Insurance Company	301064	Agent - General Lines	9/26/1989	8/15/2000
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	8/15/2000	12/30/2005
Inactive	Infinity Insurance Company	300416	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Infinity Insurance Company	300416	Agent - General Lines	4/4/1996	8/15/2000
Inactive	Infinity Select Insurance Company	300169	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Infinity Select Insurance Company	300169	Agent - General Lines	4/9/1996	8/15/2000
Inactive	Integon National Insurance Company	301600	Agent - Casualty	8/15/2000	12/2/2002
Inactive	Integon National Insurance Company	301600	Agent - General Lines	4/11/1995	8/15/2000
Inactive	Integon National Insurance Company	301600	Agent - Property	8/15/2000	12/2/2002
Denied	Jefferson Pilot Financial Insurance Company	300756	Agent - Health
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	11/14/2002	11/1/2003
Denied	Jefferson-Pilot Life Insurance Company	300379	Agent - Health
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	10/8/2002	11/1/2003
Inactive	Kansas City Fire and Marine Insurance Company	301936	Agent - General Lines	6/7/1976	12/30/1999
Inactive	Kansas City Life Insurance Company	301444	Agent - Life	12/12/2008	3/31/2012
Inactive	Life Insurance Company of North America	300711	Agent - Health	5/8/1991	6/16/1997
Inactive	Life Insurance Company of North America	300711	Agent - Life	5/8/1991	6/16/1997
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Life	2/26/2001	1/30/2003
Inactive	Ohio Casualty Insurance Company	301492	Agent - General Lines	7/7/1976	3/31/1996
Inactive	Ohio Farmers Insurance Company	301667	Agent - Casualty	8/15/2000	9/23/2009
Inactive	Ohio Farmers Insurance Company	301667	Agent - General Lines	7/1/1983	8/15/2000
Inactive	Ohio Farmers Insurance Company	301667	Agent - Property	8/15/2000	9/23/2009
Inactive	Ohio Security Insurance Company	300622	Agent - General Lines	7/7/1976	3/31/1996
Inactive	Omni Insurance Company	301545	Agent - General Lines	12/17/1991	3/31/2000
Inactive	Permanent General Assurance Corporation	300883	Agent - General Lines	10/3/1995	3/31/1998
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	3/24/2004	6/23/2004
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	3/24/2004	6/23/2004
Inactive	Progressive Max Insurance Company	301034	Agent - Casualty	8/15/2000	6/23/2004
Inactive	Progressive Max Insurance Company	301034	Agent - General Lines	12/9/1999	8/15/2000
Inactive	Progressive Max Insurance Company	301034	Agent - Property	8/15/2000	6/23/2004
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	8/15/2000	6/23/2004
Inactive	Progressive Northern Insurance Company	301378	Agent - General Lines	12/9/1999	8/15/2000
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	8/15/2000	6/23/2004
Inactive	Progressive Northwestern Insurance Company	300441	Agent - Casualty	8/15/2000	6/23/2004
Inactive	Progressive Northwestern Insurance Company	300441	Agent - General Lines	12/9/1999	8/15/2000
Inactive	Progressive Northwestern Insurance Company	300441	Agent - Property	8/15/2000	6/23/2004
Inactive	RLI Insurance Company	301217	Agent - Casualty	8/15/2000	5/20/2010
Inactive	RLI Insurance Company	301217	Agent - General Lines	6/14/1996	8/15/2000
Inactive	RLI Insurance Company	301217	Agent - Property	8/15/2000	5/20/2010
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	3/29/2004	3/31/2009
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	1/31/2002	3/3/2004
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	1/31/2002	3/3/2004
Inactive	Trumbull Insurance Company	300242	Agent - Casualty	8/15/2000	12/26/2001
Inactive	Trumbull Insurance Company	300242	Agent - General Lines	6/26/1998	8/15/2000
Inactive	Trumbull Insurance Company	300242	Agent - Property	8/15/2000	12/26/2001
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	8/15/2000	12/30/2005
Inactive	Twin City Fire Insurance Company	300721	Agent - General Lines	12/15/1977	8/15/2000
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	8/15/2000	12/30/2005
Inactive	West American Insurance Company	301112	Agent - General Lines	7/7/1976	3/31/1996
Inactive	Western Surety Company	300283	Agent - Casualty	8/15/2000	10/15/2001
Inactive	Western Surety Company	300283	Agent - General Lines	11/5/1990	8/15/2000
Inactive	Westfield Insurance Company	301950	Agent - Casualty	8/15/2000	10/6/2010
Inactive	Westfield Insurance Company	301950	Agent - General Lines	7/1/1983	8/15/2000
Inactive	Westfield Insurance Company	301950	Agent - Property	8/15/2000	10/6/2010
Inactive	Westfield National Insurance Company	301036	Agent - Casualty	8/15/2000	9/23/2009
Inactive	Westfield National Insurance Company	301036	Agent - General Lines	6/5/1985	8/15/2000
Inactive	Westfield National Insurance Company	301036	Agent - Property	8/15/2000	9/23/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Barger Insurance Agency Inc.	401109	Agent - Life
Inactive	Barger Insurance Agency Inc.	401109	Agent - Property	11/6/2003	5/26/2011
Inactive	Barger Insurance Agency Inc.	401109	Agent - Casualty	11/6/2003	5/26/2011