DEPARTMENT OF INSURANCE

Affiliations

Name	Blackburn, Mark	DOIID	376117	NAIC NPN	7202890

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	8/17/2010		3/31/2026
Active	Resident	Agent	Casualty	5/29/2007		3/31/2026
Active	Resident	Agent	Health	8/17/2010		3/31/2026
Active	Resident	Agent	Property	5/29/2007		3/31/2026
Inactive	Resident	Agent	Credit Life & Health	12/7/1992	1/23/1997
Inactive	Resident	Agent	Limited Line Credit	8/19/2003	5/31/2004
* 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	AIG Assurance Company	300897	Agent - Casualty	7/2/2007	8/3/2010
Inactive	AIG Assurance Company	300897	Agent - Property	7/2/2007	8/3/2010
Inactive	Aegis Security Insurance Company	300492	Agent - Casualty	4/9/2009	11/9/2022
Inactive	Aegis Security Insurance Company	300492	Agent - Property	4/9/2009	11/9/2022
Active	American Economy Insurance Company	300315	Agent - Casualty	11/8/2019
Active	American Economy Insurance Company	300315	Agent - Property	11/8/2019
Active	American Fire and Casualty Company	300567	Agent - Casualty	7/30/2007
Active	American Fire and Casualty Company	300567	Agent - Property	7/30/2007
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	2/17/2016	11/14/2021
Inactive	American Modern Home Insurance Company	300791	Agent - Property	2/17/2016	11/14/2021
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	4/22/2019
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	4/22/2019
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	10/20/2015	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	10/20/2015	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	2/17/2016	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	2/17/2016	11/14/2021
Active	Anthem Life Insurance Company	301209	Agent - Health	2/3/2011
Active	Anthem Life Insurance Company	301209	Agent - Life	2/3/2011
Inactive	Auto Club Property-Casualty Insurance Company	650781	Agent - Casualty	12/28/2009	4/9/2021
Inactive	Auto Club Property-Casualty Insurance Company	650781	Agent - Property	12/28/2009	4/9/2021
Active	Bristol West Insurance Company	301655	Agent - Casualty	8/8/2012
Active	Bristol West Insurance Company	301655	Agent - Property	8/8/2012
Active	Celina Mutual Insurance Company (The)	301908	Agent - Casualty	10/2/2024
Active	Celina Mutual Insurance Company (The)	301908	Agent - Property	10/2/2024
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	9/8/2007	4/26/2024
Inactive	Consolidated Insurance Company	300943	Agent - Property	9/8/2007	4/26/2024
Active	Dairyland Insurance Company	301370	Agent - Casualty	3/22/2010
Active	Dairyland Insurance Company	301370	Agent - Property	3/22/2010
Active	Erie Family Life Insurance Company	301400	Agent - Health	6/4/2019
Active	Erie Family Life Insurance Company	301400	Agent - Life	6/1/2017
Active	Erie Insurance Company	300230	Agent - Casualty	6/1/2017
Active	Erie Insurance Company	300230	Agent - Property	6/1/2017
Active	Erie Insurance Company of New York	789916	Agent - Casualty	6/1/2017
Active	Erie Insurance Company of New York	789916	Agent - Property	6/1/2017
Active	Erie Insurance Exchange	300789	Agent - Casualty	6/1/2017
Active	Erie Insurance Exchange	300789	Agent - Property	6/1/2017
Active	Erie Insurance Property & Casualty Company	789942	Agent - Casualty	6/1/2017
Active	Erie Insurance Property & Casualty Company	789942	Agent - Property	6/1/2017
Inactive	Farmers Insurance Exchange	300336	Agent - Casualty	2/16/2009	8/29/2012
Inactive	Farmers Insurance Exchange	300336	Agent - Property	2/16/2009	8/29/2012
Inactive	Federal Home Life Insurance Company	301302	Agent - Credit Life & Health	12/7/1992	12/21/1996
Active	Flagship City Insurance Company	789965	Agent - Casualty	6/1/2017
Active	Flagship City Insurance Company	789965	Agent - Property	6/1/2017
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	8/8/2012
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	8/8/2012
Inactive	Granite State Insurance Company	300818	Agent - Casualty	7/2/2007	8/3/2010
Inactive	Granite State Insurance Company	300818	Agent - Property	7/2/2007	8/3/2010
Inactive	GuideOne Elite Insurance Company	300490	Agent - Casualty	6/13/2011	11/3/2021
Inactive	GuideOne Elite Insurance Company	300490	Agent - Property	6/13/2011	11/3/2021
Inactive	GuideOne Insurance Company	301794	Agent - Casualty	6/13/2011	11/3/2021
Inactive	GuideOne Insurance Company	301794	Agent - Property	6/13/2011	11/3/2021
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Casualty	6/13/2011	11/3/2021
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Property	6/13/2011	11/3/2021
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	7/2/2007	8/3/2010
Inactive	Illinois National Insurance Company	301367	Agent - Property	7/2/2007	8/3/2010
Inactive	Indiana Insurance Company	301909	Agent - Casualty	9/8/2007	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	9/8/2007	2/3/2023
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Limited Line Credit	8/19/2003	5/31/2004
Active	Kentucky National Insurance Company	301625	Agent - Casualty	9/6/2007
Active	Kentucky National Insurance Company	301625	Agent - Property	9/6/2007
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	9/8/2007	4/26/2024
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	9/8/2007	4/26/2024
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	7/30/2007
Active	Ohio Casualty Insurance Company	301492	Agent - Property	7/30/2007
Active	Ohio Security Insurance Company	300622	Agent - Casualty	7/30/2007
Active	Ohio Security Insurance Company	300622	Agent - Property	7/30/2007
Active	Peerless Indemnity Insurance Company	571682	Agent - Casualty	9/8/2007
Active	Peerless Indemnity Insurance Company	571682	Agent - Property	9/8/2007
Active	Peerless Insurance Company	301910	Agent - Casualty	9/8/2007
Active	Peerless Insurance Company	301910	Agent - Property	9/8/2007
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Casualty	9/11/2007	8/3/2010
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Property	9/11/2007	8/3/2010
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	7/5/2007	1/15/2011
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	7/5/2007	1/15/2011
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	7/5/2007	1/15/2011
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	7/5/2007	1/15/2011
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	11/14/2018
Active	SAFECO Insurance Company of America	300159	Agent - Property	11/14/2018
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	11/14/2018
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	11/14/2018
Active	State Automobile Mutual Insurance Company	301824	Agent - Casualty	12/13/2021
Active	State Automobile Mutual Insurance Company	301824	Agent - Property	12/13/2021
Active	Trexis Insurance Corporation	599902	Agent - Casualty	6/27/2024
Active	Trexis One Insurance Corporation	684197	Agent - Casualty	6/27/2024
Inactive	Truck Insurance Exchange	300335	Agent - Casualty	2/16/2009	8/29/2012
Inactive	Truck Insurance Exchange	300335	Agent - Property	2/16/2009	8/29/2012
Inactive	United Financial Casualty Company	301886	Agent - Casualty	7/5/2007	1/15/2011
Inactive	United Financial Casualty Company	301886	Agent - Property	7/5/2007	1/15/2011
Inactive	Unitrin Auto and Home Insurance Company	301538	Agent - Casualty	7/5/2007	7/28/2017
Inactive	Unitrin Auto and Home Insurance Company	301538	Agent - Property	7/5/2007	7/28/2017
Inactive	Unitrin Preferred Insurance Company	502869	Agent - Casualty	7/5/2007	12/2/2013
Inactive	Unitrin Preferred Insurance Company	502869	Agent - Property	7/5/2007	12/2/2013
Active	West American Insurance Company	301112	Agent - Casualty	7/30/2007
Active	West American Insurance Company	301112	Agent - Property	7/30/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Designated Agent Company Inc.	681257	Agent - Life	2/3/2011
Active	Designated Agent Company Inc.	681257	Agent - Health	2/3/2011
Active	Goodwin Insurance Agency Of Cadiz, LLC	745365	Agent - Casualty	1/4/2011
Active	Goodwin Insurance Agency Of Cadiz, LLC	745365	Agent - Property	1/4/2011
Active	Goodwin Insurance Agency Of Cadiz, LLC	745365	Agent - Life	2/3/2011
Active	Goodwin Insurance Agency Of Cadiz, LLC	745365	Agent - Health	2/3/2011
Active	Goodwin Insurance Agency, Inc.	634904	Agent - Casualty	7/2/2007
Active	Goodwin Insurance Agency, Inc.	634904	Agent - Property	7/2/2007
Inactive	Medlink Inc	400721	Agent - Life	6/5/2012	3/31/2024
Inactive	Medlink Inc	400721	Agent - Health	6/5/2012	3/31/2024
Inactive	Quality Ford Auto Sales Inc.Dba Quality Ford Mer	400703	Agent - Credit Life & Health	12/7/1992	1/23/1997
Inactive	Trice-Hughes Inc.	515632	Agent - Limited Line Credit	1/5/2004	5/31/2004