DEPARTMENT OF INSURANCE

Affiliations

Name	Coffman Jr, John Thomas	DOIID	392462	NAIC NPN	4557930

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Variable Life and Variable Annuities	8/10/2010		5/31/2025
Active	Resident	Agent	Life	7/1/1999		5/31/2025
Active	Resident	Agent	Casualty	8/15/2000		5/31/2025
Active	Resident	Agent	Property	8/15/2000		5/31/2025
Active	Resident	Agent	Health	7/1/1999		5/31/2025
Inactive	Resident	Agent	General Lines	2/23/1995	8/15/2000
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	03/15/2025	05/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Allstate Indemnity Company	300778	Agent - Casualty	4/10/2009
Inactive	Allstate Indemnity Company	300778	Agent - General Lines	2/23/1995	4/3/2000
Active	Allstate Indemnity Company	300778	Agent - Property	4/10/2009
Active	Allstate Insurance Company	300773	Agent - Casualty	4/10/2009
Inactive	Allstate Insurance Company	300773	Agent - General Lines	2/23/1995	4/3/2000
Active	Allstate Insurance Company	300773	Agent - Property	4/10/2009
Active	Allstate North America Insurance Company	1121481	Agent - Casualty	1/30/2025
Active	Allstate North America Insurance Company	1121481	Agent - Property	1/30/2025
Active	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	4/10/2009
Active	Allstate Property and Casualty Insurance Company	300593	Agent - Property	4/10/2009
Active	Allstate Vehicle & Property Insurance Company	301429	Agent - Casualty	2/18/2014
Active	Allstate Vehicle & Property Insurance Company	301429	Agent - Property	2/18/2014
Active	American Family Home Insurance Company	301817	Agent - Casualty	4/29/2024
Active	American Family Home Insurance Company	301817	Agent - Property	4/29/2024
Active	American Heritage Life Insurance Company	300272	Agent - Health	4/21/2009
Active	American Heritage Life Insurance Company	300272	Agent - Life	4/21/2009
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	5/2/2019
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	5/2/2019
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	10/11/2016	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	10/11/2016	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	10/11/2016	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	10/11/2016	11/14/2021
Inactive	Beazley Insurance Company, Inc.	300899	Agent - Casualty	6/18/2001	6/17/2005
Inactive	Beazley Insurance Company, Inc.	300899	Agent - Property	6/18/2001	6/17/2005
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	2/2/2006	5/19/2009
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	4/29/2013	12/29/2016
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Variable Life and Variable Annuities	4/29/2013	9/25/2024
Inactive	Equitable Financial Life Insurance Company of America	301772	Agent - Life	5/21/2022	3/22/2023
Inactive	Equitable Financial Life Insurance Company of America	301772	Agent - Variable Life and Variable Annuities	5/21/2022	3/22/2023
Inactive	Esurance Property and Casualty Insurance Company	613279	Agent - Casualty	7/16/2021	3/8/2023
Inactive	Esurance Property and Casualty Insurance Company	613279	Agent - Property	7/16/2021	3/8/2023
Active	Everlake Assurance Company	300203	Agent - Life	12/17/2014
Active	Everlake Assurance Company	300203	Agent - Variable Life and Variable Annuities	12/17/2014
Active	Everlake Life Insurance Company	300873	Agent - Health	4/10/2009
Active	Everlake Life Insurance Company	300873	Agent - Life	4/10/2009
Active	Everlake Life Insurance Company	300873	Agent - Variable Life and Variable Annuities	9/8/2010
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	4/27/2016
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	4/27/2016
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	10/8/2023
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	10/8/2023
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Life	8/13/2010	12/21/2022
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Variable Life and Variable Annuities	8/13/2010	12/21/2022
Inactive	Independent Order of Foresters	300743	Agent - Life	6/22/2022	12/29/2023
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	11/3/2020	12/29/2020
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	11/3/2020	12/29/2020
Active	Lincoln Benefit Life Company	301110	Agent - Health	4/10/2009
Active	Lincoln Benefit Life Company	301110	Agent - Life	4/10/2009
Active	Lincoln Benefit Life Company	301110	Agent - Variable Life and Variable Annuities	9/8/2010
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	2/10/2020
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	2/10/2020
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Variable Life and Variable Annuities	2/10/2020
Active	Midland National Life Insurance Company	300923	Agent - Life	9/23/2021
Active	Midland National Life Insurance Company	300923	Agent - Variable Life and Variable Annuities	9/23/2021
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	11/23/2009	12/15/2011
Active	Pacific Life Insurance Company	301848	Agent - Life	3/17/2022
Active	Protective Life Insurance Company	300638	Agent - Health	6/17/2018
Active	Protective Life Insurance Company	300638	Agent - Life	6/17/2018
Active	Protective Life Insurance Company	300638	Agent - Variable Life and Variable Annuities	6/17/2018
Inactive	Pruco Life Insurance Company	300954	Agent - Health	8/13/2010	12/23/2024
Inactive	Pruco Life Insurance Company	300954	Agent - Life	8/13/2010	12/23/2024
Inactive	Pruco Life Insurance Company	300954	Agent - Variable Life and Variable Annuities	8/13/2010	12/23/2024
Inactive	Shelter General Insurance Company	301109	Agent - Casualty	8/15/2000	3/31/2009
Inactive	Shelter General Insurance Company	301109	Agent - General Lines	4/11/2000	8/15/2000
Inactive	Shelter General Insurance Company	301109	Agent - Property	8/15/2000	3/31/2009
Inactive	Shelter Life Insurance Company	300391	Agent - Health	4/10/2000	3/31/2009
Inactive	Shelter Life Insurance Company	300391	Agent - Life	4/10/2000	3/31/2009
Inactive	Shelter Mutual Insurance Company	301870	Agent - Casualty	8/15/2000	3/31/2009
Inactive	Shelter Mutual Insurance Company	301870	Agent - General Lines	4/11/2000	8/15/2000
Inactive	Shelter Mutual Insurance Company	301870	Agent - Property	8/15/2000	3/31/2009
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	11/23/2009	12/15/2011
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	11/23/2009	12/15/2011
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Health	1/29/2014	4/6/2018
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	1/29/2014	4/6/2018
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Variable Life and Variable Annuities	1/29/2014	4/6/2018
Active	Western Surety Company	300283	Agent - Casualty	5/22/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Coffman Enterprises Inc	700532	Agent - Life	4/16/2009
Active	Coffman Enterprises Inc	700532	Agent - Health	4/16/2009
Active	Coffman Enterprises Inc	700532	Agent - Property	4/16/2009
Active	Coffman Enterprises Inc	700532	Agent - Casualty	2/27/2009
Inactive	Daniel Boone Agency, LLC.	515760	Agent - Life	4/19/2001	3/31/2009
Inactive	Daniel Boone Agency, LLC.	515760	Agent - Health	4/19/2001	3/31/2009
Inactive	Daniel Boone Agency, LLC.	515760	Agent - Property	8/15/2000	3/31/2009
Inactive	Daniel Boone Agency, LLC.	515760	Agent - Casualty	8/15/2000	4/1/2009