DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Fuller, Charlene Kay	DOIID	572938	NAIC NPN	3087278

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	7/14/2003	10/31/2015
Inactive	Non Resident	Agent	Casualty	7/14/2003	10/31/2015
* 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	Encompass Indemnity Company	546376	Agent - Casualty	3/16/2006	9/12/2015
Inactive	Encompass Indemnity Company	546376	Agent - Property	3/16/2006	9/12/2015
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	10/28/2010	9/12/2015
Inactive	Encompass Insurance Company of America	556578	Agent - Property	10/28/2010	9/12/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/15/2014	10/31/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/15/2014	10/31/2015
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	9/15/2014	10/31/2015
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	9/15/2014	10/31/2015
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	9/15/2014	10/31/2015
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	9/15/2014	10/31/2015
Inactive	Rural Community Insurance Company	301891	Agent - Casualty	9/25/2009	12/9/2015
Inactive	Rural Community Insurance Company	301891	Agent - Property	9/25/2009	12/9/2015
Inactive	Westfield Insurance Company	301950	Agent - Casualty	11/25/2014	7/16/2015
Inactive	Westfield Insurance Company	301950	Agent - Property	11/25/2014	7/16/2015
Inactive	Westfield National Insurance Company	301036	Agent - Casualty	5/23/2008	10/23/2009
Inactive	Westfield National Insurance Company	301036	Agent - Property	5/23/2008	10/23/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	6/4/2013	5/6/2014
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	6/4/2013	5/6/2014
Inactive	Usi Insurance Services LLC	669260	Agent - Casualty	6/5/2014	7/31/2015
Inactive	Usi Insurance Services LLC	669260	Agent - Property	6/5/2014	7/31/2015
Inactive	Wells Fargo Ins Svcs Of Wv Inc	399054	Agent - Casualty	11/17/2009	6/4/2013
Inactive	Wells Fargo Ins Svcs Of Wv Inc	399054	Agent - Property	11/17/2009	6/4/2013