DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Coffman, Shelly Lynn	DOIID	593501	NAIC NPN	8186086

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Adjuster	Independent	1/31/2005	3/3/2008
Inactive	Resident	Agent	Casualty	10/17/2006	11/8/2007
Inactive	Resident	Agent	Property	10/17/2006	11/8/2007
Inactive	Resident	Apprentice Adjuster	Not Applicable	8/5/2004	1/31/2005
* 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	Auto Club Property-Casualty Insurance Company	650781	Agent - Casualty	7/6/2007	11/8/2007
Inactive	Auto Club Property-Casualty Insurance Company	650781	Agent - Property	7/6/2007	11/8/2007
Inactive	Auto-Owners Insurance Company	301480	Agent - Casualty	12/7/2006	11/8/2007
Inactive	Auto-Owners Insurance Company	301480	Agent - Property	12/7/2006	11/8/2007
Inactive	Owners Insurance Company	300796	Agent - Casualty	12/7/2006	11/8/2007
Inactive	Owners Insurance Company	300796	Agent - Property	12/7/2006	11/8/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Blake Hart Taylor & Wiseman Insurance Agy Inc.	400368	Agent - Casualty	1/24/2007	11/8/2007
Inactive	Blake Hart Taylor & Wiseman Insurance Agy Inc.	400368	Agent - Property	1/24/2007	11/8/2007

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mruk, James C	340696	Apprentice Adjuster - Not Applicable	8/5/2004	1/31/2005