DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Staley, Crystal Marie	DOIID	772823	NAIC NPN	6904006

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	1/19/2012		7/31/2026
Active	Non Resident	Agent	Casualty	1/19/2012		7/31/2026
Active	Non Resident	Agent	Personal Lines	1/19/2012		7/31/2026
* 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	Bristol West Insurance Company	301655	Agent - Casualty	7/3/2012	12/4/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	7/3/2012	12/4/2017
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/28/2012
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/28/2012
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	9/24/2013	8/29/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	9/24/2013	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	9/24/2013	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	9/24/2013	8/29/2018
Active	NCMIC Insurance Company	301007	Agent - Casualty	2/20/2012
Active	NCMIC Insurance Company	301007	Agent - Property	2/20/2012
Active	Professional Solutions Insurance Company	569414	Agent - Casualty	2/20/2012
Active	Professional Solutions Insurance Company	569414	Agent - Property	2/20/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	NCMIC Insurance Services, Inc.	399052	Agent - Property	3/20/2013
Active	NCMIC Insurance Services, Inc.	399052	Agent - Casualty	3/20/2013
Active	Professional Solutions Insurance Services, Inc	631015	Agent - Property	3/20/2013
Active	Professional Solutions Insurance Services, Inc	631015	Agent - Casualty	3/20/2013