DEPARTMENT OF INSURANCE

Affiliations

Name	Siegel, Jeremiah	DOIID	837791	NAIC NPN	17232063

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Casualty	4/7/2014	12/31/2025
Active	Non Resident	Agent	Property	4/7/2014	12/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	10/15/2025	12/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	6/21/2020	10/17/2022
Inactive	American Modern Home Insurance Company	300791	Agent - Property	6/21/2020	10/17/2022
Inactive	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	10/24/2018	10/17/2022
Inactive	American Modern Property and Casualty Insurance Company	301954	Agent - Property	10/24/2018	10/17/2022
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	5/29/2015	5/9/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Property	5/29/2015	5/9/2018
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	12/21/2016	5/9/2018
Inactive	American Southern Home Insurance Company	626276	Agent - Property	12/21/2016	5/9/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	7/18/2018	12/28/2024
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	7/18/2018	12/28/2024
Active	Homesite Insurance Company	301139	Agent - Casualty	6/20/2018
Active	Homesite Insurance Company	301139	Agent - Property	6/20/2018
Active	Homesite Insurance Company of the Midwest	874850	Agent - Casualty	6/20/2018
Active	Homesite Insurance Company of the Midwest	874850	Agent - Property	6/20/2018
Active	Midvale Indemnity Company	300292	Agent - Casualty	5/1/2019
Active	Midvale Indemnity Company	300292	Agent - Property	5/1/2019
Inactive	Progressive Direct Insurance Company	301379	Agent - Casualty	4/11/2014	5/14/2018
Inactive	Progressive Direct Insurance Company	301379	Agent - Property	4/11/2014	5/14/2018
Inactive	QBE Insurance Corporation	300515	Agent - Casualty	5/27/2015	5/10/2018
Inactive	QBE Insurance Corporation	300515	Agent - Property	5/27/2015	5/10/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Harley-Davidson Ins Services Inc	545855	Agent - Property	4/15/2015	5/24/2018
Inactive	Harley-Davidson Ins Services Inc	545855	Agent - Casualty	4/15/2015	5/24/2018
Inactive	Progressive Advantage Agency , Inc.	518222	Agent - Property	4/14/2014	5/24/2018
Inactive	Progressive Advantage Agency , Inc.	518222	Agent - Casualty	4/14/2014	5/24/2018