DEPARTMENT OF INSURANCE

Affiliations

Name	Blackburn, Matthew	DOIID	847686	NAIC NPN	11732750

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	8/8/2014	10/31/2016
Inactive	Non Resident	Agent	Casualty	8/8/2014	10/31/2016
* 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	American Family Home Insurance Company	301817	Agent - Casualty	10/23/2014	4/7/2016
Inactive	American Family Home Insurance Company	301817	Agent - Property	10/23/2014	4/7/2016
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	10/1/2014	4/7/2016
Inactive	American Modern Home Insurance Company	300791	Agent - Property	10/1/2014	4/7/2016
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	10/1/2014	4/7/2016
Inactive	American Modern Select Insurance Company	581481	Agent - Property	10/1/2014	4/7/2016
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	10/1/2014	4/7/2016
Inactive	American Southern Home Insurance Company	626276	Agent - Property	10/1/2014	4/7/2016
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	10/28/2015	5/20/2016
Inactive	Bristol West Insurance Company	301655	Agent - Property	10/28/2015	5/20/2016
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	1/19/2015	5/12/2016
Inactive	Encompass Indemnity Company	546376	Agent - Property	1/19/2015	5/12/2016
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	1/19/2015	5/12/2016
Inactive	Encompass Insurance Company of America	556578	Agent - Property	1/19/2015	5/12/2016
Inactive	Esurance Insurance Company	301072	Agent - Casualty	9/19/2014	4/19/2016
Inactive	Esurance Insurance Company	301072	Agent - Property	9/19/2014	4/19/2016
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	9/25/2014	3/30/2016
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	9/25/2014	3/30/2016
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	8/22/2014	5/20/2016
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	8/22/2014	5/20/2016
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	12/17/2015	5/20/2016
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	12/17/2015	5/20/2016
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	12/17/2015	5/20/2016
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	12/17/2015	5/20/2016
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	11/5/2014	4/13/2016
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	11/5/2014	4/13/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Casualty	8/22/2014	4/7/2016
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Property	8/22/2014	4/7/2016