DEPARTMENT OF INSURANCE

Affiliations

Name	Mitchell Ins Agcy Inc	DOIID	852048	NAIC NPN	2516449

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Casualty	9/15/2014	3/31/2026
Active	Non Resident	Agent	Health	9/15/2014	3/31/2026
Active	Non Resident	Agent	Life	9/15/2014	3/31/2026
Active	Non Resident	Agent	Property	9/15/2014	3/31/2026
Denied	Non Resident	Agent	Variable Life and Variable Annuities
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AMCO Insurance Company	300204	Agent - Casualty	12/19/2016
Active	AMCO Insurance Company	300204	Agent - Property	12/19/2016
Active	Allied Insurance Company of America	793586	Agent - Casualty	4/14/2017
Active	Allied Insurance Company of America	793586	Agent - Property	4/14/2017
Active	Allied Property and Casualty Insurance Company	300279	Agent - Casualty	12/19/2016
Active	Allied Property and Casualty Insurance Company	300279	Agent - Property	12/19/2016
Active	AmGUARD Insurance Company	500010	Agent - Casualty	1/8/2021
Active	AmGUARD Insurance Company	500010	Agent - Property	1/8/2021
Inactive	American Alternative Insurance Corporation	301697	Agent - Casualty	6/27/2017	2/3/2021
Inactive	American Alternative Insurance Corporation	301697	Agent - Property	6/27/2017	2/3/2021
Inactive	American Commerce Insurance Company	301665	Agent - Casualty	12/11/2015	3/31/2018
Inactive	American Commerce Insurance Company	301665	Agent - Property	12/11/2015	3/31/2018
Active	American Economy Insurance Company	300315	Agent - Casualty	7/17/2024
Active	American Economy Insurance Company	300315	Agent - Property	7/17/2024
Active	American Family Home Insurance Company	301817	Agent - Casualty	12/8/2020
Active	American Family Home Insurance Company	301817	Agent - Property	12/8/2020
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	11/22/2021
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	11/22/2021
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	11/10/2017	11/14/2021
Inactive	American Modern Home Insurance Company	300791	Agent - Property	11/10/2017	11/14/2021
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	11/2/2018
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	11/2/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	8/16/2017	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	8/16/2017	11/14/2021
Inactive	American Reliable Insurance Company	301889	Agent - Casualty	3/7/2018	8/24/2021
Inactive	American Reliable Insurance Company	301889	Agent - Property	3/7/2018	8/24/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	11/5/2015	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	11/5/2015	11/14/2021
Active	American Strategic Insurance Corp	883540	Agent - Casualty	6/1/2017
Active	American Strategic Insurance Corp	883540	Agent - Property	6/1/2017
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/24/2017	12/16/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/24/2017	12/16/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/24/2017	12/16/2024
Inactive	Auto-Owners Insurance Company	301480	Agent - Casualty	7/17/2017	4/19/2021
Inactive	Auto-Owners Insurance Company	301480	Agent - Property	7/17/2017	4/19/2021
Inactive	Auto-Owners Life Insurance Company	301368	Agent - Health	7/17/2017	12/9/2019
Inactive	Auto-Owners Life Insurance Company	301368	Agent - Life	7/17/2017	12/9/2019
Active	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	6/3/2015
Active	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	6/3/2015
Active	Bristol West Insurance Company	301655	Agent - Casualty	9/18/2015
Active	Bristol West Insurance Company	301655	Agent - Property	9/18/2015
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	8/16/2017	12/20/2018
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	8/16/2017	12/20/2018
Inactive	ClearPath Insurance Company	979815	Agent - Casualty	5/11/2022	1/9/2025
Inactive	Continental Casualty Company	301019	Agent - Casualty	11/30/2017	4/30/2020
Inactive	Continental Casualty Company	301019	Agent - Property	11/30/2017	4/30/2020
Inactive	Continental Insurance Company (The)	301242	Agent - Casualty	4/9/2018	4/30/2020
Inactive	Continental Insurance Company (The)	301242	Agent - Property	4/9/2018	4/30/2020
Active	Depositors Insurance Company	301634	Agent - Casualty	12/19/2016
Active	Depositors Insurance Company	301634	Agent - Property	12/19/2016
Inactive	Encova Life Insurance Company	301818	Agent - Life	8/1/2017	1/1/2024
Active	Erie Family Life Insurance Company	301400	Agent - Health	9/30/2021
Active	Erie Family Life Insurance Company	301400	Agent - Life	5/6/2015
Active	Erie Insurance Company	300230	Agent - Casualty	5/6/2015
Active	Erie Insurance Company	300230	Agent - Property	5/6/2015
Active	Erie Insurance Company of New York	789916	Agent - Casualty	9/23/2015
Active	Erie Insurance Company of New York	789916	Agent - Property	9/23/2015
Active	Erie Insurance Exchange	300789	Agent - Casualty	5/6/2015
Active	Erie Insurance Exchange	300789	Agent - Property	5/6/2015
Active	Erie Insurance Property & Casualty Company	789942	Agent - Casualty	9/23/2015
Active	Erie Insurance Property & Casualty Company	789942	Agent - Property	9/23/2015
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	6/30/2015
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Property	6/30/2015
Inactive	Farmington Casualty Company	301137	Agent - Casualty	8/16/2017	12/20/2018
Inactive	Farmington Casualty Company	301137	Agent - Property	8/16/2017	12/20/2018
Active	Fidelity and Guaranty Insurance Company	301009	Agent - Casualty	8/2/2022
Active	Fidelity and Guaranty Insurance Company	301009	Agent - Property	8/2/2022
Active	Flagship City Insurance Company	789965	Agent - Casualty	9/23/2015
Active	Flagship City Insurance Company	789965	Agent - Property	9/23/2015
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/15/2015
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/15/2015
Active	Grange Indemnity Insurance Company	300793	Agent - Casualty	10/31/2014
Active	Grange Indemnity Insurance Company	300793	Agent - Property	10/31/2014
Active	Grange Insurance Company	300234	Agent - Casualty	10/31/2014
Active	Grange Insurance Company	300234	Agent - Property	10/31/2014
Inactive	Grange Life Insurance Company	300128	Agent - Health	10/31/2014	3/31/2021
Inactive	Grange Life Insurance Company	300128	Agent - Life	10/31/2014	3/31/2021
Active	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	10/31/2014
Active	Grange Property & Casualty Insurance Company	601680	Agent - Property	10/31/2014
Active	Hartford Underwriters Insurance Company	301064	Agent - Casualty	3/21/2023
Active	Hartford Underwriters Insurance Company	301064	Agent - Property	3/21/2023
Active	Kansas City Life Insurance Company	301444	Agent - Health	5/8/2019
Active	Kansas City Life Insurance Company	301444	Agent - Life	5/8/2019
Active	Liberty Insurance Underwriters Inc.	301391	Agent - Casualty	4/19/2018
Active	Liberty Insurance Underwriters Inc.	301391	Agent - Property	4/19/2018
Active	Liberty Mutual Insurance Company	301159	Agent - Casualty	4/19/2018
Active	Liberty Mutual Insurance Company	301159	Agent - Property	4/19/2018
Active	Markel Insurance Company	301475	Agent - Casualty	8/22/2019
Active	Markel Insurance Company	301475	Agent - Property	8/22/2019
Active	Milbank Insurance Company	925185	Agent - Casualty	8/17/2022
Active	Milbank Insurance Company	925185	Agent - Property	8/17/2022
Active	Nationwide Agribusiness Insurance Company	301008	Agent - Casualty	4/14/2017
Active	Nationwide Agribusiness Insurance Company	301008	Agent - Property	4/14/2017
Active	Nationwide Assurance Company	300166	Agent - Casualty	3/4/2020
Active	Nationwide Assurance Company	300166	Agent - Property	9/15/2021
Active	Nationwide General Insurance Company	300603	Agent - Casualty	8/28/2019
Active	Nationwide General Insurance Company	300603	Agent - Property	8/28/2019
Active	Nationwide Insurance Company of America	300333	Agent - Casualty	8/28/2019
Active	Nationwide Insurance Company of America	300333	Agent - Property	8/28/2019
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	12/19/2016
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	12/19/2016
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	9/15/2021
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	9/15/2021
Active	NorGUARD Insurance Company	500015	Agent - Casualty	1/8/2021
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	6/8/2024
Active	Ohio Casualty Insurance Company	301492	Agent - Property	6/8/2024
Active	Ohio Security Insurance Company	300622	Agent - Casualty	5/8/2024
Active	Ohio Security Insurance Company	300622	Agent - Property	5/8/2024
Inactive	Owners Insurance Company	300796	Agent - Casualty	7/17/2017	4/19/2021
Inactive	Owners Insurance Company	300796	Agent - Property	7/17/2017	4/19/2021
Active	Pan-American Life Insurance Company	301530	Agent - Life	1/1/2024
Active	Progressive Casualty Insurance Company	300696	Agent - Casualty	5/8/2015
Active	Progressive Casualty Insurance Company	300696	Agent - Property	5/8/2015
Inactive	Pruco Life Insurance Company	300954	Agent - Life	12/28/2021	12/23/2024
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	6/21/2024
Active	SAFECO Insurance Company of America	300159	Agent - Property	6/21/2024
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	9/5/2024
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	9/5/2024
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Casualty	1/4/2016	12/14/2016
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Property	1/4/2016	12/14/2016
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Casualty	1/4/2016	12/14/2016
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Property	1/4/2016	12/14/2016
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Casualty	1/4/2016	12/14/2016
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Property	1/4/2016	12/14/2016
Active	Standard Fire Insurance Company (The)	301068	Agent - Casualty	6/3/2015
Active	Standard Fire Insurance Company (The)	301068	Agent - Property	6/3/2015
Active	The Phoenix Insurance Company	301502	Agent - Casualty	6/30/2017
Active	The Phoenix Insurance Company	301502	Agent - Property	6/30/2017
Inactive	Titan Indemnity Company	300556	Agent - Casualty	10/12/2015	9/14/2017
Inactive	Titan Indemnity Company	300556	Agent - Property	10/12/2015	9/14/2017
Active	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	8/10/2017
Active	Travelers Casualty Insurance Company of America	300522	Agent - Property	8/10/2017
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	8/16/2017	12/20/2018
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	8/16/2017	12/20/2018
Active	Travelers Casualty and Surety Company of America	301334	Agent - Casualty	8/16/2017
Active	Travelers Casualty and Surety Company of America	301334	Agent - Property	8/16/2017
Active	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	6/3/2015
Active	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	6/3/2015
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	8/16/2017	12/20/2018
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	8/16/2017	12/20/2018
Active	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	8/16/2017
Active	Travelers Indemnity Company of America (The)	301093	Agent - Property	8/16/2017
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	8/16/2017	10/5/2021
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	8/16/2017	10/5/2021
Active	Travelers Personal Insurance Company	705785	Agent - Casualty	4/5/2019
Active	Travelers Personal Insurance Company	705785	Agent - Property	4/5/2019
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	8/16/2017	12/20/2018
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	8/16/2017	12/20/2018
Active	Trexis Insurance Corporation	599902	Agent - Casualty	9/18/2015
Active	Trexis One Insurance Corporation	684197	Agent - Casualty	1/18/2019
Active	Trustgard Insurance Company	300104	Agent - Casualty	10/31/2014
Active	Trustgard Insurance Company	300104	Agent - Property	10/31/2014
Active	United Financial Casualty Company	301886	Agent - Casualty	5/8/2015
Active	United Financial Casualty Company	301886	Agent - Property	5/8/2015
Active	Utica Mutual Insurance Company	301933	Agent - Casualty	6/6/2016
Active	Utica Mutual Insurance Company	301933	Agent - Property	6/6/2016
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	10/12/2015	9/14/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	10/12/2015	9/14/2017
Active	Western Surety Company	300283	Agent - Casualty	3/31/2015

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Ante, Timothy David	736610	Agent - Casualty	5/7/2020
Active	Ante, Timothy David	736610	Agent - Property	5/7/2020
Active	Berger, Matthew F	1215929	Agent - Casualty	8/11/2022
Active	Berger, Matthew F	1215929	Agent - Property	8/11/2022
Active	Carr, Christina Louise	517953	Agent - Casualty	9/11/2015
Active	Carr, Christina Louise	517953	Agent - Life	9/11/2015
Active	Carr, Christina Louise	517953	Agent - Property	9/11/2015
Active	Carr, Christopher Clay	580117	Agent - Casualty	4/3/2020
Active	Carr, Christopher Clay	580117	Agent - Property	4/3/2020
Inactive	Chaffin, Ralph Edward	355719	Agent - Casualty	5/8/2015	8/3/2020
Inactive	Chaffin, Ralph Edward	355719	Agent - Health	5/8/2015	8/3/2020
Inactive	Chaffin, Ralph Edward	355719	Agent - Life	5/8/2015	8/3/2020
Inactive	Chaffin, Ralph Edward	355719	Agent - Property	5/8/2015	8/3/2020
Inactive	Cintron, James	1080811	Agent - Casualty	6/26/2020	9/15/2021
Inactive	Cintron, James	1080811	Agent - Property	6/26/2020	9/15/2021
Active	Cipparrone, Courtney	856860	Agent - Casualty	5/8/2015
Active	Cipparrone, Courtney	856860	Agent - Life	5/8/2015
Active	Cipparrone, Courtney	856860	Agent - Property	5/8/2015
Active	Cook, Cory Lynn	1215807	Agent - Casualty	8/11/2022
Active	Cook, Cory Lynn	1215807	Agent - Property	8/11/2022
Inactive	Fields, Kara	857960	Agent - Casualty	5/8/2015	8/3/2020
Inactive	Fields, Kara	857960	Agent - Property	5/8/2015	8/3/2020
Active	Gardner, Richard Matthew	856753	Agent - Casualty	4/2/2015
Denied	Gardner, Richard Matthew	856753	Agent - Health
Active	Gardner, Richard Matthew	856753	Agent - Life	5/7/2015
Active	Gardner, Richard Matthew	856753	Agent - Property	4/9/2015
Inactive	Ingberg, Rebecca L	688404	Agent - Casualty	12/6/2016	3/31/2018
Inactive	Ingberg, Rebecca L	688404	Agent - Health	12/6/2016	5/16/2018
Inactive	Ingberg, Rebecca L	688404	Agent - Life	12/6/2016	1/31/2019
Inactive	Ingberg, Rebecca L	688404	Agent - Property	12/6/2016	3/31/2018
Active	Jenkins, Amy J	857244	Agent - Casualty	5/8/2015
Inactive	Jenkins, Amy J	857244	Agent - Health	11/12/2015	3/31/2021
Active	Jenkins, Amy J	857244	Agent - Life	5/8/2015
Active	Jenkins, Amy J	857244	Agent - Property	5/8/2015
Inactive	Jones, Kimberly K	856782	Agent - Casualty	5/8/2015	11/11/2015
Inactive	Jones, Kimberly K	856782	Agent - Health	11/12/2015	12/27/2016
Inactive	Jones, Kimberly K	856782	Agent - Life	5/8/2015	7/31/2015
Inactive	Jones, Kimberly K	856782	Agent - Property	5/8/2015	11/11/2015
Inactive	Kiddey, Ryan	878328	Agent - Casualty	7/2/2015	12/6/2016
Inactive	Kiddey, Ryan	878328	Agent - Property	7/2/2015	12/6/2016
Inactive	Leising, Keeley	1114849	Agent - Casualty	1/19/2021	5/31/2022
Inactive	Leising, Keeley	1114849	Agent - Property	1/19/2021	5/31/2022
Inactive	Lowry, Bridgett Ann	652928	Agent - Casualty	4/3/2020	9/15/2021
Inactive	Lowry, Bridgett Ann	652928	Agent - Property	4/3/2020	9/15/2021
Active	Mikolajczak-Busby, Rachael Lynn	1195960	Agent - Casualty	2/13/2025
Pending	Mikolajczak-Busby, Rachael Lynn	1195960	Agent - Health
Active	Mikolajczak-Busby, Rachael Lynn	1195960	Agent - Life	2/13/2025
Active	Mikolajczak-Busby, Rachael Lynn	1195960	Agent - Property	2/13/2025
Active	Mitchell, Colin	920191	Agent - Casualty	11/26/2018
Active	Mitchell, Colin	920191	Agent - Property	11/26/2018
Active	Mitchell, Robb W	851649	Agent - Casualty	9/15/2014
Active	Mitchell, Robb W	851649	Agent - Health	9/15/2014
Active	Mitchell, Robb W	851649	Agent - Life	9/15/2014
Active	Mitchell, Robb W	851649	Agent - Property	9/15/2014
Active	Ray, Kelly	857877	Agent - Casualty	5/8/2015
Active	Ray, Kelly	857877	Agent - Health	11/12/2015
Active	Ray, Kelly	857877	Agent - Life	5/8/2015
Active	Ray, Kelly	857877	Agent - Property	5/8/2015
Inactive	Schuck, Danielle Yvette	366202	Agent - Casualty	9/15/2021	10/17/2022
Inactive	Schuck, Danielle Yvette	366202	Agent - Property	9/15/2021	10/17/2022
Active	Wandell, Jenah Lynn	897436	Agent - Casualty	4/7/2020
Active	Wandell, Jenah Lynn	897436	Agent - Property	4/7/2020