DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clack, Marshall B	DOIID	863129	NAIC NPN	3977183

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	1/20/2015	9/21/2017
Inactive	Non Resident	Independent Adjuster	Property & Casualty	12/19/2014	9/21/2017
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Crawford & Company	401229	Independent Adjuster - Property & Casualty	12/19/2014	2/24/2015
Inactive	Crawford & Company	401229	Administrator - Not Applicable	1/29/2015	2/24/2015