DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Jackson, Charles H	DOIID	960616	NAIC NPN	18463144

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	7/18/2017	2/28/2023
Inactive	Non Resident	Agent	Property	7/18/2017	2/28/2023
* 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	North River Insurance Company (The)	301739	Agent - Casualty	7/24/2017	3/8/2023
Inactive	North River Insurance Company (The)	301739	Agent - Property	7/24/2017	3/8/2023
Inactive	United States Fire Insurance Company	582240	Agent - Casualty	7/24/2017	3/8/2023
Inactive	United States Fire Insurance Company	582240	Agent - Property	7/24/2017	3/8/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	PTZ Insurance Agency LTD	695420	Agent - Property	8/3/2017	1/5/2022
Inactive	PTZ Insurance Agency LTD	695420	Agent - Casualty	8/3/2017	1/5/2022