DEPARTMENT OF INSURANCE

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	Designated Home State
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.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Residence	Not Public Information
Business / Home Office	Clack Adjustment Company Inc 1030 Kingston Rd NwConyers, GA 300124017

Phone Information

Type	Phone
Business / Home Office	(404) 550-9367