DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Jacobsen, Jeff M	DOIID	1263615	NAIC NPN	10360547

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	3/21/2023		8/31/2025
Active	Non Resident	Agent	Casualty	3/21/2023		8/31/2025
Active	Non Resident	Agent	Property	3/21/2023		8/31/2025
Active	Non Resident	Agent	Life	3/21/2023		8/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	06/15/2025	08/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AAA Life Insurance Company	300287	Agent - Health	4/11/2023
Active	AAA Life Insurance Company	300287	Agent - Life	4/11/2023
Active	Bristol West Insurance Company	301655	Agent - Casualty	4/5/2023
Active	Bristol West Insurance Company	301655	Agent - Property	4/5/2023
Active	CSAA Fire & Casualty Insurance Company	606666	Agent - Casualty	4/4/2023
Active	CSAA Fire & Casualty Insurance Company	606666	Agent - Property	4/4/2023
Active	CSAA General Insurance Company	606675	Agent - Casualty	4/4/2023
Active	CSAA General Insurance Company	606675	Agent - Property	4/4/2023
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	4/5/2023
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	4/5/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aca Club Insurance Agency, Inc.	1033550	Agent - Casualty	4/4/2023
Active	Aca Club Insurance Agency, Inc.	1033550	Agent - Life	4/11/2023
Active	Aca Club Insurance Agency, Inc.	1033550	Agent - Health	4/11/2023
Active	Aca Club Insurance Agency, Inc.	1033550	Agent - Property	4/4/2023