DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Jeffery	DOIID	1365396	NAIC NPN	21341293

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Casualty	10/23/2024	6/30/2028
Active	Resident	Agent	Life	10/16/2024	6/30/2028
Active	Resident	Agent	Property	10/31/2024	6/30/2028
* 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	04/15/2026	06/30/2026	02/04/2026	02/04/2026	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Auto-Owners Insurance Company	301480	Agent - Casualty	10/31/2024	12/23/2025
Inactive	Auto-Owners Insurance Company	301480	Agent - Property	10/31/2024	12/23/2025
Inactive	Auto-Owners Life Insurance Company	301368	Agent - Life	10/28/2024	12/23/2025
Active	Erie Family Life Insurance Company	301400	Agent - Life	3/5/2026
Active	Erie Insurance Company	300230	Agent - Casualty	3/5/2026
Active	Erie Insurance Company	300230	Agent - Property	3/5/2026
Active	Erie Insurance Company of New York	789916	Agent - Casualty	3/5/2026
Active	Erie Insurance Company of New York	789916	Agent - Property	3/5/2026
Active	Erie Insurance Exchange	300789	Agent - Casualty	3/5/2026
Active	Erie Insurance Exchange	300789	Agent - Property	3/5/2026
Active	Erie Insurance Property & Casualty Company	789942	Agent - Casualty	3/5/2026
Active	Erie Insurance Property & Casualty Company	789942	Agent - Property	3/5/2026
Active	Flagship City Insurance Company	789965	Agent - Casualty	3/5/2026
Active	Flagship City Insurance Company	789965	Agent - Property	3/5/2026
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	2/9/2026
Active	Ohio Casualty Insurance Company	301492	Agent - Property	2/9/2026
Inactive	Owners Insurance Company	300796	Agent - Casualty	10/31/2024	12/23/2025
Inactive	Owners Insurance Company	300796	Agent - Property	10/31/2024	12/23/2025
Active	Progressive Casualty Insurance Company	300696	Agent - Casualty	11/6/2024
Active	Progressive Casualty Insurance Company	300696	Agent - Property	11/6/2024
Active	Transamerica Life Insurance Company	300571	Agent - Life	2/4/2026
Active	United Financial Casualty Company	301886	Agent - Casualty	11/6/2024
Active	United Financial Casualty Company	301886	Agent - Property	11/6/2024
Active	West Bend Insurance Company	672974	Agent - Casualty	4/10/2025
Active	West Bend Insurance Company	672974	Agent - Property	4/10/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Community First Insurance, Inc.	1195563	Agent - Casualty	2/4/2026
Active	Community First Insurance, Inc.	1195563	Agent - Life	2/4/2026
Active	Community First Insurance, Inc.	1195563	Agent - Property	2/4/2026