DEPARTMENT OF INSURANCE

Affiliations

Name	Audubon Insurance Service Inc.	DOIID	398441	NAIC NPN	7220895

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	6/11/2021		3/31/2027
Active	Resident	Agent	Property	6/11/2021		3/31/2027
Active	Resident	Agent	Life	6/11/2021		3/31/2027
Active	Resident	Agent	Casualty	6/11/2021		3/31/2027
Denied	Resident	Agent	Personal Lines
Inactive	Resident	Agent	General Lines	3/31/1982	8/15/2000
Inactive	Resident	Agent	Health Maintenance Organization	10/25/1996	3/2/1999
* 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	01/15/2025	03/31/2025	01/15/2025	01/15/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allstate Northbrook Indemnity Company	301309	Agent - Casualty	12/15/2004	2/28/2008
Inactive	Allstate Northbrook Indemnity Company	301309	Agent - Property	12/15/2004	2/28/2008
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Casualty	8/15/2000	2/28/2008
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - General Lines	1/27/1998	8/15/2000
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Property	8/15/2000	2/28/2008
Inactive	American Economy Insurance Company	300315	Agent - General Lines	7/31/1995	3/31/1998
Inactive	American States Insurance Company	301230	Agent - General Lines	7/31/1995	3/31/1998
Inactive	American States Life Insurance Company	301884	Agent - Health	7/31/1995	11/26/2001
Inactive	American States Life Insurance Company	301884	Agent - Life	7/31/1995	11/26/2001
Inactive	American States Preferred Insurance Company	300609	Agent - General Lines	7/31/1995	3/31/1998
Inactive	Assurance Company of America	300432	Agent - General Lines	2/21/1996	8/15/2000
Inactive	Celtic Insurance Company	300877	Agent - Health	3/30/1995	3/31/1997
Inactive	Celtic Insurance Company	300877	Agent - Life	3/30/1995	3/31/1997
Inactive	Clear Spring Life and Annuity Company	300919	Agent - Life	7/25/2019	3/31/2021
Inactive	Globe American Casualty Company	301033	Agent - General Lines	3/30/1990	2/14/1997
Inactive	Hallmark National Insurance Company	300494	Agent - General Lines	1/6/1995	6/7/1999
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	10/25/1996	3/2/1999
Inactive	Humana Insurance Company	301104	Agent - Health	5/23/1995	3/2/1999
Inactive	Humana Insurance Company	301104	Agent - Life	5/23/1995	3/2/1999
Inactive	Infinity Insurance Company	300416	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Infinity Insurance Company	300416	Agent - General Lines	8/31/1994	8/15/2000
Inactive	Infinity Select Insurance Company	300169	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Infinity Select Insurance Company	300169	Agent - General Lines	5/17/1996	8/15/2000
Inactive	Investors Life Insurance Company of Indiana	301657	Agent - Life	3/31/1982	7/11/1999
Inactive	John Alden Life Insurance Company	300573	Agent - Health	6/19/2000	12/29/2008
Inactive	John Alden Life Insurance Company	300573	Agent - Life	6/19/2000	12/29/2008
Inactive	Kentucky National Insurance Company	301625	Agent - Casualty	8/15/2000	1/10/2013
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	3/31/1982	8/15/2000
Inactive	Kentucky National Insurance Company	301625	Agent - Property	8/15/2000	1/10/2013
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	6/2/1995	4/3/2000
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	6/2/1995	4/3/2000
Inactive	Maryland Casualty Company	301719	Agent - General Lines	2/21/1996	8/15/2000
Inactive	Meridian Mutual Insurance Company	301303	Agent - General Lines	3/31/1982	12/9/1999
Inactive	National Casualty Company	301483	Agent - Health	1/29/1986	2/20/2003
Inactive	National Summit Insurance Company	300348	Agent - Casualty	8/15/2000	7/22/2003
Inactive	National Summit Insurance Company	300348	Agent - General Lines	9/26/1996	8/15/2000
Inactive	National Summit Insurance Company	300348	Agent - Property	8/15/2000	7/22/2003
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	5/1/1996	2/24/2000
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	5/1/1996	7/8/2003
Inactive	PAFCO General Insurance Company	301645	Agent - General Lines	3/31/1982	5/21/1997
Inactive	State Auto Property & Casualty Insurance Company	301953	Agent - General Lines	2/15/1990	6/7/1999
Inactive	State Automobile Mutual Insurance Company	301824	Agent - General Lines	2/15/1990	6/7/1999
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Health	6/19/1998	9/12/2007
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	6/19/1998	9/12/2007

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bruckert, John Allan	302355	Agent - General Lines	4/9/1981	2/9/1997
Inactive	Bruckert, John Allan	302355	Agent - Health	4/9/1981	2/9/1997
Inactive	Bruckert, John Allan	302355	Agent - Life	4/9/1981	2/9/1997
Active	Bruckert, Mark Allan	330379	Agent - Casualty	6/11/2021
Inactive	Bruckert, Mark Allan	330379	Agent - General Lines	4/9/1981	8/15/2000
Active	Bruckert, Mark Allan	330379	Agent - Health	6/11/2021
Active	Bruckert, Mark Allan	330379	Agent - Life	6/11/2021
Active	Bruckert, Mark Allan	330379	Agent - Property	6/11/2021