DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Green, Matthew Jacob	DOIID	659576	NAIC NPN	9357035

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	7/13/2007	11/30/2020
Inactive	Non Resident	Agent	Health	2/13/2009	11/30/2020
Inactive	Non Resident	Agent	Casualty	7/13/2007	11/30/2020
Active	Non Resident	Independent Adjuster	Property & Casualty	1/8/2024		11/30/2026
Inactive	Non Resident	Staff Adjuster	Property & Casualty	8/20/2019	12/19/2023
* 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
Independent Adjuster	09/15/2026	11/30/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Casualty	8/6/2007	5/6/2019
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Health	3/2/2009	9/24/2015
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Property	8/6/2007	5/6/2019
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	7/13/2015	12/13/2019
Inactive	American Modern Home Insurance Company	300791	Agent - Property	7/13/2015	12/13/2019
Inactive	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	3/5/2019	12/13/2019
Inactive	American Modern Property and Casualty Insurance Company	301954	Agent - Property	3/5/2019	12/13/2019
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	7/13/2015	4/23/2020
Inactive	American Southern Home Insurance Company	626276	Agent - Property	7/13/2015	4/23/2020
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/13/2012	5/15/2019
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/13/2012	5/15/2019
Inactive	Homesite Insurance Company	301139	Agent - Casualty	10/24/2017	5/16/2019
Inactive	Homesite Insurance Company	301139	Agent - Property	10/24/2017	5/16/2019
Inactive	Homesite Insurance Company of the Midwest	874850	Agent - Casualty	10/24/2017	5/16/2019
Inactive	Homesite Insurance Company of the Midwest	874850	Agent - Property	10/24/2017	5/16/2019
Inactive	RLI Insurance Company	301217	Agent - Casualty	11/28/2011	5/13/2019
Inactive	RLI Insurance Company	301217	Agent - Property	11/28/2011	5/13/2019
Inactive	Trusted Resource Underwriters Exchange of Ohio	581481	Agent - Casualty	7/13/2015	4/23/2020
Inactive	Trusted Resource Underwriters Exchange of Ohio	581481	Agent - Property	7/13/2015	4/23/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AFICS, Inc	1122840	Independent Adjuster - Property & Casualty	1/12/2024
Inactive	American Family Connect Insurance Agency, Inc.	619157	Agent - Casualty	11/17/2011	4/23/2020
Inactive	American Family Connect Insurance Agency, Inc.	619157	Agent - Property	11/17/2011	4/23/2020