DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Tschepikow, Benjamin W	DOIID	1046993	NAIC NPN	16648880

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	7/10/2019		9/30/2025
Active	Non Resident	Agent	Property	7/10/2019		9/30/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	7/10/2019		9/30/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	CRC Ins Services, LLC	502276	Agent - Casualty
Denied	CRC Ins Services, LLC	502276	Agent - Property
Active	CRC Ins Services, LLC	502276	Surplus Lines Broker - Not Applicable	12/6/2022