DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Czaja, Dominika	DOIID	1097143	NAIC NPN	15795754

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/9/2020		10/31/2025
Active	Non Resident	Agent	Life	9/9/2020		10/31/2025
* 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	08/15/2025	10/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USAA Life Insurance Company	300734	Agent - Health	9/11/2020	9/10/2024
Inactive	USAA Life Insurance Company	300734	Agent - Life	9/11/2020	9/10/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USAA Life General Agency Inc	399318	Agent - Life	6/7/2022	9/10/2024
Inactive	USAA Life General Agency Inc	399318	Agent - Health	6/7/2022	9/10/2024