DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Backman, Jevyn K	DOIID	1157773	NAIC NPN	8712620

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	9/9/2021		8/31/2026
Active	Non Resident	Agent	Travel	9/9/2021		8/31/2026
Active	Non Resident	Agent	Casualty	9/9/2021		8/31/2026
* 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	06/15/2024	08/31/2024	06/05/2024	06/05/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Mitsui Sumitomo Insurance Company of America	301070	Agent - Casualty	9/26/2022
Active	Mitsui Sumitomo Insurance Company of America	301070	Agent - Property	9/26/2022
Active	Mitsui Sumitomo Insurance USA Inc.	301681	Agent - Casualty	9/26/2022
Active	Mitsui Sumitomo Insurance USA Inc.	301681	Agent - Property	9/26/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Propel Insurance Agency , LLC	536922	Agent - Casualty	10/18/2023
Active	Propel Insurance Agency , LLC	536922	Agent - Property	10/18/2023