DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Shah, Jackylene	DOIID	1165580	NAIC NPN	18558519

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	10/11/2021		8/31/2026
Active	Non Resident	Agent	Property	10/11/2021		8/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	10/11/2021		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	06/15/2026	08/31/2026
Surplus Lines Broker	06/15/2026	08/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	United States Fire Insurance Company	582240	Agent - Casualty	8/22/2024
Active	United States Fire Insurance Company	582240	Agent - Property	8/22/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Amwins Insurance Brokerage LLC	624422	Agent - Casualty
Denied	Amwins Insurance Brokerage LLC	624422	Agent - Property
Active	Amwins Insurance Brokerage LLC	624422	Surplus Lines Broker - Not Applicable	4/18/2022