DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Dershem, Tiffany	DOIID	1193619	NAIC NPN	20257042

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	3/16/2022	1/31/2024
Inactive	Non Resident	Agent	Casualty	3/16/2022	1/31/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Independence American Insurance Company	524747	Agent - Casualty	11/13/2023	1/31/2024
Inactive	Independence American Insurance Company	524747	Agent - Property	11/13/2023	1/31/2024
Inactive	United States Fire Insurance Company	582240	Agent - Casualty	4/10/2022	1/31/2024
Inactive	United States Fire Insurance Company	582240	Agent - Property	4/10/2022	1/31/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	The American Equity Underwriters Inc	578641	Agent - Casualty	5/12/2022	1/31/2024
Inactive	The American Equity Underwriters Inc	578641	Agent - Property	5/12/2022	1/31/2024