DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Stephens, Jeremy Lane	DOIID	1208066	NAIC NPN	20348641

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Property	8/4/2022		8/31/2024
Active	Resident	Agent	Casualty	8/4/2022		8/31/2024
Active	Resident	Surplus Lines Broker	Not Applicable	10/11/2022		8/31/2024
* 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
Surplus Lines Broker	06/15/2024	08/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Everest Denali Insurance Company	941054	Agent - Casualty	9/1/2022
Active	Everest Denali Insurance Company	941054	Agent - Property	9/1/2022
Active	Everest National Insurance Company	301319	Agent - Casualty	9/1/2022
Active	Everest National Insurance Company	301319	Agent - Property	9/1/2022
Active	Everest Premier Insurance Company	941053	Agent - Casualty	9/1/2022
Active	Everest Premier Insurance Company	941053	Agent - Property	9/1/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aegis Ins Services Inc	916921	Agent - Casualty	9/1/2022
Active	Aegis Ins Services Inc	916921	Agent - Property	9/1/2022