DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Blank, Martin J	DOIID	319161	NAIC NPN	2154665

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	9/30/1998	2/28/2005
Inactive	Non Resident	Agent	General Lines	7/28/1999	2/29/2000
* 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	Tesla Insurance Company	300337	Agent - General Lines	7/28/1999	2/29/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AEGIS Group Inc., (The)	401227	Adjuster - Independent	9/3/1999	2/28/2005