DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Jacob, Jack Anthony	DOIID	361828	NAIC NPN	1565241

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	8/15/2000	11/30/2003
Inactive	Non Resident	Agent	General Lines	8/3/1999	8/15/2000
Inactive	Non Resident	Agent	Property	8/15/2000	11/30/2003
* 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	Centre Insurance Company	301599	Agent - Casualty	8/15/2000	4/14/2003
Inactive	Centre Insurance Company	301599	Agent - General Lines	5/18/2000	8/15/2000
Inactive	Centre Insurance Company	301599	Agent - Property	8/15/2000	4/14/2003
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Casualty	8/15/2000	11/30/2003
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - General Lines	4/6/2000	8/15/2000
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Property	8/15/2000	11/30/2003
Inactive	Harleysville Insurance Company	301462	Agent - Casualty	8/15/2000	11/30/2003
Inactive	Harleysville Insurance Company	301462	Agent - General Lines	8/3/1999	8/15/2000
Inactive	Harleysville Insurance Company	301462	Agent - Property	8/15/2000	11/30/2003
Inactive	Progressive Max Insurance Company	301034	Agent - Casualty	10/16/2000	11/24/2003
Inactive	Progressive Max Insurance Company	301034	Agent - Property	10/16/2000	11/24/2003
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	10/16/2000	11/24/2003
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	10/16/2000	11/24/2003
Inactive	Progressive Northwestern Insurance Company	300441	Agent - Casualty	10/16/2000	11/24/2003
Inactive	Progressive Northwestern Insurance Company	300441	Agent - Property	10/16/2000	11/24/2003
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	8/1/2002	1/31/2003
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	8/1/2002	1/31/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Securian Financial Network, Inc	400561	Agent - Property	2/19/2002	2/6/2003
Inactive	Securian Financial Network, Inc	400561	Agent - Casualty	2/19/2002	2/6/2003