DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Ballard, Daniel Joseph	DOIID	369849	NAIC NPN	258773

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	General Lines	4/12/1991	8/15/2000
Inactive	Non Resident	Agent	Casualty	8/15/2000	7/31/2004
Inactive	Non Resident	Agent	Property	8/15/2000	7/31/2004
* 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	21st Century North America Insurance Company	300884	Agent - Casualty	8/15/2000	7/31/2004
Inactive	21st Century North America Insurance Company	300884	Agent - General Lines	7/28/1997	8/15/2000
Inactive	21st Century North America Insurance Company	300884	Agent - Property	8/15/2000	7/31/2004
Inactive	Sentry Insurance Company	300222	Agent - General Lines	4/12/1991	11/18/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AMA Insurance Agency Inc.	396159	Agent - Property	8/15/2000	1/9/2004
Inactive	AMA Insurance Agency Inc.	396159	Agent - Casualty	8/15/2000	1/9/2004
Inactive	Synergence Group, Inc.	526302	Agent - Property	11/19/2002	1/9/2004
Inactive	Synergence Group, Inc.	526302	Agent - Casualty	11/19/2002	1/9/2004