DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Jason D	DOIID	504574	NAIC NPN	7211689

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Apprentice Adjuster	Not Applicable	4/20/2000	4/20/2001
Inactive	Resident	Independent Adjuster	Property & Casualty	4/11/2001	8/1/2016
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	National Equine Adjusting Inc.	401293	Independent Adjuster - Property & Casualty	4/11/2001	8/1/2016