DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Jacobsen, Eric B	DOIID	558867	NAIC NPN	2719506

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	2/24/2003	1/23/2008
Inactive	Non Resident	Agent	Health	2/24/2003	1/23/2008
Inactive	Non Resident	Agent	Life	2/24/2003	1/23/2008
Inactive	Non Resident	Agent	Property	2/24/2003	1/23/2008
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	2/3/2006	1/23/2008
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	10/29/2004	3/4/2005
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	10/29/2004	3/4/2005
Inactive	Fireman's Fund Insurance Company	301423	Agent - Casualty	6/30/2003	3/29/2007
Inactive	Fireman's Fund Insurance Company	301423	Agent - Health	6/30/2003	1/23/2008
Inactive	Fireman's Fund Insurance Company	301423	Agent - Property	6/30/2003	3/29/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Scanlon & Assoc Ins Brokers Inc	574440	Agent - Casualty	3/31/2005	3/17/2007
Inactive	Scanlon & Assoc Ins Brokers Inc	574440	Agent - Health	3/31/2005	3/17/2007
Denied	Scanlon & Assoc Ins Brokers Inc	574440	Agent - Life
Inactive	Scanlon & Assoc Ins Brokers Inc	574440	Agent - Property	3/31/2005	3/17/2007
Inactive	Scanlon & Assoc Ins Brokers Inc	574440	Surplus Lines Broker - Not Applicable	2/3/2006	1/23/2008