DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Kuypers, Scott David	DOIID	578726	NAIC NPN	1590876

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	10/20/2003	7/31/2023
Inactive	Non Resident	Agent	Property	10/20/2003	7/31/2023
* 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	10/28/2003	2/7/2017
Inactive	21st Century North America Insurance Company	300884	Agent - Property	10/28/2003	2/7/2017
Inactive	American Home Assurance Company	300246	Agent - Casualty	10/28/2003	9/27/2011
Inactive	American Home Assurance Company	300246	Agent - Property	10/28/2003	9/27/2011
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	2/6/2016	7/31/2023
Inactive	Bristol West Insurance Company	301655	Agent - Property	2/6/2016	7/31/2023
Inactive	Farmers Insurance Exchange	300336	Agent - Casualty	6/12/2020	8/10/2022
Inactive	Farmers Insurance Exchange	300336	Agent - Property	6/12/2020	8/10/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Foremost Express Insurance Agency Inc.	515334	Agent - Casualty	12/18/2017	12/31/2018
Inactive	Foremost Express Insurance Agency Inc.	515334	Agent - Property	12/18/2017	12/31/2018
Inactive	Fx Insurance Agency, LLC	646184	Agent - Casualty	12/5/2018	7/31/2023
Inactive	Fx Insurance Agency, LLC	646184	Agent - Property	12/5/2018	7/31/2023