DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Backman, Natalie	DOIID	630111	NAIC NPN	6441818

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	4/15/2014	11/17/2014
Inactive	Non Resident	Agent	Property	4/15/2014	11/17/2014
* 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 Centennial Insurance Company	301840	Agent - Casualty	6/29/2006	10/31/2010
Inactive	21st Century Centennial Insurance Company	301840	Agent - Property	6/29/2006	10/31/2010
Inactive	21st Century North America Insurance Company	300884	Agent - Casualty	6/29/2006	10/31/2010
Inactive	21st Century North America Insurance Company	300884	Agent - Property	6/29/2006	10/31/2010
Inactive	American Home Assurance Company	300246	Agent - Casualty	6/29/2006	10/31/2010
Inactive	American Home Assurance Company	300246	Agent - Property	6/29/2006	10/31/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	1/26/2007	10/31/2010
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	1/26/2007	10/31/2010