DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Jasen, Lawrence N	DOIID	656442	NAIC NPN	3289272

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	5/30/2007		8/31/2025
Active	Non Resident	Agent	Property	5/30/2007		8/31/2025
Active	Non Resident	Agent	Personal Lines	5/30/2007		8/31/2025
Active	Non Resident	Agent	Casualty	5/30/2007		8/31/2025
Active	Non Resident	Agent	Health	5/30/2007		8/31/2025
* 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	Atlantic Specialty Insurance Company	518595	Agent - Casualty	1/17/2008	1/5/2010
Inactive	Atlantic Specialty Insurance Company	518595	Agent - Property	1/17/2008	1/5/2010
Inactive	Employers' Fire Insurance Company (The)	301255	Agent - Casualty	1/17/2008	1/5/2010
Inactive	Employers' Fire Insurance Company (The)	301255	Agent - Property	1/17/2008	1/5/2010
Active	Fireman's Fund Insurance Company	301423	Agent - Casualty	9/21/2010
Active	Fireman's Fund Insurance Company	301423	Agent - Property	9/21/2010
Inactive	Lamorak Insurance Company	301231	Agent - Casualty	1/17/2008	1/5/2010
Inactive	Lamorak Insurance Company	301231	Agent - Property	1/17/2008	1/5/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	USI Insurance Services National, Inc	509421	Agent - Life
Denied	USI Insurance Services National, Inc	509421	Agent - Health
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	1/3/2012	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	1/3/2012	10/9/2019
Denied	USI Insurance Services National, Inc	509421	Agent - Personal Lines
Denied	Usi Insurance Services LLC	669260	Agent - Life
Denied	Usi Insurance Services LLC	669260	Agent - Health
Active	Usi Insurance Services LLC	669260	Agent - Property	12/27/2018
Active	Usi Insurance Services LLC	669260	Agent - Casualty	12/27/2018
Inactive	Wells Fargo Ins Services Of New York Inc	569345	Agent - Property	8/30/2007	1/5/2010
Inactive	Wells Fargo Ins Services Of New York Inc	569345	Agent - Casualty	8/30/2007	1/5/2010
Denied	Wells Fargo Ins Services Of New York Inc	569345	Agent - Personal Lines