DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Shaw, Rita Smith	DOIID	656459	NAIC NPN	3078927

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	5/31/2007	1/31/2011
Inactive	Non Resident	Agent	Casualty	5/31/2007	1/31/2011
Inactive	Non Resident	Agent	Property	5/31/2007	1/31/2011
Inactive	Non Resident	Agent	Health	5/31/2007	1/31/2011
* 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	12/20/2007	1/31/2011
Inactive	21st Century Centennial Insurance Company	301840	Agent - Property	12/20/2007	1/31/2011
Inactive	21st Century North America Insurance Company	300884	Agent - Casualty	12/20/2007	1/31/2011
Inactive	21st Century North America Insurance Company	300884	Agent - Property	12/20/2007	1/31/2011
Inactive	American Home Assurance Company	300246	Agent - Casualty	12/20/2007	1/31/2011
Inactive	American Home Assurance Company	300246	Agent - Property	12/20/2007	1/31/2011
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	4/10/2009	1/31/2011
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	4/10/2009	1/31/2011
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	4/16/2010	5/13/2010
Inactive	Tesla Insurance Company	300337	Agent - Casualty	8/15/2008	4/29/2010
Inactive	Tesla Insurance Company	300337	Agent - Property	8/15/2008	4/29/2010
Inactive	Tesla Property & Casualty, Inc.	301611	Agent - Casualty	8/15/2008	4/29/2010
Inactive	Tesla Property & Casualty, Inc.	301611	Agent - Property	8/15/2008	4/29/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Balboa Insurance Services Inc.	516610	Agent - Property	9/21/2009	5/4/2010
Inactive	Balboa Insurance Services Inc.	516610	Agent - Casualty	9/21/2009	5/4/2010