DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Kollock, Benjamin Robert	DOIID	681898	NAIC NPN	10673322

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	6/4/2008	11/13/2017
Inactive	Non Resident	Agent	Property	6/4/2008	11/13/2017
Inactive	Non Resident	Agent	Travel	6/4/2008	11/13/2017
Inactive	Non Resident	Agent	Health	6/4/2008	11/13/2017
* 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	Insurance Company of the State of Pennsylvania	300807	Agent - Casualty	1/31/2012	7/17/2014
Inactive	Insurance Company of the State of Pennsylvania	300807	Agent - Health	1/31/2012	7/17/2014
Inactive	Insurance Company of the State of Pennsylvania	300807	Agent - Property	1/31/2012	7/17/2014
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	6/23/2008	11/13/2017
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	6/23/2008	11/13/2017
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	6/23/2008	11/13/2017
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Travel	4/27/2009	11/13/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Travel Guard Group Inc.	396290	Agent - Travel	3/10/2016	11/9/2017