DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Goen Jr, Roy E	DOIID	697735	NAIC NPN	780853

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	1/21/2009	5/31/2015
Inactive	Non Resident	Agent	Casualty	1/21/2009	5/31/2015
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	1/28/2009	5/31/2015
* 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	MAG Mutual Insurance Company	500011	Agent - Casualty	1/26/2009	6/3/2015
Inactive	MAG Mutual Insurance Company	500011	Agent - Property	1/26/2009	6/3/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mag Mutual Ins Agency Llc	704396	Agent - Casualty	1/3/2014	5/31/2015
Inactive	Mag Mutual Ins Agency Llc	704396	Agent - Property	1/3/2014	5/31/2015
Inactive	Mag Mutual Ins Agency Llc	704396	Surplus Lines Broker - Not Applicable	1/22/2014	5/31/2015