DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Smith, Brent Alan	DOIID	698032	NAIC NPN	2333603

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	1/27/2009	4/2/2018
Inactive	Non Resident	Agent	Property	1/27/2009	4/2/2018
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	8/19/2016	4/2/2018
* 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	2/13/2009	3/19/2018
Inactive	MAG Mutual Insurance Company	500011	Agent - Property	2/13/2009	3/19/2018

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	Surplus Lines Broker - Not Applicable	1/12/2017	4/2/2018