DEPARTMENT OF INSURANCE

Affiliations

Name	Retta, Beneyam	DOIID	753191	NAIC NPN	14376566

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	4/28/2011	11/30/2016
Inactive	Non Resident	Agent	Casualty	4/28/2011	11/30/2016
Inactive	Non Resident	Agent	Property	4/28/2011	11/30/2016
* 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	American Family Home Insurance Company	301817	Agent - Casualty	10/18/2013	9/14/2016
Inactive	American Family Home Insurance Company	301817	Agent - Property	10/18/2013	9/14/2016
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	9/18/2015	8/19/2016
Inactive	American Modern Select Insurance Company	581481	Agent - Property	9/18/2015	8/19/2016
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	9/18/2015	8/19/2016
Inactive	American Southern Home Insurance Company	626276	Agent - Property	9/18/2015	8/19/2016
Inactive	Auto-Owners Insurance Company	301480	Agent - Casualty	8/12/2011	10/4/2012
Inactive	Auto-Owners Insurance Company	301480	Agent - Property	8/12/2011	10/4/2012
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	10/28/2015	10/20/2016
Inactive	Bristol West Insurance Company	301655	Agent - Property	10/28/2015	10/20/2016
Inactive	Esurance Insurance Company	301072	Agent - Casualty	8/5/2014	6/27/2016
Inactive	Esurance Insurance Company	301072	Agent - Property	8/5/2014	6/27/2016
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	5/26/2011	10/4/2016
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	5/26/2011	10/4/2016
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	5/16/2011	10/20/2016
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	5/16/2011	10/20/2016
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	12/17/2015	10/20/2016
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	12/17/2015	10/20/2016
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	12/17/2015	10/20/2016
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	12/17/2015	10/20/2016
Inactive	Owners Insurance Company	300796	Agent - Casualty	8/12/2011	10/4/2012
Inactive	Owners Insurance Company	300796	Agent - Property	8/12/2011	10/4/2012
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	6/2/2011	9/16/2016
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	6/2/2011	9/16/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Property	6/8/2011	8/24/2016
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Casualty	6/8/2011	8/24/2016