DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Pack, Jasmine S	DOIID	768251	NAIC NPN	16450100

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	5/6/2015	7/31/2018
Inactive	Non Resident	Agent	Health	11/4/2011	7/31/2014
Inactive	Non Resident	Agent	Property	5/6/2015	7/31/2018
* 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	21st Century North America Insurance Company	300884	Agent - Casualty	5/13/2015	10/26/2015
Inactive	21st Century North America Insurance Company	300884	Agent - Property	5/13/2015	10/26/2015
Inactive	Esurance Insurance Company	301072	Agent - Casualty	5/7/2015	10/29/2015
Inactive	Esurance Insurance Company	301072	Agent - Property	5/7/2015	10/29/2015
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Casualty	8/11/2016	9/11/2017
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Property	8/11/2016	9/11/2017
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	8/11/2016	9/11/2017
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	8/11/2016	9/11/2017
Inactive	Permanent General Assurance Corporation of Ohio	709250	Agent - Casualty	5/13/2015	11/3/2015
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	5/21/2015	10/28/2015
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	5/21/2015	10/28/2015
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	5/21/2015	10/28/2015
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	5/21/2015	10/28/2015
Inactive	Titan Indemnity Company	300556	Agent - Casualty	7/17/2015	6/22/2017
Inactive	Titan Indemnity Company	300556	Agent - Property	7/17/2015	6/22/2017
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	8/10/2012	10/26/2012
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/10/2012	10/26/2012
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	7/17/2015	6/22/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	7/17/2015	6/22/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Alorica Customer Care, Inc.	800938	Agent - Health
Inactive	TZ Insurance Solutions LLC	727470	Agent - Property	5/12/2015	2/18/2016
Inactive	TZ Insurance Solutions LLC	727470	Agent - Casualty	5/12/2015	2/18/2016