DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Evon, Thomas	DOIID	770015	NAIC NPN	16461857

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	12/2/2011	7/31/2016
Inactive	Non Resident	Agent	Casualty	12/2/2011	7/31/2016
Inactive	Non Resident	Agent	Health	12/2/2011	7/31/2016
* 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	AMEX Assurance Company	301728	Agent - Casualty	12/8/2011	9/24/2012
Inactive	AMEX Assurance Company	301728	Agent - Health	12/8/2011	9/24/2012
Inactive	AMEX Assurance Company	301728	Agent - Property	12/8/2011	9/24/2012
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Casualty	10/1/2012	3/26/2015
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Health	10/1/2012	3/26/2015
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Property	10/1/2012	3/26/2015
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	11/2/2012	3/16/2015
Inactive	American Modern Home Insurance Company	300791	Agent - Property	11/2/2012	3/16/2015
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	11/2/2012	3/16/2015
Inactive	American Modern Select Insurance Company	581481	Agent - Property	11/2/2012	3/16/2015
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	11/2/2012	3/16/2015
Inactive	American Southern Home Insurance Company	626276	Agent - Property	11/2/2012	3/16/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	11/26/2012	3/25/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	11/26/2012	3/25/2015
Inactive	RLI Insurance Company	301217	Agent - Casualty	11/6/2012	3/24/2015
Inactive	RLI Insurance Company	301217	Agent - Property	11/6/2012	3/24/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	APAC Customer Services Inc	505425	Agent - Health	12/13/2011	9/24/2012
Inactive	APAC Customer Services Inc	505425	Agent - Property	12/13/2011	9/24/2012
Inactive	APAC Customer Services Inc	505425	Agent - Casualty	12/13/2011	9/24/2012
Inactive	American Family Connect Insurance Agency, Inc.	619157	Agent - Property	11/26/2012	3/12/2015
Inactive	American Family Connect Insurance Agency, Inc.	619157	Agent - Casualty	11/26/2012	3/12/2015