DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Test, Adam	DOIID	888275	NAIC NPN	17686432

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/7/2015	5/4/2018
Inactive	Non Resident	Agent	Life	10/7/2015	5/4/2018
Inactive	Non Resident	Agent	Casualty	10/7/2015	5/4/2018
Inactive	Non Resident	Agent	Property	10/7/2015	5/4/2018
* 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	Continental American Insurance Company	301700	Agent - Health	10/7/2015	3/19/2018
Inactive	Continental American Insurance Company	301700	Agent - Life	10/7/2015	3/19/2018
Inactive	National Casualty Company	301483	Agent - Casualty	10/9/2015	12/1/2016
Inactive	National Casualty Company	301483	Agent - Property	10/9/2015	12/1/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	DVM Insurance Agency	636779	Agent - Property	10/9/2015	12/1/2016
Inactive	DVM Insurance Agency	636779	Agent - Casualty	10/9/2015	12/1/2016