DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Van Leersum, Jeroen	DOIID	971020	NAIC NPN	18334659

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	10/5/2017	10/31/2021
* 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	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	10/24/2017	10/31/2021
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	10/10/2017	8/26/2020
Inactive	RiverSource Life Insurance Company	301952	Agent - Life	10/5/2017	12/23/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ameriprise Financial Services, LLC	398326	Agent - Life	5/1/2018	10/31/2021