DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Carroll, Shaffawn	DOIID	976530	NAIC NPN	17782118

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	11/14/2017	12/12/2019
Inactive	Non Resident	Agent	Property	11/14/2017	12/12/2019
* 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	Permanent General Assurance Corporation of Ohio	709250	Agent - Casualty	11/16/2017	3/13/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	General Automobile Ins Services Inc	706632	Agent - Casualty	11/17/2017	3/13/2018