DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Shaw, Leslie	DOIID	995390	NAIC NPN	7251842

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	5/23/2018	7/31/2020
Inactive	Non Resident	Agent	Health	5/23/2018	7/31/2020
Inactive	Non Resident	Agent	Casualty	5/23/2018	7/31/2020
Inactive	Non Resident	Agent	Property	5/23/2018	7/31/2020
* 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	Church Mutual Insurance Company, S.I.	301554	Agent - Casualty	5/30/2018	7/29/2020
Inactive	Church Mutual Insurance Company, S.I.	301554	Agent - Property	5/30/2018	7/29/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	C M I C Specialty Services Inc	645077	Agent - Casualty	5/30/2018	7/29/2020
Denied	C M I C Specialty Services Inc	645077	Agent - Health
Inactive	C M I C Specialty Services Inc	645077	Agent - Property	5/30/2018	7/29/2020