DEPARTMENT OF INSURANCE

Name	Long, Shawn J	DOIID	360263	NAIC NPN	252914

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Agent	Life	10/18/2018		6/30/2027
Active	Non Resident	Agent	Health	10/18/2018		6/30/2027

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2025	06/30/2025	04/03/2025	04/03/2025	Yes

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Business / Home Office	3304 N. Cedar Crest Circle Fort Wayne, IN 468091502
Residence	Not Public Information

Internet Information

Type	Address
Business Email	shawngoingforward1@gmail.com

Phone Information

Type	Phone
Business / Home Office	(260) 414-6477