DEPARTMENT OF INSURANCE

Name	Irwin Siegel Agency, Inc.	DOIID	401154	NAIC NPN	654183

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Administrator	Not Applicable	3/25/1999	5/1/2009
Denied	Non Resident	Agent	Health	7/19/1999
Inactive	Non Resident	Agent	Casualty	8/15/2000	3/31/2019
Inactive	Non Resident	Agent	Property	8/15/2000	3/31/2019
Inactive	Non Resident	Agent	General Lines	7/19/1999	8/15/2000
Inactive	Non Resident	Agent	Life	7/19/1999	8/16/2006
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	3/18/2009	3/31/2019

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

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	25 Lake Louise Marie Road Po Box 309Rock Hill, NY 12775

Internet Information

Type	Address
Business Email	jenny.mellan@siegelagency.com

Phone Information

Type	Phone
Business / Home Office	(845) 796-3400