DEPARTMENT OF INSURANCE

Name	Belzer, Donn William	DOIID	611008	NAIC NPN	1899815

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	6/27/2005	2/9/2017
Inactive	Non Resident	Agent	Property	6/27/2005	2/9/2017
Denied	Non Resident	Class type not selected (Individual)	Line of Authority not selected
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	1/19/2006	2/9/2017

*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. 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	14955 W Sprague Rd Ste 292 Strongsville, OH 441361799
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(513) 504-1852