DEPARTMENT OF INSURANCE

Name	Albousafi, Mariam Salma	DOIID	952990	NAIC NPN	18392272

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Agent	Personal Lines	5/2/2017	3/28/2023
Active	Non Resident	Staff Adjuster	Property & Casualty	4/3/2023		11/30/2026	Florida

*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
Staff Adjuster	09/15/2024	11/30/2024	09/18/2024	09/18/2024	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	3901 W Innovation St Apt 319 Sioux Falls, SD 571077059
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(605) 323-7916