DEPARTMENT OF INSURANCE

Affiliations

Name	Jacobson, Kathryn Ann	DOIID	500234	NAIC NPN	242905

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	General Lines	12/31/1999	8/15/2000
Inactive	Non Resident	Agent	Property	8/15/2000	8/28/2012
Inactive	Non Resident	Agent	Casualty	8/15/2000	8/28/2012
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	4/11/2006	3/31/2013
* 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	ACE American Insurance Company	300625	Agent - Casualty	12/12/2008	4/12/2012
Inactive	ACE American Insurance Company	300625	Agent - Property	12/12/2008	4/12/2012
Inactive	American Home Assurance Company	300246	Agent - Casualty	4/23/2001	8/28/2012
Inactive	American Home Assurance Company	300246	Agent - Property	4/23/2001	8/28/2012
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	8/15/2000	8/28/2012
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - General Lines	12/31/1999	8/15/2000
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	8/15/2000	8/28/2012
Inactive	Great American Insurance Company of New York	301897	Agent - Casualty	8/15/2000	5/5/2003
Inactive	Great American Insurance Company of New York	301897	Agent - General Lines	12/31/1999	8/15/2000
Inactive	Great American Insurance Company of New York	301897	Agent - Property	8/15/2000	5/5/2003
Inactive	Insurance Company of the State of Pennsylvania	300807	Agent - Casualty	4/23/2001	8/28/2012
Inactive	Insurance Company of the State of Pennsylvania	300807	Agent - Property	4/23/2001	8/28/2012
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	4/23/2001	8/28/2012
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	4/23/2001	8/28/2012
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	8/15/2000	8/28/2012
Inactive	The Phoenix Insurance Company	301502	Agent - General Lines	12/31/1999	8/15/2000
Inactive	The Phoenix Insurance Company	301502	Agent - Property	8/15/2000	8/28/2012
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	4/21/2006	8/28/2012
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	4/21/2006	8/28/2012
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	4/21/2006	8/28/2012
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	4/21/2006	8/28/2012
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	4/21/2006	8/28/2012
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	4/21/2006	8/28/2012
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	4/21/2006	8/28/2012
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	4/21/2006	8/28/2012
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	8/15/2000	8/28/2012
Inactive	Travelers Property Casualty Company of America	301649	Agent - General Lines	12/31/1999	8/15/2000
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	8/15/2000	8/28/2012
Inactive	Westchester Fire Insurance Company	301414	Agent - Casualty	5/10/2007	1/1/2011
Inactive	Westchester Fire Insurance Company	300990	Agent - Casualty	1/1/2011	4/12/2012
Inactive	Westchester Fire Insurance Company	301414	Agent - Property	5/10/2007	1/1/2011
Inactive	Westchester Fire Insurance Company	300990	Agent - Property	1/1/2011	4/12/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Seabury & Smith Inc	394854	Agent - Property	6/19/2008	1/24/2012
Inactive	Seabury & Smith Inc	394854	Agent - Casualty	6/19/2008	1/24/2012