DEPARTMENT OF INSURANCE

Name	Tysdal, Justin Jay	DOIID	596765	NAIC NPN	1477295

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Administrator	Not Applicable	5/4/2005		10/31/2025

*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
Administrator	08/15/2025	10/31/2025

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	Seven Corners, Inc. 303 Congressional BlvdCarmel, IN 460325631
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(800) 335-0611