Individual Information

BRENT IRVING ALLEN

SCOTTSDALE, AZ 85261-6230

Active

ballen@amriskusa.com

10/12/2004

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	129115	10/01/2001	Active	10/12/2004	10/31/2025
Non-Res. Surplus Lines Broker	661523	08/11/2009	Active	08/11/2009	08/31/2027

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	10/01/2001	Active	10/12/2004
Property	10/01/2001	Active	10/12/2004
Surplus Lines	08/11/2009	Active	08/14/2014
Casualty	04/22/1992	Inactive	10/01/2001
Health	04/22/1992	Inactive	10/01/2001
Health	10/01/2001	Inactive	05/01/2004
Life	04/22/1992	Inactive	10/01/2001
Life	10/01/2001	Inactive	05/01/2004
Property	04/22/1992	Inactive	10/01/2001
Surety	04/22/1992	Inactive	01/01/2020
Surety	10/01/2001	Inactive	01/01/2020

Company Name	Appointment Type	Status	Active Date
17
ACE AMERICAN INSURANCE COMPANY	Casualty	Active	03/08/2021
	Property	Active	03/08/2021
1778
Company Name	Appointment Type	Status	Active Date
AMERICAN FIRE AND CASUALTY COMPANY	Casualty	Active	10/07/2008
	Property	Active	10/07/2008
72
Company Name	Appointment Type	Status	Active Date
AMERICAN RELIABLE INSURANCE COMPANY	Casualty	Active	10/04/2023
	Property	Active	10/04/2023
309
Company Name	Appointment Type	Status	Active Date
HARTFORD FIRE INSURANCE COMPANY	Casualty	Active	11/04/2004
	Property	Active	11/04/2004
1233
Company Name	Appointment Type	Status	Active Date
INDEMNITY INSURANCE COMPANY OF NORTH AMERICA	Casualty	Active	03/08/2021
	Property	Active	03/08/2021
492
Company Name	Appointment Type	Status	Active Date
OHIO CASUALTY INSURANCE COMPANY, THE	Casualty	Active	10/07/2008
	Property	Active	10/07/2008
1776
Company Name	Appointment Type	Status	Active Date
OHIO SECURITY INSURANCE COMPANY	Casualty	Active	10/07/2008
	Property	Active	10/07/2008
715
Company Name	Appointment Type	Status	Active Date
WEST AMERICAN INSURANCE COMPANY	Casualty	Active	10/07/2008
	Property	Active	10/07/2008

row(s) 1 - 16 of 16

Organization	Association Type	Type	Beg dte	End dte
ALLEN FINANCIAL INSURANCE GROUP	Designated Resp Lic Prdcr	Agency	09/15/2020	-

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