black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

JACOB SPISAK

PRODUCER NON-RESIDENT

License Number:
PRN441137
Status:
First Licensure:
01/07/2023
Cancel Date:
None

Mailing:
WAXHAW, NC 28173
Phone:
+1 (919) 754-4023
Fax:
+1 (919) 926-4664
Email:
relationdoi@3hcs.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 01/07/2023

Agency

Name Issue Date License Number Expiration Date Cancel Date
RELATION INSURANCE SERVICES OF NORTH CAROLINA INC
01/07/2023 AGN286049

Employer

None.

Authority

Description Issue Date Termination Date Status
CASUALTY 01/07/2023 Active
PROPERTY 01/07/2023 Active

License/Disciplinary Action

None.

ADJUSTER NON-RESIDENT

License Number:
ADN352939
Status:
First Licensure:
04/21/2020
Cancel Date:
04/01/2022
Renewal Date:
04/01/2022

Mailing:
WAXHAW, NC 28173
Phone:
+1 (919) 754-4023
Fax:
+1 (919) 926-4664
Email:
relationdoi@3hcs.com

History

License Type Start Date End Date
ADJUSTER NON-RESIDENT 04/21/2020 03/31/2022

Agency

None.

Authority

Description Issue Date Termination Date Status Additional Information
LIMITED TO HOME STATE 04/21/2020 04/01/2022 Terminated
Designated State:
North Carolina

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
17112536

Other Addresses

Address Type
11215 N COMMUNITY HOUSE RD STE 100
CHARLOTTE, NC 28277-4961
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 05/18/2025 08:16:57 AM