DEPARTMENT OF INSURANCE

Affiliations

Name	Haselhorst, Todd Gerard	DOIID	940590	NAIC NPN	3520239

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	12/27/2016	12/31/2017
Inactive	Non Resident	Agent	Property	12/27/2016	12/31/2017
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fairly Consulting Group, LLC	947181	Agent - Property	3/21/2017	12/31/2017
Inactive	Fairly Consulting Group, LLC	947181	Agent - Casualty	3/21/2017	12/31/2017