DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Tholen, Timothy	DOIID	1000866	NAIC NPN	17205569

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	7/13/2018		11/30/2024
Active	Non Resident	Agent	Property	7/13/2018		11/30/2024
* 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
Agent	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Liberty Insurance Underwriters Inc.	301391	Agent - Casualty	9/10/2018
Active	Liberty Insurance Underwriters Inc.	301391	Agent - Property	9/10/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Mercer Health & Benefits Administration Llc	656414	Agent - Casualty	1/28/2019
Active	Mercer Health & Benefits Administration Llc	656414	Agent - Property	1/28/2019