DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Petersen, Sharon Jean	DOIID	328686	NAIC NPN	2849219

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	12/9/1999	8/31/2012
Inactive	Non Resident	Agent	Health	12/9/1999	8/31/2012
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	4/22/2010	6/17/2011
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	7/21/2004	4/28/2011
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	7/21/2004	4/28/2011
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	4/20/2005	1/21/2008
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	7/29/2004	8/31/2012
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	12/9/1999	5/6/2004
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	12/9/1999	5/6/2004
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	3/30/2010	4/14/2011
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	3/30/2010	4/14/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Financial Insurance Services, Inc.	514710	Agent - Life	10/22/2001	4/5/2004
Inactive	Financial Insurance Services, Inc.	514710	Agent - Health	10/22/2001	4/5/2004