DEPARTMENT OF INSURANCE

Affiliations

Name	Hollan, Shelby M	DOIID	364271	NAIC NPN	7197730

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Denied	Resident	Agent	Health
Inactive	Resident	Agent	General Lines	6/23/1997	8/15/2000
Inactive	Resident	Agent	Life	12/2/2008	1/1/2011
Inactive	Resident	Agent	Casualty	3/21/2005	1/1/2011
Inactive	Resident	Agent	Property	3/21/2005	1/1/2011
* 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	AmTrust Insurance Company	300179	Agent - Casualty	3/21/2005	10/14/2009
Inactive	AmTrust Insurance Company	300179	Agent - General Lines	6/5/2000	8/15/2000
Inactive	AmTrust Insurance Company	300179	Agent - Property	3/21/2005	10/14/2009
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	3/24/2005	1/1/2011
Inactive	American Fire and Casualty Company	300567	Agent - Property	3/24/2005	1/1/2011
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	9/8/2007	1/1/2011
Inactive	Consolidated Insurance Company	300943	Agent - Property	9/8/2007	1/1/2011
Inactive	Continental Insurance Company (The)	301242	Agent - Casualty	11/9/2000	9/3/2002
Inactive	Continental Insurance Company (The)	301242	Agent - Property	11/9/2000	11/4/2002
Inactive	First National Insurance Company of America	301690	Agent - Casualty	10/7/2008	1/1/2011
Inactive	First National Insurance Company of America	301690	Agent - Property	10/7/2008	1/1/2011
Inactive	General Insurance Company of America	300261	Agent - Casualty	10/7/2008	1/1/2011
Inactive	General Insurance Company of America	300261	Agent - Property	10/7/2008	1/1/2011
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	3/21/2005	1/1/2011
Inactive	Grange Indemnity Insurance Company	300793	Agent - General Lines	11/12/1997	8/15/2000
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	3/21/2005	1/1/2011
Inactive	Grange Insurance Company	300234	Agent - Casualty	3/21/2005	1/1/2011
Inactive	Grange Insurance Company	300234	Agent - General Lines	6/23/1997	8/15/2000
Inactive	Grange Insurance Company	300234	Agent - Property	3/21/2005	1/1/2011
Inactive	Grange Life Insurance Company	300128	Agent - Life	12/8/2008	1/1/2011
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	1/11/2008	1/1/2011
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	1/11/2008	1/1/2011
Inactive	Indiana Insurance Company	301909	Agent - Casualty	9/8/2007	1/1/2011
Inactive	Indiana Insurance Company	301909	Agent - Property	9/8/2007	1/1/2011
Inactive	Kentucky National Insurance Company	301625	Agent - Casualty	8/15/2000	7/10/2003
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	8/6/1999	8/15/2000
Inactive	Kentucky National Insurance Company	301625	Agent - Property	8/15/2000	7/10/2003
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	9/8/2007	1/1/2011
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	9/8/2007	1/1/2011
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	3/21/2005	1/1/2011
Inactive	Ohio Casualty Insurance Company	301492	Agent - General Lines	9/9/1997	8/15/2000
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	3/21/2005	1/1/2011
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	3/21/2005	1/1/2011
Inactive	Ohio Security Insurance Company	300622	Agent - General Lines	10/4/1999	8/15/2000
Inactive	Ohio Security Insurance Company	300622	Agent - Property	3/21/2005	1/1/2011
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	9/8/2007	1/1/2011
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	9/8/2007	1/1/2011
Inactive	Peerless Insurance Company	301910	Agent - Casualty	9/8/2007	1/1/2011
Inactive	Peerless Insurance Company	301910	Agent - Property	9/8/2007	1/1/2011
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	10/7/2008	1/1/2011
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	10/7/2008	1/1/2011
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	10/7/2008	1/1/2011
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	10/7/2008	1/1/2011
Inactive	Security National Insurance Company	301151	Agent - Casualty	3/21/2005	10/14/2009
Inactive	Security National Insurance Company	301151	Agent - General Lines	6/5/2000	8/15/2000
Inactive	Security National Insurance Company	301151	Agent - Property	3/21/2005	10/14/2009
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	8/15/2000	3/3/2004
Inactive	State Automobile Mutual Insurance Company	301824	Agent - General Lines	4/28/1998	8/15/2000
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	8/15/2000	3/3/2004
Inactive	Trinity Universal Insurance Company	300911	Agent - Casualty	3/21/2005	6/9/2009
Inactive	Trinity Universal Insurance Company	300911	Agent - General Lines	6/5/2000	8/15/2000
Inactive	Trinity Universal Insurance Company	300911	Agent - Property	3/21/2005	6/9/2009
Inactive	West American Insurance Company	301112	Agent - Casualty	3/24/2005	1/1/2011
Inactive	West American Insurance Company	301112	Agent - Property	3/24/2005	1/1/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Roth Wall & Webb Inc	694907	Agent - Property	12/5/2008	1/1/2011
Inactive	Roth Wall & Webb Inc	694907	Agent - Casualty	12/5/2008	1/1/2011
Inactive	Roth Wall & Webb Inc	694907	Agent - Life	12/8/2008	1/1/2011
Inactive	Roth Wall & Webb Incorporated	399180	Agent - Property	3/21/2005	1/1/2011
Inactive	Roth Wall & Webb Incorporated	399180	Agent - Casualty	3/21/2005	1/1/2011