DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Nelsen, Mary K	DOIID	384713	NAIC NPN	245115

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	6/22/2007	1/31/2013
Inactive	Non Resident	Agent	Personal Lines	7/21/2003	1/31/2013
Inactive	Non Resident	Agent	Health	3/6/1995	1/31/2013
Inactive	Non Resident	Agent	Life	3/6/1995	1/31/2013
Inactive	Non Resident	Agent	Casualty	6/22/2007	1/31/2013
* 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	AMEX Assurance Company	301728	Agent - Casualty	8/4/2011	1/2/2013
Inactive	AMEX Assurance Company	301728	Agent - Health	8/4/2011	1/2/2013
Inactive	AMEX Assurance Company	301728	Agent - Property	8/4/2011	1/2/2013
Inactive	Central States Health and Life Company of Omaha	301874	Agent - Health	12/28/2004	11/29/2011
Inactive	Central States Health and Life Company of Omaha	301874	Agent - Life	12/28/2004	11/29/2011
Inactive	Central States Indemnity Company of Omaha	300285	Agent - Casualty	7/13/2007	11/29/2011
Inactive	Central States Indemnity Company of Omaha	300285	Agent - Health	7/13/2007	11/29/2011
Inactive	Central States Indemnity Company of Omaha	300285	Agent - Personal Lines	12/28/2004	11/29/2011
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	3/2/2009	1/31/2013
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	3/2/2009	1/31/2013
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	3/30/2005	1/31/2013
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	3/6/1995	9/1/2004
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	3/6/1995	9/1/2004

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	1/8/2013
Inactive	Financial Insurance Services, Inc.	514710	Agent - Health	10/22/2001	1/8/2013
Inactive	Financial Insurance Services, Inc.	514710	Agent - Casualty	7/20/2007	1/2/2013
Inactive	Financial Insurance Services, Inc.	514710	Agent - Property	8/8/2011	1/2/2013