DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Nelsen, Penny Larae	DOIID	501222	NAIC NPN	766155

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	1/11/2000	9/5/2012
Inactive	Non Resident	Agent	Life	1/11/2000	9/5/2012
* 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 - Health	3/24/2006	7/29/2010
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	3/24/2006	7/29/2010
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	9/9/2008	11/16/2011
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	9/9/2008	11/16/2011
Inactive	Liberty Life Insurance Company	301542	Agent - Health	10/3/2005	6/30/2006
Inactive	Liberty Life Insurance Company	301542	Agent - Life	10/3/2005	6/30/2006
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	6/29/2004	3/22/2005
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	6/29/2004	3/22/2005
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	8/25/2008	9/5/2012
Inactive	Principal Life Insurance Company	300129	Agent - Health	2/15/2007	2/13/2009
Inactive	Principal Life Insurance Company	300129	Agent - Life	2/15/2007	12/8/2008
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	5/24/2011	3/7/2012
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	5/24/2011	3/7/2012
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	9/9/2008	7/28/2009
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	9/9/2008	7/28/2009

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	2/11/2005
Inactive	Financial Insurance Services, Inc.	514710	Agent - Health	10/22/2001	2/11/2005
Inactive	QBE First Enterprises LLC	610980	Agent - Life	1/30/2007	2/13/2012
Inactive	QBE First Enterprises LLC	610980	Agent - Health	1/30/2007	2/13/2012