DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Nelson, Ann Burkley	DOIID	503807	NAIC NPN	2342011

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	8/15/2000	1/31/2012
Inactive	Non Resident	Agent	General Lines	3/27/2000	8/15/2000
Inactive	Non Resident	Agent	Casualty	8/15/2000	1/31/2012
* 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	Grange Indemnity Insurance Company	300793	Agent - Casualty	4/20/2004	1/31/2012
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	4/20/2004	1/31/2012
Inactive	Grange Insurance Company	300234	Agent - Casualty	4/20/2004	1/31/2012
Inactive	Grange Insurance Company	300234	Agent - Property	4/20/2004	1/31/2012
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	2/25/2008	1/31/2012
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	2/25/2008	1/31/2012
Inactive	Ohio Farmers Insurance Company	301667	Agent - Casualty	2/22/2008	11/4/2009
Inactive	Ohio Farmers Insurance Company	301667	Agent - Property	2/22/2008	11/4/2009
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	4/20/2004	1/31/2012
Inactive	Trustgard Insurance Company	300104	Agent - Property	4/20/2004	1/31/2012
Inactive	Westfield Insurance Company	301950	Agent - Casualty	8/15/2000	1/31/2012
Inactive	Westfield Insurance Company	301950	Agent - General Lines	3/27/2000	8/15/2000
Inactive	Westfield Insurance Company	301950	Agent - Property	8/15/2000	1/31/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Westfield Services Inc	396034	Agent - General Lines	7/10/2000	8/15/2000
Inactive	Westfield Services Inc	396034	Agent - Property	8/15/2000	1/31/2012
Inactive	Westfield Services Inc	396034	Agent - Casualty	8/15/2000	1/31/2012