DEPARTMENT OF INSURANCE

Affiliations

Name	Jones, Mary H.	DOIID	524860	NAIC NPN	3231952

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	8/13/2001	4/30/2004
Inactive	Non Resident	Agent	Life	5/11/2001	4/30/2004
Inactive	Non Resident	Agent	Health	5/11/2001	4/30/2004
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nationwide Life Insurance Company	300495	Agent - Variable Life and Variable Annuities	8/13/2001	4/30/2004
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	11/5/2001	4/30/2004
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	11/5/2001	4/30/2004
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	5/11/2001	4/30/2004
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	5/11/2001	4/30/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Variable Life and Variable Annuities	8/13/2001	3/7/2003