DEPARTMENT OF INSURANCE

Affiliations

Name	Anderson, Jon Michael	DOIID	590104	NAIC NPN	8105488

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Administrator	Not Applicable	2/18/2010	5/31/2012
Inactive	Resident	Agent	Life	6/8/2010	6/1/2012
Inactive	Resident	Agent	Variable Life and Variable Annuities	6/4/2004	4/22/2006
Inactive	Resident	Agent	Health	6/8/2010	6/1/2012
* 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	BaltasVision, LLC	598376	Agent - Health	6/16/2010	6/1/2012
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	12/23/2004	4/22/2006
Inactive	Everlake Life Insurance Company	300873	Agent - Life	6/9/2004	4/22/2006
Inactive	Everlake Life Insurance Company	300873	Agent - Variable Life and Variable Annuities	6/9/2004	4/22/2006
Inactive	Genworth Life Insurance Company	300623	Agent - Health	11/23/2004	4/22/2006
Inactive	Genworth Life Insurance Company	300623	Agent - Life	11/23/2004	4/22/2006
Inactive	Glenbrook Life and Annuity Company	301384	Agent - Life	6/9/2004	1/1/2005
Inactive	Glenbrook Life and Annuity Company	301384	Agent - Variable Life and Variable Annuities	6/9/2004	1/1/2005
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	6/21/2004	4/22/2006
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	6/9/2004	4/22/2006
Inactive	Nationwide Life Insurance Company	300495	Agent - Variable Life and Variable Annuities	6/9/2004	4/22/2006
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	6/9/2004	4/22/2006
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Variable Life and Variable Annuities	6/9/2004	4/22/2006
Inactive	Pacific Life Insurance Company	301848	Agent - Life	6/8/2004	4/22/2006
Inactive	Pacific Life Insurance Company	301848	Agent - Variable Life and Variable Annuities	6/8/2004	4/22/2006
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	6/14/2004	4/22/2006
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	6/14/2004	4/22/2006
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Variable Life and Variable Annuities	6/14/2004	4/22/2006
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	6/14/2004	4/22/2006
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	6/14/2004	4/22/2006
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Variable Life and Variable Annuities	6/14/2004	4/22/2006
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	6/21/2004	4/22/2006
Inactive	Transamerica Life Insurance Company	300571	Agent - Variable Life and Variable Annuities	6/21/2004	4/22/2006
Inactive	Western National Life Insurance Company	300461	Agent - Life	6/7/2004	6/24/2005
Inactive	Western National Life Insurance Company	300461	Agent - Variable Life and Variable Annuities	6/7/2004	6/24/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	The Partners Workplace Solutions Group, Inc.	695818	Agent - Health	6/16/2010	10/27/2010
Denied	The Partners Workplace Solutions Group, Inc.	695818	Agent - Life