DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Johnson, Jeremy Scott	DOIID	612964	NAIC NPN	8550378

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Resident	Agent	Life
Denied	Resident	Agent	Health
Inactive	Resident	Agent	Casualty	10/13/2009	7/1/2011
Inactive	Resident	Agent	Property	10/13/2009	7/1/2011
* 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	American Family Home Insurance Company	301817	Agent - Casualty	11/1/2009	12/10/2010
Inactive	American Family Home Insurance Company	301817	Agent - Property	11/1/2009	12/10/2010
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	11/1/2009	12/13/2010
Inactive	American Modern Select Insurance Company	581481	Agent - Property	11/1/2009	12/13/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CMH Homes, Inc.	398100	Agent - Casualty	11/6/2009	12/13/2010
Inactive	CMH Homes, Inc.	398100	Agent - Property	11/6/2009	12/13/2010