DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Zoeller-Grissom, Jessica A	DOIID	618951	NAIC NPN	7142120

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	10/31/2005	7/31/2010
Inactive	Non Resident	Agent	Casualty	10/31/2005	7/31/2010
* 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	AMEX Assurance Company	301728	Agent - Casualty	11/3/2005	6/26/2007
Inactive	AMEX Assurance Company	301728	Agent - Property	11/3/2005	6/26/2007
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Casualty	7/7/2006	1/7/2010
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Property	7/7/2006	1/7/2010
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	1/17/2006	7/31/2010
Inactive	American Modern Home Insurance Company	300791	Agent - Property	1/17/2006	7/31/2010
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	1/17/2006	7/31/2010
Inactive	American Modern Select Insurance Company	581481	Agent - Property	1/17/2006	7/31/2010
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	12/7/2005	3/2/2010
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	12/7/2005	3/2/2010
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	12/7/2005	3/2/2010
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	12/7/2005	3/2/2010
Inactive	RLI Insurance Company	301217	Agent - Casualty	1/10/2006	1/7/2010
Inactive	RLI Insurance Company	301217	Agent - Property	1/10/2006	1/7/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Family Connect Insurance Agency, Inc.	619157	Agent - Property	11/10/2005	1/5/2010
Inactive	American Family Connect Insurance Agency, Inc.	619157	Agent - Casualty	11/10/2005	1/5/2010