DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bengtson, Bradley R	DOIID	638932	NAIC NPN	7678732

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	1/13/2010	12/27/2010
Inactive	Non Resident	Agent	Property	1/13/2010	12/27/2010
Inactive	Non Resident	Agent	Personal Lines	9/6/2006	12/27/2010
* 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	Nationwide Mutual Insurance Company	301749	Agent - Casualty	1/27/2010	12/27/2010
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Personal Lines	3/16/2007	1/27/2010
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	1/27/2010	12/27/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Personal Lines	3/16/2007	1/27/2010
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Property	2/4/2010	12/27/2010
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Casualty	2/4/2010	12/27/2010