DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Jensen, Holly	DOIID	694537	NAIC NPN	10689071

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Personal Lines	12/14/2011	12/31/2016
Inactive	Non Resident	Agent	Life	12/14/2011	12/31/2016
* 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 Life Insurance Company	300495	Agent - Life	7/20/2012	12/14/2014
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	7/20/2012	12/14/2014
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Personal Lines	1/27/2012	5/21/2015
Inactive	Progressive Casualty Insurance Company	300696	Agent - Personal Lines	1/12/2009	8/3/2010

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	1/30/2012	5/14/2015
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Life	12/3/2013	12/14/2014