DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Willis, Jason L	DOIID	694558	NAIC NPN	10693042

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	2/4/2009	8/18/2009
Inactive	Non Resident	Agent	Personal Lines	12/2/2008	8/18/2009
* 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	6/16/2009	8/18/2009
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	6/16/2009	8/18/2009
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Personal Lines	1/7/2009	7/22/2009

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	1/20/2009	7/22/2009
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Life	6/16/2009	7/23/2009