DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Hussin, Therese L	DOIID	696854	NAIC NPN	6528371

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	1/8/2009	10/31/2012
Inactive	Non Resident	Agent	Property	1/8/2009	10/31/2012
* 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 Connect Property and Casualty Insurance Company	622403	Agent - Casualty	1/16/2009	2/15/2012
Inactive	American Family Connect Property and Casualty Insurance Company	622403	Agent - Property	1/16/2009	2/15/2012
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	11/10/2010	10/31/2012
Inactive	American Modern Home Insurance Company	300791	Agent - Property	11/10/2010	10/31/2012
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	11/10/2010	10/31/2012
Inactive	American Modern Select Insurance Company	581481	Agent - Property	11/10/2010	10/31/2012
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	11/10/2010	10/31/2012
Inactive	American Southern Home Insurance Company	626276	Agent - Property	11/10/2010	10/31/2012
Inactive	RLI Insurance Company	301217	Agent - Casualty	2/23/2011	10/31/2012
Inactive	RLI Insurance Company	301217	Agent - Property	2/23/2011	10/31/2012

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 - Casualty	3/9/2009	1/18/2012
Inactive	American Family Connect Insurance Agency, Inc.	619157	Agent - Property	3/9/2009	1/18/2012