DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mellberg, Joshua David	DOIID	726508	NAIC NPN	7683100

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	11/20/2015		1/31/2026
Active	Non Resident	Agent	Life	4/14/2010		1/31/2026
* 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	Allianz Life Insurance Company of North America	301791	Agent - Life	5/30/2014	9/2/2014
Inactive	American Equity Investment Life Insurance Company	300389	Agent - Life	11/10/2014	12/15/2022
Active	American General Life Insurance Company	301585	Agent - Health	1/28/2016
Active	American General Life Insurance Company	301585	Agent - Life	5/25/2015
Active	American National Insurance Company	301861	Agent - Life	12/30/2015
Active	Athene Annuity and Life Company	301893	Agent - Life	7/16/2016
Inactive	EquiTrust Life Insurance Company	502870	Agent - Life	1/5/2015	10/9/2019
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	4/14/2015
Active	Forethought Life Insurance Company	301407	Agent - Life	9/11/2014
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/11/2016	12/14/2016
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	6/30/2011	4/2/2013
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Life	9/5/2012	1/3/2021
Active	Nassau Life and Annuity Company	513671	Agent - Life	2/10/2021
Inactive	National Western Life Insurance Company	301515	Agent - Life	12/3/2012	10/22/2019
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	9/10/2015	12/10/2018
Inactive	Pacific Life Insurance Company	301848	Agent - Health	5/21/2018	12/6/2019
Inactive	Pacific Life Insurance Company	301848	Agent - Life	5/21/2018	12/6/2019
Inactive	Security Benefit Life Insurance Company	300583	Agent - Life	3/22/2011	12/17/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Joshua David Mellberg LLC	859326	Agent - Life	11/3/2014
Active	Joshua David Mellberg LLC	859326	Agent - Health	1/15/2016