DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Motacek, Domenica	DOIID	838240	NAIC NPN	10510414

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	6/8/2015	1/31/2018
Inactive	Non Resident	Agent	Casualty	4/12/2014	1/31/2018
Inactive	Non Resident	Agent	Property	4/12/2014	1/31/2018
* 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	4/15/2014	5/12/2016
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	4/15/2014	5/12/2016
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	5/7/2014	5/23/2016
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	5/7/2014	5/23/2016

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 - Property	4/15/2014	5/23/2016
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Casualty	4/15/2014	5/23/2016
Denied	Nationwide Sales Solutions Inc	631821	Agent - Life