DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Jongema, Ann Marie	DOIID	876666	NAIC NPN	3392575

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	4/30/2015	2/28/2017
Inactive	Non Resident	Agent	Casualty	4/30/2015	2/28/2017
Active	Non Resident	Independent Adjuster	Property & Casualty	9/17/2019		2/28/2027
* 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	State Farm Fire and Casualty Company	301809	Agent - Casualty	5/28/2015	4/4/2016
Inactive	State Farm Fire and Casualty Company	301809	Agent - Property	5/28/2015	4/4/2016
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	5/28/2015	4/4/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Broadspire Services, Inc.	396187	Independent Adjuster - Property & Casualty	12/11/2019