DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Van Den Bos, Paul	DOIID	911128	NAIC NPN	13035980

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Personal Lines	3/29/2016		6/30/2025
* 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
Active	Nationwide Mutual Insurance Company	301749	Agent - Personal Lines	4/1/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Nationwide Sales Solutions Inc	631821	Agent - Personal Lines	4/14/2016