DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Wagner, Kelsie Rose	DOIID	928164	NAIC NPN	18089234

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	9/7/2016	12/31/2017
Inactive	Non Resident	Agent	Property	9/7/2016	12/31/2017
Inactive	Non Resident	Staff Adjuster	Property & Casualty	1/9/2018	12/31/2021
* 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 Home Insurance Company	301817	Agent - Casualty	9/9/2016	8/2/2017
Inactive	American Family Home Insurance Company	301817	Agent - Property	9/9/2016	8/2/2017
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	9/9/2016	8/2/2017
Inactive	American Modern Home Insurance Company	300791	Agent - Property	9/9/2016	8/2/2017
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	9/9/2016	8/2/2017
Inactive	American Modern Select Insurance Company	581481	Agent - Property	9/9/2016	8/2/2017
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	9/9/2016	8/2/2017
Inactive	American Southern Home Insurance Company	626276	Agent - Property	9/9/2016	8/2/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Atlas Ins Agcy Inc	523813	Agent - Property	9/15/2016	8/2/2017
Inactive	Atlas Ins Agcy Inc	523813	Agent - Casualty	9/15/2016	8/2/2017