DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Van Fossen, Llyssa	DOIID	939172	NAIC NPN	18218689

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	12/8/2016		9/30/2024
Active	Non Resident	Agent	Property	12/8/2016		9/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	07/15/2024	09/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Casualty	3/1/2022	7/5/2022
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Property	3/1/2022	7/5/2022
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	9/27/2023
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	9/27/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	NBS Insurance Agency Inc	515576	Agent - Property	9/27/2023
Active	NBS Insurance Agency Inc	515576	Agent - Casualty	9/27/2023
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Property	9/27/2023	9/29/2023
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Casualty	9/27/2023	9/29/2023