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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Independent Adjuster	12/15/2026	02/28/2027

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