Individual Information

PETER PAUL FOLLESE

FOREST LAKE, MN 55025

Active

s.barron@mynationalbroker.com

02/07/2019

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3413853	02/07/2019	Active	02/07/2019	02/29/2028

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	02/07/2019	Active	02/07/2019
Health	05/28/2024	Active	05/28/2024
Life	02/07/2019	Active	02/07/2019
Property	02/07/2019	Active	02/07/2019

Company Name	Appointment Type	Status	Active Date
1645
ALLIED PROPERTY AND CASUALTY INSURANCE COMPANY	Casualty	Active	04/04/2021
	Property	Active	04/04/2021
1646
Company Name	Appointment Type	Status	Active Date
AMCO INSURANCE COMPANY	Casualty	Active	04/04/2021
	Property	Active	04/04/2021
339
Company Name	Appointment Type	Status	Active Date
CINCINNATI LIFE INSURANCE COMPANY, THE	Life	Active	01/10/2023
1647
Company Name	Appointment Type	Status	Active Date
DEPOSITORS INSURANCE COMPANY	Casualty	Active	04/04/2021
	Property	Active	04/04/2021
214
Company Name	Appointment Type	Status	Active Date
EMC NATIONAL LIFE COMPANY	Life	Active	02/21/2019
1236
Company Name	Appointment Type	Status	Active Date
NATIONWIDE AGRIBUSINESS INSURANCE COMPANY	Casualty	Active	04/04/2021
	Property	Active	04/04/2021
461
Company Name	Appointment Type	Status	Active Date
NATIONWIDE MUTUAL INSURANCE COMPANY	Casualty	Active	04/04/2021
	Property	Active	04/04/2021
1302
Company Name	Appointment Type	Status	Active Date
PROGRESSIVE NORTHERN INSURANCE COMPANY	Casualty	Active	04/11/2022
	Property	Active	04/11/2022
608
Company Name	Appointment Type	Status	Active Date
STANDARD FIRE INSURANCE COMPANY (THE)	Casualty	Active	06/10/2021
	Property	Active	06/10/2021
1261
Company Name	Appointment Type	Status	Active Date
UNITED FINANCIAL CASUALTY COMPANY	Casualty	Active	04/11/2022
	Property	Active	04/11/2022
672
Company Name	Appointment Type	Status	Active Date
UNITED OF OMAHA LIFE INSURANCE COMPANY	Health	Active	05/29/2024
	Life	Active	05/16/2023

row(s) 1 - 20 of 20

Organization	Association Type	Type	Beg dte	End dte
NATIONAL INSURANCE BROKERS LLC	Designated Resp Lic Prdcr	Agency	12/21/2022	-

1 - 1