DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burbank, Amber Rose	DOIID	1026789	NAIC NPN	9255030

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	1/28/2019	5/31/2023
Inactive	Non Resident	Agent	Property	1/28/2019	5/31/2023
* 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	Bristol West Insurance Company	301655	Agent - Casualty	7/21/2021	5/31/2023
Inactive	Bristol West Insurance Company	301655	Agent - Property	7/21/2021	5/31/2023
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	7/21/2021	5/31/2023
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	7/21/2021	5/31/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Texas Wasatch Insurance Services LP	990805	Agent - Casualty	11/19/2021	5/31/2023
Inactive	Texas Wasatch Insurance Services LP	990805	Agent - Property	11/19/2021	5/31/2023