DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Walter	DOIID	1108517	NAIC NPN	19622594

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Property	11/2/2020		5/31/2024
Pending Replacement	Non Resident	Agent	Casualty	11/2/2020		5/31/2024
* 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	11/4/2020	11/21/2022
Inactive	Bristol West Insurance Company	301655	Agent - Property	11/4/2020	11/21/2022
Inactive	Farmers Insurance Exchange	300336	Agent - Casualty	11/4/2020	11/21/2022
Inactive	Farmers Insurance Exchange	300336	Agent - Property	11/4/2020	11/21/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fx Insurance Agency, LLC	646184	Agent - Casualty	11/4/2020	11/21/2022
Inactive	Fx Insurance Agency, LLC	646184	Agent - Property	11/4/2020	11/21/2022