DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Burckhart, Sydney Pearl	DOIID	1132968	NAIC NPN	19888962

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	5/5/2021		7/31/2027
Active	Non Resident	Agent	Casualty	5/5/2021		7/31/2027
* 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
Agent	05/15/2025	07/31/2025	05/06/2025	05/06/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Independence American Insurance Company	524747	Agent - Casualty	9/10/2023
Active	Independence American Insurance Company	524747	Agent - Property	9/10/2023
Active	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	5/20/2021
Active	Liberty Mutual Fire Insurance Company	301913	Agent - Property	5/20/2021
Active	United States Fire Insurance Company	582240	Agent - Casualty	5/17/2021
Active	United States Fire Insurance Company	582240	Agent - Property	5/17/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	PTZ Insurance Agency LTD	695420	Agent - Casualty	12/5/2022
Active	PTZ Insurance Agency LTD	695420	Agent - Property	12/5/2022