DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Faulkner, Phyllis Yvonne	DOIID	310057	NAIC NPN	7160173

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	12/13/1996	7/1/1998
Inactive	Resident	Agent	Life	12/13/1996	7/1/1998
Inactive	Resident	Agent	General Lines	5/4/1995	7/1/1998
* 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	All American Life Insurance Company	300702	Agent - Health	12/13/1996	7/1/1998
Inactive	All American Life Insurance Company	300702	Agent - Life	12/13/1996	7/1/1998
Inactive	American Fire and Casualty Company	300567	Agent - General Lines	11/21/1996	7/1/1998
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	5/4/1995	7/11/1996
Inactive	Ohio Casualty Insurance Company	301492	Agent - General Lines	10/28/1996	7/1/1998
Inactive	Ohio Security Insurance Company	300622	Agent - General Lines	11/21/1996	7/1/1998
Inactive	West American Insurance Company	301112	Agent - General Lines	11/21/1996	7/1/1998

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	R. J. Roberts, Inc.	399902	Agent - General Lines	5/18/1998	7/1/1998
Inactive	R. J. Roberts, Inc.	399902	Agent - Life	4/18/1998	7/1/1998
Inactive	R. J. Roberts, Inc.	399902	Agent - Health	4/18/1998	7/1/1998