DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Brock, Buffy Gail	DOIID	314184	NAIC NPN	7162154

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	8/7/2000	9/30/2004
Inactive	Resident	Agent	Credit Life & Health	4/6/1999	8/7/2000
* 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	Southern Financial Life Insurance Company	300664	Agent - Credit Life & Health	4/6/1999	8/7/2000
Inactive	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	8/7/2000	9/30/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Citizens Guaranty Bank	398229	Agent - Credit Life & Health	4/6/1999	8/7/2000
Inactive	Citizens Guaranty Bank	398229	Agent - Limited Line Credit	8/7/2000	2/7/2003