DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lacy III, Frank Burbridge	DOIID	393677	NAIC NPN	7210226

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	8/26/1964	12/1/2000
Inactive	Resident	Agent	Life	8/26/1964	12/1/2000
Inactive	Resident	Agent	General Lines	1/28/1985	8/15/2000
* 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	Equitable Financial Life Insurance Company	300808	Agent - Health	9/17/1987	3/31/1997
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	9/17/1987	3/31/1997
Inactive	Principal Life Insurance Company	300129	Agent - Health	11/12/1965	12/1/2000
Inactive	Principal Life Insurance Company	300129	Agent - Life	11/12/1965	12/1/2000
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	8/26/1964	12/1/2000
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	8/26/1964	12/1/2000
Inactive	Reliance Insurance Company	300785	Agent - General Lines	8/10/1992	8/15/2000
Inactive	State Automobile Mutual Insurance Company	301824	Agent - General Lines	1/28/1985	3/31/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Higgins Insurance Inc.	399505	Agent - General Lines	4/6/1987	8/15/2000
Inactive	Higgins Insurance Inc.	399505	Agent - Life	4/6/1987	12/1/2000
Inactive	Higgins Insurance Inc.	399505	Agent - Health	4/6/1987	12/1/2000