DEPARTMENT OF INSURANCE

Affiliations

Name	Burks II, G. Richard	DOIID	393856	NAIC NPN	3313706

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Denied	Resident	Agent	Variable Life and Variable Annuities
Inactive	Resident	Agent	Life	8/24/1978	10/1/2023
Inactive	Resident	Agent	General Lines	8/24/1978	8/15/2000
Inactive	Resident	Agent	Casualty	8/15/2000	10/1/2023
Inactive	Resident	Agent	Health	8/24/1978	10/1/2023
Inactive	Resident	Agent	Property	8/15/2000	10/1/2023
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Life Insurance Company	301140	Agent - Health	6/4/1996	10/24/2002
Inactive	Aetna Life Insurance Company	301140	Agent - Life	6/4/1996	10/24/2002
Inactive	All America Insurance Company	300078	Agent - Casualty	11/2/2017	5/15/2023
Inactive	All America Insurance Company	300078	Agent - Property	11/2/2017	5/15/2023
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Casualty	8/15/2000	12/2/2004
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - General Lines	4/24/1986	8/15/2000
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Property	8/15/2000	12/2/2004
Inactive	American Economy Insurance Company	300315	Agent - Casualty	8/15/2000	10/15/2021
Inactive	American Economy Insurance Company	300315	Agent - General Lines	8/24/1978	8/15/2000
Inactive	American Economy Insurance Company	300315	Agent - Property	8/15/2000	10/15/2021
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	10/7/2008	10/15/2021
Inactive	American Fire and Casualty Company	300567	Agent - Property	10/7/2008	10/15/2021
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	10/14/2002	10/1/2023
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Property	10/14/2002	10/1/2023
Inactive	American Interstate Insurance Company	301092	Agent - Casualty	3/6/2009	10/1/2023
Inactive	American Interstate Insurance Company	301092	Agent - Property	3/6/2009	10/1/2023
Inactive	American Select Insurance Company	301229	Agent - Casualty	3/23/2001	8/26/2009
Inactive	American Select Insurance Company	301229	Agent - Property	3/23/2001	8/26/2009
Inactive	American States Insurance Company	301230	Agent - Casualty	8/15/2000	10/15/2021
Inactive	American States Insurance Company	301230	Agent - General Lines	8/24/1978	8/15/2000
Inactive	American States Insurance Company	301230	Agent - Property	8/15/2000	10/15/2021
Inactive	American States Life Insurance Company	301884	Agent - Health	8/24/1978	12/4/2001
Inactive	American States Life Insurance Company	301884	Agent - Life	8/24/1978	12/4/2001
Inactive	American States Preferred Insurance Company	300609	Agent - Casualty	8/15/2000	5/18/2011
Inactive	American States Preferred Insurance Company	300609	Agent - General Lines	3/29/1988	8/15/2000
Inactive	American States Preferred Insurance Company	300609	Agent - Property	8/15/2000	5/18/2011
Inactive	American Zurich Insurance Company	300592	Agent - Casualty	10/14/2002	10/1/2023
Inactive	American Zurich Insurance Company	300592	Agent - Property	10/14/2002	10/1/2023
Inactive	Assurance Company of America	300432	Agent - Casualty	10/14/2002	1/22/2014
Inactive	Assurance Company of America	300432	Agent - Property	10/14/2002	1/22/2014
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - General Lines	3/1/2000	8/15/2000
Inactive	Blackboard Insurance Company	301640	Agent - Casualty	10/14/2002	11/30/2007
Inactive	Blackboard Insurance Company	301640	Agent - Property	10/14/2002	11/30/2007
Inactive	Bridgefield Casualty Insurance Company	500013	Agent - Casualty	2/19/2007	12/18/2015
Inactive	Central Mutual Insurance Company	300965	Agent - Casualty	11/2/2017	5/15/2023
Inactive	Central Mutual Insurance Company	300965	Agent - Property	11/2/2017	5/15/2023
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	4/29/2004	6/17/2016
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - General Lines	5/5/1997	8/15/2000
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	4/29/2004	6/17/2016
Inactive	Cincinnati Casualty Company (The)	300308	Agent - Casualty	2/6/2016	10/1/2023
Inactive	Cincinnati Casualty Company (The)	300308	Agent - Property	2/6/2016	10/1/2023
Inactive	Cincinnati Indemnity Company (The)	301566	Agent - Casualty	2/6/2016	10/1/2023
Inactive	Cincinnati Indemnity Company (The)	301566	Agent - Property	2/6/2016	10/1/2023
Inactive	Cincinnati Insurance Company	301298	Agent - Casualty	2/6/2016	10/1/2023
Inactive	Cincinnati Insurance Company	301298	Agent - Property	2/6/2016	10/1/2023
Inactive	Colonial American Casualty & Surety Company	300769	Agent - Casualty	10/14/2002	10/1/2023
Inactive	Colonial American Casualty & Surety Company	300769	Agent - Property	10/14/2002	10/1/2023
Inactive	Commercial Insurance Company of Newark, New Jersey	300328	Agent - General Lines	2/5/1997	3/31/1998
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	10/7/2008	10/1/2023
Inactive	Consolidated Insurance Company	300943	Agent - Property	10/7/2008	10/1/2023
Inactive	Continental Casualty Company	301019	Agent - Casualty	8/15/2000	12/2/2004
Inactive	Continental Casualty Company	301019	Agent - General Lines	4/24/1986	8/15/2000
Inactive	Continental Casualty Company	301019	Agent - Property	8/15/2000	12/2/2004
Inactive	Continental Insurance Company (The)	301242	Agent - Casualty	8/15/2000	9/3/2002
Inactive	Continental Insurance Company (The)	301242	Agent - General Lines	1/31/1997	8/15/2000
Inactive	Continental Insurance Company (The)	301242	Agent - Property	8/15/2000	9/3/2002
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	2/27/2014	5/4/2023
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	2/27/2014	5/4/2023
Inactive	Farmington Casualty Company	301137	Agent - General Lines	3/7/1990	3/31/1996
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - Casualty	8/15/2000	9/3/2002
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - General Lines	2/1/1997	8/15/2000
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - Property	8/15/2000	9/3/2002
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Casualty	10/14/2002	10/1/2023
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Property	10/14/2002	10/1/2023
Inactive	Firemen's Insurance Company of Newark, New Jersey	300247	Agent - General Lines	2/4/1997	3/31/1998
Inactive	First National Insurance Company of America	301690	Agent - Casualty	8/15/2000	10/15/2021
Inactive	First National Insurance Company of America	301690	Agent - General Lines	4/13/1987	8/15/2000
Inactive	First National Insurance Company of America	301690	Agent - Property	8/15/2000	10/15/2021
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	11/13/2012	4/17/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	11/13/2012	4/17/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	11/13/2012	4/17/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	11/13/2012	4/17/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	11/13/2012	4/17/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	11/13/2012	4/17/2018
Inactive	General Insurance Company of America	300261	Agent - Casualty	8/15/2000	10/15/2021
Inactive	General Insurance Company of America	300261	Agent - General Lines	4/13/1987	8/15/2000
Inactive	General Insurance Company of America	300261	Agent - Property	8/15/2000	10/15/2021
Inactive	Glens Falls Insurance Company (The)	301922	Agent - General Lines	2/20/1997	12/30/1999
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	11/26/2007	10/1/2023
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	11/26/2007	10/1/2023
Inactive	Grange Insurance Company	300234	Agent - Casualty	11/26/2007	10/1/2023
Inactive	Grange Insurance Company	300234	Agent - Property	11/26/2007	10/1/2023
Inactive	Grange Life Insurance Company	300128	Agent - Health	11/26/2007	12/22/2016
Inactive	Grange Life Insurance Company	300128	Agent - Life	11/26/2007	12/22/2016
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	11/26/2007	10/1/2023
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	11/26/2007	10/1/2023
Inactive	Great American Insurance Company	301586	Agent - Casualty	2/8/2013	4/25/2019
Inactive	Great American Insurance Company	301586	Agent - Property	2/8/2013	4/25/2019
Inactive	Indiana Insurance Company	301909	Agent - Casualty	10/7/2008	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	10/7/2008	2/3/2023
Inactive	Jewelers Mutual Insurance Company, SI	301935	Agent - Casualty	2/19/2002	5/13/2019
Inactive	Jewelers Mutual Insurance Company, SI	301935	Agent - Property	2/19/2002	5/13/2019
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	10/23/1997	11/4/2004
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	10/23/1997	11/4/2004
Inactive	Kansas City Fire and Marine Insurance Company	301936	Agent - General Lines	2/4/1997	12/30/1999
Inactive	Kentucky Medical Insurance Company	301260	Agent - General Lines	5/25/1995	8/15/2000
Inactive	Maryland Casualty Company	301719	Agent - Casualty	10/14/2002	1/22/2014
Inactive	Maryland Casualty Company	301719	Agent - Property	10/14/2002	1/22/2014
Denied	Medical Protective Company (The)	301207	Agent - Casualty
Denied	Medical Protective Company (The)	301207	Agent - Property
Inactive	Meridian Security Insurance Company	300423	Agent - Casualty	11/2/2020	10/1/2023
Inactive	Meridian Security Insurance Company	300423	Agent - Property	11/2/2020	10/1/2023
Inactive	Milbank Insurance Company	925185	Agent - Casualty	3/11/2020	10/1/2023
Inactive	Milbank Insurance Company	925185	Agent - Property	3/11/2020	10/1/2023
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Casualty	8/15/2000	12/2/2004
Inactive	National Fire Insurance Company of Hartford	301063	Agent - General Lines	4/24/1986	8/15/2000
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Property	8/15/2000	12/2/2004
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	10/7/2008	10/1/2023
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	10/7/2008	10/1/2023
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	10/14/2002	1/22/2014
Inactive	Northern Insurance Company of New York	301317	Agent - Property	10/14/2002	1/22/2014
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	10/7/2008	5/27/2022
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	10/7/2008	5/27/2022
Inactive	Ohio Farmers Insurance Company	301667	Agent - Casualty	8/15/2000	8/26/2009
Inactive	Ohio Farmers Insurance Company	301667	Agent - General Lines	6/7/1993	8/15/2000
Inactive	Ohio Farmers Insurance Company	301667	Agent - Property	8/15/2000	8/26/2009
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	12/4/2022	10/1/2023
Inactive	Ohio Security Insurance Company	300622	Agent - Property	12/4/2022	10/1/2023
Inactive	Old Guard Insurance Company	533854	Agent - Casualty	6/1/2021	6/10/2021
Inactive	Old Guard Insurance Company	533854	Agent - Property	6/1/2021	6/10/2021
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	10/7/2008	10/1/2023
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	10/7/2008	10/1/2023
Inactive	Peerless Insurance Company	301910	Agent - Casualty	10/7/2008	10/1/2023
Inactive	Peerless Insurance Company	301910	Agent - Property	10/7/2008	10/1/2023
Denied	Protective Life Insurance Company	300638	Agent - Variable Life and Variable Annuities
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	8/15/2000	10/1/2023
Inactive	SAFECO Insurance Company of America	300159	Agent - General Lines	4/13/1987	8/15/2000
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	8/15/2000	10/1/2023
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	8/15/2000	5/27/2022
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - General Lines	4/13/1987	8/15/2000
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	8/15/2000	5/27/2022
Inactive	SAFECO National Insurance Company	300989	Agent - Casualty	8/15/2000	5/17/2011
Inactive	SAFECO National Insurance Company	300989	Agent - General Lines	2/13/1992	8/15/2000
Inactive	SAFECO National Insurance Company	300989	Agent - Property	8/15/2000	5/17/2011
Inactive	Silver Oak Casualty, Inc.	517101	Agent - Casualty	3/6/2009	11/23/2010
Inactive	Silver Oak Casualty, Inc.	517101	Agent - Property	3/6/2009	11/23/2010
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - General Lines	3/16/1983	8/12/1996
Inactive	St. Paul Mercury Insurance Company	300783	Agent - General Lines	3/16/1983	8/12/1996
Inactive	Standard Fire Insurance Company (The)	301068	Agent - General Lines	3/1/2000	8/15/2000
Inactive	Star Insurance Company	301553	Agent - Casualty	8/15/2000	4/30/2003
Inactive	Star Insurance Company	301553	Agent - General Lines	12/28/1999	8/15/2000
Inactive	Star Insurance Company	301553	Agent - Property	8/15/2000	4/30/2003
Inactive	State Auto Property & Casualty Insurance Company	301953	Agent - Casualty	3/6/2020	10/1/2023
Inactive	State Auto Property & Casualty Insurance Company	301953	Agent - Property	3/6/2020	10/1/2023
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	4/30/2021	10/1/2023
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	4/30/2021	10/1/2023
Inactive	Symetra Life Insurance Company	301691	Agent - Health	11/1/1998	12/4/2001
Inactive	Symetra Life Insurance Company	301691	Agent - Life	11/1/1998	12/4/2001
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	4/29/2004	6/17/2016
Inactive	The Phoenix Insurance Company	301502	Agent - General Lines	4/28/1997	8/15/2000
Inactive	The Phoenix Insurance Company	301502	Agent - Property	4/29/2004	6/17/2016
Inactive	Transcontinental Insurance Company	301731	Agent - Casualty	8/15/2000	12/2/2004
Inactive	Transcontinental Insurance Company	301731	Agent - General Lines	4/24/1986	8/15/2000
Inactive	Transcontinental Insurance Company	301731	Agent - Property	8/15/2000	12/2/2004
Inactive	Transportation Insurance Company	301575	Agent - Casualty	8/15/2000	12/2/2004
Inactive	Transportation Insurance Company	301575	Agent - General Lines	4/24/1986	8/15/2000
Inactive	Transportation Insurance Company	301575	Agent - Property	8/15/2000	12/2/2004
Inactive	TravCo Insurance Company	301828	Agent - General Lines	4/24/1997	8/15/2000
Inactive	Travelers Casualty Company of Connecticut	301505	Agent - General Lines	1/29/1991	3/31/1996
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - General Lines	8/18/1999	8/15/2000
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	4/29/2004	6/17/2016
Inactive	Travelers Casualty and Surety Company	301067	Agent - General Lines	4/12/1982	8/15/2000
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	4/29/2004	6/17/2016
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - General Lines	1/28/1991	3/31/1996
Inactive	Travelers Commercial Casualty Company	301695	Agent - General Lines	8/18/1999	8/15/2000
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	4/29/2004	6/17/2016
Inactive	Travelers Indemnity Company (The)	301855	Agent - General Lines	5/2/1997	8/15/2000
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	4/29/2004	6/17/2016
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	4/29/2004	6/17/2016
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - General Lines	4/28/1997	8/15/2000
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	4/29/2004	6/17/2016
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	4/29/2004	6/17/2016
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - General Lines	4/25/1997	8/15/2000
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	4/29/2004	6/17/2016
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	4/29/2004	6/17/2016
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	4/29/2004	6/17/2016
Inactive	Travelers Property Casualty Insurance Company	301508	Agent - General Lines	1/24/1991	3/31/1996
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	11/26/2007	10/1/2023
Inactive	Trustgard Insurance Company	300104	Agent - Property	11/26/2007	10/1/2023
Inactive	Valley Forge Insurance Company	301052	Agent - Casualty	8/15/2000	12/2/2004
Inactive	Valley Forge Insurance Company	301052	Agent - General Lines	4/24/1986	8/15/2000
Inactive	Valley Forge Insurance Company	301052	Agent - Property	8/15/2000	12/2/2004
Inactive	Voya Retirement Insurance and Annuity Company	300643	Agent - Health	10/29/1984	11/15/2008
Inactive	Voya Retirement Insurance and Annuity Company	300643	Agent - Life	10/29/1984	11/15/2008
Inactive	West American Insurance Company	301112	Agent - Casualty	10/7/2008	5/27/2022
Inactive	West American Insurance Company	301112	Agent - Property	10/7/2008	5/27/2022
Inactive	Westfield Champion Insurance Company	1054839	Agent - Casualty	6/1/2021	6/10/2021
Inactive	Westfield Champion Insurance Company	1054839	Agent - Property	6/1/2021	6/10/2021
Inactive	Westfield Insurance Company	301950	Agent - Casualty	8/15/2000	5/19/2023
Inactive	Westfield Insurance Company	301950	Agent - General Lines	6/7/1993	8/15/2000
Inactive	Westfield Insurance Company	301950	Agent - Property	8/15/2000	5/19/2023
Inactive	Westfield National Insurance Company	301036	Agent - Casualty	8/15/2000	8/26/2009
Inactive	Westfield National Insurance Company	301036	Agent - General Lines	6/7/1993	8/15/2000
Inactive	Westfield National Insurance Company	301036	Agent - Property	8/15/2000	8/26/2009
Inactive	Westfield Premier Insurance Company	1055055	Agent - Casualty	6/1/2021	6/10/2021
Inactive	Westfield Premier Insurance Company	1055055	Agent - Property	6/1/2021	6/10/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Casualty	6/1/2021	6/10/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Property	6/1/2021	6/10/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Casualty	6/1/2021	6/10/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Property	6/1/2021	6/10/2021
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	10/14/2002	10/1/2023
Inactive	Zurich American Insurance Company	301121	Agent - Property	10/14/2002	10/1/2023
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	10/14/2002	10/1/2023
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Property	10/14/2002	10/1/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Assuredpartners Nl, Llc	762387	Agent - Life
Denied	Assuredpartners Nl, Llc	762387	Agent - Health
Inactive	Assuredpartners Nl, Llc	762387	Agent - Property	8/16/2018	4/11/2023
Inactive	Assuredpartners Nl, Llc	762387	Agent - Casualty	8/16/2018	4/11/2023
Inactive	Assuredpartners Of Kentucky LLC	798010	Agent - Life	2/2/2016	12/22/2016
Inactive	Assuredpartners Of Kentucky LLC	798010	Agent - Health	2/2/2016	12/22/2016
Inactive	Assuredpartners Of Kentucky LLC	798010	Agent - Property	2/2/2016	5/23/2018
Inactive	Assuredpartners Of Kentucky LLC	798010	Agent - Casualty	2/2/2016	5/23/2018
Inactive	Plantside Holdings, Inc.	398775	Agent - General Lines	3/29/1982	8/15/2000
Inactive	Plantside Holdings, Inc.	398775	Agent - Life	3/29/1982	12/22/2016
Inactive	Plantside Holdings, Inc.	398775	Agent - Health	3/29/1982	12/22/2016
Inactive	Plantside Holdings, Inc.	398775	Agent - Property	8/15/2000	2/12/2018
Inactive	Plantside Holdings, Inc.	398775	Agent - Casualty	8/15/2000	2/12/2018