DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Faulkner Jr, Robert David	DOIID	512778	NAIC NPN	7214355

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Limited Line Credit	10/30/2015		7/31/2025
* 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	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	8/3/2000	7/31/2013
Active	Southern Financial Life Insurance Company	300664	Agent - Limited Line Credit	11/5/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Citizens State Bank	399070	Agent - Limited Line Credit	1/31/2005	5/5/2006