DEPARTMENT OF INSURANCE
Affiliations
NameCrockett, David MarkDOIID654962NAIC NPN9147830
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth9/14/2015 9/30/2025
ActiveNon ResidentAgentProperty9/2/2015 9/30/2025
ActiveNon ResidentAgentLife9/14/2015 9/30/2025
ActiveNon ResidentAgentCasualty9/2/2015 9/30/2025
InactiveNon ResidentAgentVariable Life and Variable Annuities5/3/20079/30/2011 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveEquitable Financial Life Insurance Company300808Agent - Life5/17/200710/12/2009
InactiveEquitable Financial Life Insurance Company300808Agent - Variable Life and Variable Annuities5/17/200710/12/2009
InactiveTalcott Resolution Life Insurance Company301759Agent - Life5/29/20075/10/2010
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities5/29/20075/10/2010
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life5/29/20075/10/2010
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities5/29/20075/10/2010
InactiveVenerable Insurance and Annuity Company301006Agent - Life5/18/200712/22/2009
InactiveVenerable Insurance and Annuity Company301006Agent - Variable Life and Variable Annuities5/18/200712/22/2009
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveUbs Financial Services Ins Agency Inc399373Agent - Life6/28/20075/10/2010
InactiveUbs Financial Services Ins Agency Inc399373Agent - Variable Life and Variable Annuities6/28/20075/10/2010

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