DEPARTMENT OF INSURANCE

Affiliations

Name	Banta, Zachary Dean	DOIID	681409	NAIC NPN	10853876

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Denied	Resident	Agent	Variable Life and Variable Annuities	6/6/2008	7/16/2008
Inactive	Resident	Agent	Limited Line Credit	5/17/2010	4/30/2019
Inactive	Resident	Agent	Life	6/6/2008	7/16/2008
* 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	Foresters Life Insurance and Annuity Company	300882	Agent - Life	6/6/2008	7/16/2008
Inactive	Foresters Life Insurance and Annuity Company	300882	Agent - Variable Life and Variable Annuities	6/6/2008	7/16/2008
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Limited Line Credit	5/17/2010	4/30/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Citizens Union Bank of Shelbyville	398748	Agent - Limited Line Credit	7/22/2010	6/28/2013
Inactive	United Citizens Bank & Trust Company	398804	Agent - Limited Line Credit	5/8/2018	4/30/2019