DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burkhart, Richard Robin	DOIID	712561	NAIC NPN	8793692

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	9/1/2009	7/31/2016
Inactive	Non Resident	Agent	Health	9/1/2009	7/31/2016
* 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	American Heritage Life Insurance Company	300272	Agent - Health	10/4/2012	7/31/2016
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	10/4/2012	7/31/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	11/19/2012	7/31/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/8/2013	7/31/2016
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/8/2013	7/31/2016
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	9/25/2009	3/14/2016
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	9/25/2009	3/14/2016
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	10/23/2012	6/5/2015
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	10/23/2012	6/5/2015
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	12/15/2015	7/31/2016
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	12/15/2015	7/31/2016
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	9/25/2009	3/14/2016
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	9/25/2009	3/14/2016
Inactive	Union Security Insurance Company	301844	Agent - Health	11/5/2014	3/24/2016
Inactive	Union Security Insurance Company	301844	Agent - Life	11/5/2014	3/24/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Of Illinois Inc	398318	Agent - Life	8/10/2012	7/31/2016
Inactive	Willis Of Illinois Inc	398318	Agent - Health	8/10/2012	7/31/2016