DEPARTMENT OF INSURANCE

Name	Fortner III, Richard Harold	DOIID	899811	NAIC NPN	17778155

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Non Resident	Agent	Personal Lines	11/20/2015	6/30/2019
Inactive	Non Resident	Staff Adjuster	Property & Casualty	9/7/2017	6/30/2019

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Residence	Not Public Information
Business / Home Office	419 Bent Creek Dr Greer, SC 296501107

Phone Information

Type	Phone
Business / Home Office	(864) 360-8703