DEPARTMENT OF INSURANCE

Name	Black Gould & Assoc Inc	DOIID	1048488	NAIC NPN	954035

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Agent	Life	7/24/2019		3/31/2025
Active	Non Resident	Agent	Health	7/24/2019		3/31/2025

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

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2025	03/31/2025

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	3800 N Central 9th Fl Phoenix, AZ 85012

Phone Information

Type	Phone
Business / Home Office	(602) 277-2144 Ext-1318