DEPARTMENT OF INSURANCE

Name	Ballner, Rita D	DOIID	1311471	NAIC NPN	8038206

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Casualty	11/20/2023	1/31/2025
Active	Non Resident	Agent	Property	11/20/2023	1/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	11/27/2023	1/31/2025

*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	11/15/2024	01/31/2025
Surplus Lines Broker	11/15/2024	01/31/2025

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	50 California St Fl 12 San Francisco, CA 941114646

Phone Information

Type	Phone
Business / Home Office	(415) 391-2141