DEPARTMENT OF INSURANCE

Name	Goldberg, David Ross	DOIID	323062	NAIC NPN	1469132

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Resident	Administrator	Not Applicable	6/17/1993		5/31/2024
Inactive	Resident	Agent	Health Maintenance Organization	6/15/1998	3/1/2001
Pending Replacement	Resident	Agent	Life	5/5/1989		5/31/2024
Pending Replacement	Resident	Agent	Variable Life and Variable Annuities	9/6/2001		5/31/2024
Pending Replacement	Resident	Agent	Health	7/11/1989		5/31/2024
AFFIDAVIT ON FILE

*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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Administrator	03/15/2024	05/31/2024
Agent	03/15/2024	05/31/2024

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
Business / Home Office	Annuity Associates, Inc 121 Petunia CourtNicholasville, KY 40356
Residence	Not Public Information

Internet Information

Type	Address
Business Email	goldberg.r.david@gmail.com

Phone Information

Type	Phone
Business / Home Office	(502) 836-2476