DEPARTMENT OF INSURANCE

Name	Maverick Insurance, LLC	DOIID	553924	NAIC NPN	7333091

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Denied	Non Resident	Agent	Variable Life and Variable Annuities
Inactive	Non Resident	Agent	Property	9/24/2002	3/31/2014
Inactive	Non Resident	Agent	Casualty	9/24/2002	3/31/2014
Inactive	Non Resident	Agent	Life	10/14/2002	3/31/2014
Inactive	Non Resident	Agent	Health	10/14/2002	3/31/2014
Inactive	Non Resident	Property & Casualty Consultant	Not Applicable	1/22/2007	3/31/2014
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	12/29/2008	6/21/2012

*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.

No License Renewal Information

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

Address Information

Type	Address
Business / Home Office	2325 Green Valley Road Suite 205New Albany, IN 47150
Mailing	2325 Green Valley Road Suite 205New Albany, IN 47150

Internet Information

Type	Address
Business Email	kris.diebold@neacelukens.com - Bad Email-Correction requested

Phone Information

Type	Phone
Business / Home Office	(812) 941-4110