DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Blakeman, Jack N	DOIID	303558	NAIC NPN	7157251

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	10/4/1983	4/1/1999
Inactive	Resident	Agent	Health	10/4/1983	4/1/1999
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/17/1996	4/1/1999
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/17/1996	4/1/1999
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	7/27/1990	4/1/1999
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	7/27/1990	4/1/1999
Inactive	Freedom Life Insurance Company of America	300074	Agent - Health	4/13/1994	4/1/1999
Inactive	Freedom Life Insurance Company of America	300074	Agent - Life	4/13/1994	4/1/1999
Inactive	Golden Rule Insurance Company	301943	Agent - Health	12/18/1987	3/31/1997
Inactive	Golden Rule Insurance Company	301943	Agent - Life	12/18/1987	3/31/1997
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	6/13/1985	4/1/1999
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	6/13/1985	4/1/1999
Inactive	Pioneer Life Insurance Company	300110	Agent - Health	3/13/1996	4/1/1999
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	3/13/1996	4/1/1999
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Health	4/13/1987	12/29/1998
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Life	4/13/1987	12/29/1998
Inactive	United American Insurance Company	300910	Agent - Health	10/4/1983	4/1/1999
Inactive	United American Insurance Company	300910	Agent - Life	10/4/1983	4/1/1999
Inactive	Wilco Life Insurance Company	300122	Agent - Health	12/9/1991	4/1/1999
Inactive	Wilco Life Insurance Company	300122	Agent - Life	12/9/1991	4/1/1999

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/25/1996	4/1/1999
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/25/1996	4/1/1999
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	4/1/1999