DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Hacker, Carl	DOIID	311450	NAIC NPN	7160861

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	3/13/1990	1/31/2007
Inactive	Resident	Agent	Life	3/13/1990	1/31/2007
AFFIDAVIT ON FILE
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Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Conseco Health Insurance Company	301725	Agent - Health	9/6/2000	6/26/2003
Inactive	Conseco Health Insurance Company	301725	Agent - Life	9/6/2000	6/26/2003
Inactive	Continental General Insurance Company	300691	Agent - Health	4/2/1991	8/16/1996
Inactive	Continental General Insurance Company	300691	Agent - Life	4/2/1991	8/16/1996
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	9/19/1997	5/12/2003
Inactive	Pioneer Life Insurance Company	300110	Agent - Health	3/30/1995	10/23/2002
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	3/30/1995	10/23/2002
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Health	3/13/1990	3/31/1997
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Life	3/13/1990	3/31/1997

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Frank Bradshaw Co	399179	Agent - Life	5/20/1992	8/10/2000
Inactive	Frank Bradshaw Co	399179	Agent - Health	5/20/1992	8/10/2000