DEPARTMENT OF INSURANCE

Affiliations

Name	Pollack, Jay M	DOIID	327576	NAIC NPN	245063

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	1/31/2014	8/31/2015
Inactive	Non Resident	Agent	Health	1/31/2014	8/31/2015
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	1/31/2014	8/31/2015
* 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.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	2/6/2014	9/10/2015
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	8/14/2007	8/31/2009
Inactive	First Colony Life Insurance Company	301179	Agent - Health	4/5/1994	12/20/2006
Inactive	First Colony Life Insurance Company	301179	Agent - Life	4/5/1994	12/20/2006
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	8/14/2007	8/31/2009
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	8/14/2007	8/31/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mesirow Ins Services Inc	510824	Agent - Life	8/14/2007	8/31/2009
Inactive	Mesirow Ins Services Inc	510824	Agent - Health	8/14/2007	8/31/2009