DEPARTMENT OF INSURANCE

Affiliations

Name	Hawk, Keith S.	DOIID	518016	NAIC NPN	1866986

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	11/17/2000	9/30/2006
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	5/31/2001	9/30/2006
Inactive	Non Resident	Agent	Health	11/17/2000	9/30/2006
* 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	Equitable Financial Life Insurance Company	300808	Agent - Life	4/8/2005	9/30/2006
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Variable Life and Variable Annuities	4/8/2005	9/30/2006
Inactive	Everlake Life Insurance Company	300873	Agent - Life	8/22/2002	10/16/2002
Inactive	Everlake Life Insurance Company	300873	Agent - Variable Life and Variable Annuities	8/22/2002	10/16/2002
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	4/8/2005	9/30/2006
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Variable Life and Variable Annuities	4/8/2005	9/30/2006
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	4/12/2005	9/30/2006
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Variable Life and Variable Annuities	4/12/2005	9/30/2006
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	4/12/2005	9/30/2006
Inactive	Nationwide Life Insurance Company	300495	Agent - Variable Life and Variable Annuities	4/12/2005	9/30/2006
Inactive	Northbrook Life Insurance Company	301020	Agent - Life	12/15/2000	10/25/2002
Inactive	Northbrook Life Insurance Company	301020	Agent - Variable Life and Variable Annuities	4/13/2001	10/25/2002
Inactive	SunAmerica Annuity and Life Assurance Company	301930	Agent - Life	12/18/2001	3/7/2006
Inactive	SunAmerica Annuity and Life Assurance Company	301930	Agent - Variable Life and Variable Annuities	12/18/2001	3/7/2006
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	11/17/2000	9/30/2006
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	11/17/2000	9/30/2006
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Variable Life and Variable Annuities	5/31/2001	9/30/2006
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	11/17/2000	9/30/2006
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	11/17/2000	9/30/2006
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Variable Life and Variable Annuities	5/31/2001	9/30/2006
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	7/31/2002	9/30/2006
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Variable Life and Variable Annuities	7/31/2002	9/30/2006
Inactive	Western National Life Insurance Company	300461	Agent - Life	10/15/2003	9/30/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ubs Financial Services Ins Agency Inc	399373	Agent - Life	4/11/2005	9/30/2006
Inactive	Ubs Financial Services Ins Agency Inc	399373	Agent - Health	4/11/2005	9/30/2006
Inactive	Ubs Financial Services Ins Agency Inc	399373	Agent - Variable Life and Variable Annuities	4/11/2005	9/30/2006