DEPARTMENT OF INSURANCE
Affiliations
NameBlack, Michael JDOIID674425NAIC NPN5694467
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentVariable Life and Variable Annuities2/19/20083/31/2013 
InactiveNon ResidentAgentHealth2/19/20083/31/2013 
InactiveNon ResidentAgentLife2/19/20083/31/2013 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveEquitable Financial Life Insurance Company300808Agent - Health9/11/20123/31/2013
InactiveEquitable Financial Life Insurance Company300808Agent - Life9/11/20123/31/2013
InactiveEquitable Financial Life Insurance Company300808Agent - Variable Life and Variable Annuities3/21/20083/31/2013
InactiveGenworth Life Insurance Company300623Agent - Health3/24/20088/10/2009
InactiveGenworth Life Insurance Company300623Agent - Life3/24/20088/10/2009
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health3/24/200810/4/2009
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life3/24/200810/4/2009
InactiveGenworth Life and Annuity Insurance Company301276Agent - Variable Life and Variable Annuities3/24/200810/4/2009
InactiveNew York Life Insurance and Annuity Corporation300726Agent - Life2/24/20093/31/2013
InactiveNew York Life Insurance and Annuity Corporation300726Agent - Variable Life and Variable Annuities2/24/20093/31/2013
InactiveTalcott Resolution Life Insurance Company301759Agent - Health3/26/200812/29/2008
InactiveTalcott Resolution Life Insurance Company301759Agent - Life3/26/200812/29/2008
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities3/26/200812/29/2008
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Health3/26/200812/29/2008
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life3/26/200812/29/2008
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities3/26/200812/29/2008
InactiveTransamerica Life Insurance Company300571Agent - Life3/26/20083/31/2013
InactiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities3/26/20083/31/2013
InactiveTransamerica Occidental Life Insurance Company300966Agent - Life3/26/200810/1/2008
InactiveTransamerica Occidental Life Insurance Company300966Agent - Variable Life and Variable Annuities3/26/200810/1/2008
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveRaymond James Insurance Group, Inc.398342Agent - Life9/7/20123/31/2013
InactiveRaymond James Insurance Group, Inc.398342Agent - Health9/11/20123/31/2013
InactiveRaymond James Insurance Group, Inc.398342Agent - Variable Life and Variable Annuities9/7/20123/31/2013
InactiveWells Fargo Wealth Brokerage Insurance Agency, LLC547888Agent - Life3/26/20083/31/2013
InactiveWells Fargo Wealth Brokerage Insurance Agency, LLC547888Agent - Health3/26/200810/4/2009

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