DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lacey, Michael	DOIID	682079	NAIC NPN	10904376

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	6/26/2008	10/1/2009
Inactive	Resident	Agent	Health	6/26/2008	10/1/2009
* 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	Equitable Financial Life Insurance Company	300808	Agent - Health	8/19/2008	9/10/2008
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	8/19/2008	9/10/2008
Inactive	Equitable Financial Life Insurance Company of America	301772	Agent - Health	8/19/2008	9/10/2008
Inactive	Equitable Financial Life Insurance Company of America	301772	Agent - Life	8/19/2008	9/10/2008
Inactive	NYLIFE Insurance Company of Arizona	301642	Agent - Health	9/9/2008	11/7/2008
Inactive	NYLIFE Insurance Company of Arizona	301642	Agent - Life	9/9/2008	11/7/2008
Inactive	New York Life Insurance Company	300431	Agent - Health	9/9/2008	11/7/2008
Inactive	New York Life Insurance Company	300431	Agent - Life	9/9/2008	11/7/2008
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Health	9/9/2008	11/7/2008
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	9/9/2008	11/7/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	NYLIFE Securities, LLC	645470	Agent - Health	10/24/2008	11/7/2008
Inactive	NYLIFE Securities, LLC	645470	Agent - Life	10/24/2008	11/7/2008