DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Tabackman, Manny	DOIID	703495	NAIC NPN	807624

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	4/9/2009	2/28/2014
Inactive	Non Resident	Agent	Property	4/9/2009	2/28/2014
* 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	Cincinnati Insurance Company	301298	Agent - Casualty	7/9/2010	6/3/2013
Inactive	Cincinnati Insurance Company	301298	Agent - Property	7/9/2010	6/3/2013
Inactive	Rural Community Insurance Company	301891	Agent - Property	8/24/2010	11/23/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	7/9/2010	6/3/2013
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	7/9/2010	6/3/2013