DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Hartz, Mathew Todd	DOIID	728558	NAIC NPN	15667994

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	5/18/2010		1/31/2026
Active	Non Resident	Agent	Health	5/18/2010		1/31/2026
* 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
Active	Mutual of Omaha Insurance Company	301012	Agent - Health	2/14/2012
Active	Mutual of Omaha Insurance Company	301012	Agent - Life	3/5/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	C.M.G. Agency, Inc.	554100	Agent - Life	3/5/2012
Active	C.M.G. Agency, Inc.	554100	Agent - Health	2/14/2012