Individual Information

MICHAEL BENJAMIN BLACKHAM

TAYLORSVILLE, UT 84118

Active

mblackham.lpl@macu.com

01/12/2011

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	557889	09/06/2007	Active	01/12/2011	01/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Health	09/06/2007	Active	01/12/2011
Life	09/06/2007	Active	01/12/2011
Var. Annuities/Var. Life	09/06/2007	Active	01/12/2011

Company Name	Appointment Type	Status	Active Date
63
AMERICAN NATIONAL INSURANCE COMPANY	Life	Active	05/19/2024
1260
Company Name	Appointment Type	Status	Active Date
ATHENE ANNUITY AND LIFE COMPANY	Life	Active	09/23/2022
114006
Company Name	Appointment Type	Status	Active Date
EAGLE LIFE INSURANCE COMPANY	Life	Active	01/22/2024
1025
Company Name	Appointment Type	Status	Active Date
FORETHOUGHT LIFE INSURANCE COMPANY	Health	Active	02/10/2016
	Life	Active	02/10/2016
897
Company Name	Appointment Type	Status	Active Date
JACKSON NATIONAL LIFE INSURANCE COMPANY	Life	Active	04/26/2021
	Var. Annuities/Var. Life	Active	04/26/2021
512
Company Name	Appointment Type	Status	Active Date
PACIFIC LIFE INSURANCE COMPANY	Life	Active	08/09/2011
	Var. Annuities/Var. Life	Active	08/09/2011
817
Company Name	Appointment Type	Status	Active Date
PRUCO LIFE INSURANCE COMPANY	Life	Active	05/14/2024
	Var. Annuities/Var. Life	Active	05/14/2024
13434
Company Name	Appointment Type	Status	Active Date
S USA LIFE INSURANCE COMPANY INC	Life	Active	09/21/2021
890
Company Name	Appointment Type	Status	Active Date
TRANSAMERICA LIFE INSURANCE COMPANY	Life	Active	09/11/2015
	Var. Annuities/Var. Life	Active	09/11/2015
98384
Company Name	Appointment Type	Status	Active Date
WESTERN UNITED LIFE ASSURANCE COMPANY	Life	Active	08/31/2017

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