DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Van Nelson, Samantha	DOIID	1049441	NAIC NPN	16176990

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Independent Adjuster	Property & Casualty	1/10/2024		6/30/2026
Inactive	Non Resident	Staff Adjuster	Property & Casualty	7/31/2019	1/10/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Independent Adjuster	04/15/2026	06/30/2026

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Broadspire Services, Inc.	396187	Independent Adjuster - Property & Casualty	1/23/2024