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DEPARTMENT OF INSURANCE
Affiliations
Name
Gollakner, Samantha Marie
DOIID
854006
NAIC NPN
17380387
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Non Resident
Agent
Life
9/29/2014
4/30/2016
Inactive
Non Resident
Agent
Health
9/29/2014
4/30/2016
Active
Non Resident
Independent Adjuster
Property & Casualty
10/14/2024
4/30/2026
* 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
02/15/2026
04/30/2026
Appointments with the following Insurers
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Time Insurance Company
300683
Agent - Health
10/2/2014
6/16/2015
Inactive
Time Insurance Company
300683
Agent - Life
10/2/2014
6/16/2015
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Active
AFICS, Inc
1122840
Independent Adjuster - Property & Casualty
10/25/2024
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