DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bajusz, Samantha Lizbeth	DOIID	1066350	NAIC NPN	19358130

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Property	12/3/2019	12/31/2021
Inactive	Resident	Agent	Health	1/28/2020	12/31/2021
Inactive	Resident	Agent	Casualty	12/12/2019	12/31/2021
* 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	AMEX Assurance Company	301728	Agent - Casualty	3/24/2020	6/25/2020
Inactive	AMEX Assurance Company	301728	Agent - Health	3/24/2020	6/25/2020
Inactive	AMEX Assurance Company	301728	Agent - Property	3/24/2020	6/25/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Alorica Inc.	1074645	Agent - Casualty	3/24/2020	6/25/2020
Inactive	Alorica Inc.	1074645	Agent - Health	3/24/2020	6/25/2020
Inactive	Alorica Inc.	1074645	Agent - Property	3/24/2020	6/25/2020