DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Souriyavong, Samantha Vanissa	DOIID	1108364	NAIC NPN	18695845

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	10/30/2020	11/30/2022
Inactive	Non Resident	Agent	Property	10/30/2020	11/30/2022
* 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	American Modern Home Insurance Company	300791	Agent - Casualty	12/11/2020	6/28/2021
Inactive	American Modern Home Insurance Company	300791	Agent - Property	12/11/2020	6/28/2021
Inactive	American National Property and Casualty Company	300392	Agent - Casualty	12/14/2020	6/24/2021
Inactive	American National Property and Casualty Company	300392	Agent - Property	12/14/2020	6/24/2021
Inactive	Homesite Insurance Company	301139	Agent - Casualty	3/3/2021	11/30/2022
Inactive	Homesite Insurance Company	301139	Agent - Property	3/3/2021	11/30/2022
Inactive	Homesite Insurance Company of the Midwest	874850	Agent - Casualty	3/3/2021	11/30/2022
Inactive	Homesite Insurance Company of the Midwest	874850	Agent - Property	3/3/2021	11/30/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Multifamily Internet Ventures, LLC	638890	Agent - Casualty	12/11/2020	8/17/2021
Inactive	Multifamily Internet Ventures, LLC	638890	Agent - Property	12/11/2020	8/17/2021