DEPARTMENT OF INSURANCE
Affiliations
NameMathis, Samuel DOIID1164182NAIC NPN19836124
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentLife10/5/2021 10/31/2025
ActiveNon ResidentAgentVariable Life and Variable Annuities10/5/2021 10/31/2025
ActiveNon ResidentAgentHealth10/5/2021 10/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveJackson National Life Insurance Company300486Agent - Life11/22/2021 
ActiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities11/22/2021 
ActivePruco Life Insurance Company300954Agent - Life11/23/2021 
ActivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities11/23/2021 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveJanney Montgomery Scott LLC519818Agent - Life12/21/2021 
DeniedJanney Montgomery Scott LLC519818Agent - Health  
ActiveJanney Montgomery Scott LLC519818Agent - Variable Life and Variable Annuities12/21/2021 

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