PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NameSamson, Thomas WesleyDOIID1186120NAIC NPN20223290
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
Pending ReplacementNon ResidentAgentProperty2/2/2022 9/30/2026
Pending ReplacementNon ResidentAgentCasualty2/2/2022 9/30/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent07/15/202609/30/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveIndependence American Insurance Company524747Agent - Casualty9/11/20231/14/2026
InactiveIndependence American Insurance Company524747Agent - Property9/11/20231/14/2026
Pending ReplacementNorth River Insurance Company (The)301739Agent - Casualty3/8/2022 
Pending ReplacementNorth River Insurance Company (The)301739Agent - Property3/8/2022 
Pending ReplacementUnited States Fire Insurance Company582240Agent - Casualty3/8/2022 
Pending ReplacementUnited States Fire Insurance Company582240Agent - Property3/8/2022 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
Pending ReplacementPTZ Insurance Agency LTD695420Agent - Casualty3/8/2022 
Pending ReplacementPTZ Insurance Agency LTD695420Agent - Property3/8/2022 

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