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DEPARTMENT OF INSURANCE
Affiliations
Name
Clark, Samantha
DOIID
1238316
NAIC NPN
19828718
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Active
Non Resident
Agent
Property
2/2/2024
10/31/2025
Active
Non Resident
Agent
Casualty
2/2/2024
10/31/2025
Inactive
Non Resident
Agent
Personal Lines
10/24/2022
10/31/2023
* 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
Church Mutual Insurance Company, S.I.
301554
Agent - Casualty
10/11/2024
10/17/2024
Inactive
Church Mutual Insurance Company, S.I.
301554
Agent - Property
10/11/2024
10/17/2024
Inactive
Foremost Insurance Company Grand Rapids, Michigan
301027
Agent - Casualty
6/7/2024
9/9/2024
Inactive
Foremost Insurance Company Grand Rapids, Michigan
301027
Agent - Property
6/7/2024
9/9/2024
Inactive
National General Insurance Company
300152
Agent - Casualty
2/5/2024
9/10/2024
Inactive
National General Insurance Company
300152
Agent - Property
2/5/2024
9/10/2024
Inactive
Progressive Direct Insurance Company
301379
Agent - Personal Lines
10/25/2022
1/23/2023
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Affinity Brokerage, LLC
544886
Agent - Casualty
2/6/2024
8/19/2024
Inactive
Affinity Brokerage, LLC
544886
Agent - Property
2/6/2024
8/19/2024
Inactive
Direct General Insurance Agency Inc
1018980
Agent - Casualty
2/6/2024
8/19/2024
Inactive
Direct General Insurance Agency Inc
1018980
Agent - Property
2/6/2024
8/19/2024
Inactive
National General Ins Marketing Inc
621228
Agent - Casualty
2/6/2024
8/19/2024
Inactive
National General Ins Marketing Inc
621228
Agent - Property
2/6/2024
8/19/2024
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