DEPARTMENT OF INSURANCE
Affiliations
NameClark, Samantha DOIID1238316NAIC NPN19828718
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentProperty2/2/2024 10/31/2025
ActiveNon ResidentAgentCasualty2/2/2024 10/31/2025
InactiveNon ResidentAgentPersonal Lines10/24/202210/31/2023 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveChurch Mutual Insurance Company, S.I.301554Agent - Casualty10/11/202410/17/2024
InactiveChurch Mutual Insurance Company, S.I.301554Agent - Property10/11/202410/17/2024
InactiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Casualty6/7/20249/9/2024
InactiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Property6/7/20249/9/2024
InactiveNational General Insurance Company300152Agent - Casualty2/5/20249/10/2024
InactiveNational General Insurance Company300152Agent - Property2/5/20249/10/2024
InactiveProgressive Direct Insurance Company301379Agent - Personal Lines10/25/20221/23/2023
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAffinity Brokerage, LLC544886Agent - Casualty2/6/20248/19/2024
InactiveAffinity Brokerage, LLC544886Agent - Property2/6/20248/19/2024
InactiveDirect General Insurance Agency Inc1018980Agent - Casualty2/6/20248/19/2024
InactiveDirect General Insurance Agency Inc1018980Agent - Property2/6/20248/19/2024
InactiveNational General Ins Marketing Inc621228Agent - Casualty2/6/20248/19/2024
InactiveNational General Ins Marketing Inc621228Agent - Property2/6/20248/19/2024

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