DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Hazelton, Samuel	DOIID	1257018	NAIC NPN	19735882

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	2/17/2023		5/31/2026
Active	Non Resident	Agent	Property	2/17/2023		5/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	03/15/2026	05/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Strategic Insurance Corp	883540	Agent - Casualty	6/21/2023	8/14/2025
Inactive	American Strategic Insurance Corp	883540	Agent - Property	6/21/2023	8/14/2025
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	3/18/2025	8/6/2025
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	3/18/2025	8/6/2025
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	5/14/2026
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	5/14/2026

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Rate Insurance LLC	791806	Agent - Casualty	5/14/2026
Active	Rate Insurance LLC	791806	Agent - Property	5/14/2026