DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Brooks, Samantha	DOIID	1309878	NAIC NPN	19195749

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	11/9/2023		10/31/2026
Active	Non Resident	Agent	Property	11/9/2023		10/31/2026
* 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
Active	Midvale Indemnity Company	300292	Agent - Casualty	11/9/2023
Active	Midvale Indemnity Company	300292	Agent - Property	11/9/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Fx Insurance Agency, LLC	646184	Agent - Casualty	11/9/2023
Active	Fx Insurance Agency, LLC	646184	Agent - Property	11/9/2023
Active	Kraft Lake Insurance Agency, Inc.	658511	Agent - Casualty	11/9/2023
Active	Kraft Lake Insurance Agency, Inc.	658511	Agent - Property	11/9/2023