DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	08/15/2026	10/31/2026

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