DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Visser, Samuel	DOIID	1331545	NAIC NPN	17781557

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	3/25/2024		3/31/2027
Active	Non Resident	Agent	Property	3/25/2024		3/31/2027
* 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	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Farmers Insurance Exchange	300336	Agent - Casualty	4/30/2024
Active	Farmers Insurance Exchange	300336	Agent - Property	4/30/2024

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	4/30/2024
Active	Fx Insurance Agency, LLC	646184	Agent - Property	4/30/2024
Active	Kraft Lake Insurance Agency, Inc.	658511	Agent - Casualty	4/30/2024
Active	Kraft Lake Insurance Agency, Inc.	658511	Agent - Property	4/30/2024