DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Stacy, Samantha Leigh	DOIID	1346182	NAIC NPN	18822411

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Limited Line Credit	6/19/2024		6/30/2026
* 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
Pending Replacement	American Health and Life Insurance Company	300844	Agent - Limited Line Credit	6/28/2024
Pending Replacement	Triton Insurance Company	300654	Agent - Limited Line Credit	6/28/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending Replacement	Onemain Assurance Services LLC	751094	Agent - Limited Line Credit	6/28/2024