DEPARTMENT OF INSURANCE

Affiliations

Name	Sams, Shannon Dell	DOIID	304965	NAIC NPN	7157860

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	6/16/1992		6/30/2025
Active	Resident	Agent	Casualty	7/30/2003		6/30/2025
Active	Resident	Agent	Property	7/30/2003		6/30/2025
Active	Resident	Agent	Life	6/16/1992		6/30/2025
Inactive	Resident	Agent	General Lines	12/12/1989	8/15/2000
* 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
Inactive	AIG Assurance Company	300897	Agent - Casualty	8/14/2003	9/24/2010
Inactive	AIG Assurance Company	300897	Agent - General Lines	2/15/1995	8/15/2000
Inactive	AIG Assurance Company	300897	Agent - Property	8/14/2003	9/24/2010
Inactive	American Bankers Insurance Company of Florida	300360	Agent - Casualty	11/20/2003	1/6/2006
Inactive	American Bankers Insurance Company of Florida	300360	Agent - Property	11/20/2003	1/6/2006
Active	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019
Active	American Economy Insurance Company	300315	Agent - Property	11/9/2019
Inactive	American Family Home Insurance Company	301817	Agent - Casualty	9/18/2003	11/14/2021
Inactive	American Family Home Insurance Company	301817	Agent - General Lines	5/4/1993	8/15/2000
Inactive	American Family Home Insurance Company	301817	Agent - Property	9/18/2003	11/14/2021
Inactive	American Investors Life Insurance Company, Inc.	301358	Agent - Life	5/20/2003	10/1/2004
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	9/18/2003	11/14/2021
Inactive	American Modern Home Insurance Company	300791	Agent - General Lines	2/24/1995	8/15/2000
Inactive	American Modern Home Insurance Company	300791	Agent - Property	9/18/2003	11/14/2021
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	12/13/2018
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	12/13/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	9/21/2005	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	9/21/2005	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	8/15/2008	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	8/15/2008	11/14/2021
Inactive	American States Insurance Company	301230	Agent - Casualty	8/18/2006	10/20/2011
Inactive	American States Insurance Company	301230	Agent - Property	8/18/2006	10/20/2011
Inactive	American Zurich Insurance Company	300592	Agent - Casualty	5/31/2006	10/11/2010
Inactive	American Zurich Insurance Company	300592	Agent - Property	5/31/2006	10/11/2010
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/14/1998	12/11/2002
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/14/1998	12/11/2002
Inactive	Assurance Company of America	300432	Agent - Casualty	5/31/2006	10/11/2010
Inactive	Assurance Company of America	300432	Agent - Property	5/31/2006	10/11/2010
Active	Bristol West Insurance Company	301655	Agent - Casualty	1/15/2007
Active	Bristol West Insurance Company	301655	Agent - Property	1/15/2007
Active	Dairyland Insurance Company	301370	Agent - Casualty	8/28/2003
Inactive	Falls Lake National Insurance Company	301796	Agent - Casualty	8/15/2000	3/22/2002
Inactive	Falls Lake National Insurance Company	301796	Agent - General Lines	4/24/1996	8/15/2000
Inactive	Farmers Insurance Exchange	300336	Agent - Casualty	10/1/2008	8/22/2012
Inactive	Farmers Insurance Exchange	300336	Agent - Property	10/1/2008	8/22/2012
Inactive	First National Insurance Company of America	301690	Agent - Casualty	8/18/2006	10/20/2011
Inactive	First National Insurance Company of America	301690	Agent - Property	8/18/2006	10/20/2011
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/14/2004
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/14/2004
Inactive	General Insurance Company of America	300261	Agent - Casualty	8/18/2006	10/20/2011
Inactive	General Insurance Company of America	300261	Agent - Property	8/18/2006	10/20/2011
Inactive	Generali - U.S. Branch	301128	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Generali - U.S. Branch	301128	Agent - General Lines	8/30/1996	8/15/2000
Inactive	Generali - U.S. Branch	301128	Agent - Property	8/15/2000	3/31/2002
Inactive	Globe American Casualty Company	301033	Agent - Casualty	8/15/2000	12/11/2002
Inactive	Globe American Casualty Company	301033	Agent - General Lines	11/13/1991	8/15/2000
Inactive	Globe American Casualty Company	301033	Agent - Property	8/15/2000	12/11/2002
Inactive	Golden Rule Insurance Company	301943	Agent - Health	11/15/1995	9/27/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Life	11/15/1995	9/27/2017
Inactive	Granite State Insurance Company	300818	Agent - Casualty	8/14/2003	9/24/2010
Inactive	Granite State Insurance Company	300818	Agent - General Lines	6/23/2000	8/15/2000
Inactive	Granite State Insurance Company	300818	Agent - Property	8/14/2003	9/24/2010
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Casualty	8/15/2000	12/11/2002
Inactive	GuideOne Specialty Insurance Company	300278	Agent - General Lines	12/12/1989	8/15/2000
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Property	8/15/2000	12/11/2002
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	3/28/2007	11/9/2010
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	3/28/2007	11/9/2010
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	8/14/2003	9/24/2010
Inactive	Illinois National Insurance Company	301367	Agent - General Lines	2/3/1995	8/15/2000
Inactive	Illinois National Insurance Company	301367	Agent - Property	8/14/2003	9/24/2010
Inactive	Infinity Casualty Insurance Company	301280	Agent - Casualty	8/15/2000	3/22/2002
Inactive	Infinity Casualty Insurance Company	301280	Agent - General Lines	8/21/1996	8/15/2000
Inactive	Infinity Standard Insurance Company	301643	Agent - Casualty	8/15/2000	12/11/2002
Inactive	Infinity Standard Insurance Company	301643	Agent - General Lines	1/5/1993	8/15/2000
Inactive	Infinity Standard Insurance Company	301643	Agent - Property	8/15/2000	12/11/2002
Active	Investors Heritage Life Insurance Company	300363	Agent - Life	2/9/2018
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	6/16/1992	10/25/2000
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	6/16/1992	10/25/2000
Inactive	Lincoln General Insurance Company	301580	Agent - Casualty	1/19/2004	4/17/2006
Inactive	Lincoln General Insurance Company	301580	Agent - Property	1/19/2004	4/17/2006
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Health	7/14/2021	6/14/2024
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Life	7/14/2021	6/14/2024
Inactive	Maryland Casualty Company	301719	Agent - Casualty	5/31/2006	10/11/2010
Inactive	Maryland Casualty Company	301719	Agent - Property	5/31/2006	10/11/2010
Inactive	Midland National Life Insurance Company	300923	Agent - Health	2/24/2005	4/14/2021
Active	Midland National Life Insurance Company	300923	Agent - Life	2/24/2005
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	3/28/1998	12/11/2002
Inactive	National Insurance Association	301386	Agent - Casualty	8/15/2000	12/11/2002
Inactive	National Insurance Association	301386	Agent - General Lines	10/26/1995	8/15/2000
Inactive	National Insurance Association	301386	Agent - Property	8/15/2000	12/11/2002
Inactive	National Summit Insurance Company	300348	Agent - General Lines	8/5/1996	12/14/1998
Inactive	National Western Life Insurance Company	301515	Agent - Health	7/29/2003	2/11/2005
Inactive	National Western Life Insurance Company	301515	Agent - Life	7/29/2003	2/11/2005
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	5/31/2006	10/11/2010
Inactive	Northern Insurance Company of New York	301317	Agent - Property	5/31/2006	10/11/2010
Inactive	PAFCO General Insurance Company	301645	Agent - Casualty	8/15/2000	12/11/2002
Inactive	PAFCO General Insurance Company	301645	Agent - General Lines	11/5/1997	8/15/2000
Inactive	PAFCO General Insurance Company	301645	Agent - Property	8/15/2000	12/11/2002
Inactive	Permanent General Assurance Corporation	300883	Agent - General Lines	5/9/1996	3/31/2000
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Casualty	9/10/2007	1/25/2011
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Property	9/10/2007	1/25/2011
Inactive	QBE Insurance Corporation	300515	Agent - Casualty	8/15/2000	11/1/2002
Inactive	QBE Insurance Corporation	300515	Agent - General Lines	12/8/1999	8/15/2000
Inactive	QBE Insurance Corporation	300515	Agent - Property	8/15/2000	11/1/2002
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	8/18/2006
Active	SAFECO Insurance Company of America	300159	Agent - Property	8/18/2006
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	8/18/2006
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	8/18/2006
Inactive	South Carolina Insurance Company	300080	Agent - General Lines	4/18/1998	6/7/2000
Inactive	Time Insurance Company	300683	Agent - Health	8/31/1992	3/31/1997
Inactive	Time Insurance Company	300683	Agent - Life	8/31/1992	3/31/1997
Active	Trexis Insurance Corporation	599902	Agent - Casualty	1/10/2005
Active	Trexis One Insurance Corporation	684197	Agent - Casualty	10/23/2008
Inactive	Truck Insurance Exchange	300335	Agent - Casualty	10/1/2008	8/22/2012
Inactive	Truck Insurance Exchange	300335	Agent - Property	10/1/2008	8/22/2012
Inactive	United American Insurance Company	300910	Agent - Health	5/25/2004	2/5/2009
Inactive	United American Insurance Company	300910	Agent - Life	5/25/2004	2/5/2009
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/18/2015	2/14/2017
Active	Western Surety Company	300283	Agent - Casualty	4/2/2004
Inactive	Western Surety Company	300283	Agent - General Lines	12/12/1991	8/15/2000
Inactive	Windhaven National Insurance Company	300094	Agent - Casualty	8/15/2000	3/22/2002
Inactive	Windhaven National Insurance Company	300094	Agent - General Lines	8/21/1996	8/15/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	10/23/1998	6/23/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	10/23/1998	6/23/2008
Active	Designated Agent Company Inc.	681257	Agent - Life	6/27/2008
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/27/2008	4/14/2021