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	Life	6/16/1992		6/30/2027
Active	Resident	Agent	Health	6/16/1992		6/30/2027
Active	Resident	Agent	Casualty	7/30/2003		6/30/2027
Active	Resident	Agent	Property	7/30/2003		6/30/2027
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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2025	06/30/2025	02/10/2025	02/10/2025	Yes

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
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/31/2025
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
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	2/9/2018	9/20/2024
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
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/27/2008	2/17/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/27/2008	4/14/2021