DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Samson, Kathleen Dianne	DOIID	503468	NAIC NPN	7211372

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Apprentice Adjuster	Not Applicable	2/28/2000	2/28/2001
Inactive	Resident	Independent Adjuster	Property & Casualty	4/5/2006	6/30/2011
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Berkley Casualty Company	300731	Independent Adjuster - Property & Casualty	3/19/2001	1/23/2002
Inactive	Brentwood Serv Administrators Inc	397924	Independent Adjuster - Property & Casualty	4/7/2006	1/4/2010
Inactive	Central Mutual Insurance Company	300965	Independent Adjuster - Property & Casualty	1/23/2002	5/9/2002

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Roose, Theodore Carlton	326012	Apprentice Adjuster - Not Applicable	2/28/2000	2/28/2001