DEPARTMENT OF INSURANCE

Affiliations

Name	Belden, Samuel	DOIID	526519	NAIC NPN	3820166

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	8/4/2003	1/31/2014
Inactive	Non Resident	Agent	Life	8/4/2003	1/31/2014
Inactive	Non Resident	Agent	Casualty	3/1/2015	1/31/2018
Inactive	Non Resident	Agent	Property	3/1/2015	1/31/2018
* 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	Electric Insurance Company	301758	Agent - Casualty	5/19/2004	8/19/2011
Inactive	Electric Insurance Company	301758	Agent - Property	5/19/2004	8/19/2011
Inactive	Esurance Insurance Company	301072	Agent - Casualty	1/14/2008	12/9/2010
Inactive	Esurance Insurance Company	301072	Agent - Property	1/14/2008	12/9/2010
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Casualty	5/20/2004	8/25/2011
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Property	5/20/2004	8/25/2011
Inactive	First National Insurance Company of America	301690	Agent - Casualty	2/25/2004	8/23/2011
Inactive	First National Insurance Company of America	301690	Agent - Property	2/25/2004	8/23/2011
Inactive	General Insurance Company of America	300261	Agent - Casualty	5/7/2009	8/23/2011
Inactive	General Insurance Company of America	300261	Agent - Property	5/7/2009	8/23/2011
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	10/21/2012	5/20/2013
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	10/21/2012	5/20/2013
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	6/4/2001	6/25/2003
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	6/4/2001	6/25/2003
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	6/4/2001	6/25/2003
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	6/4/2001	6/25/2003
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	6/4/2001	6/25/2003
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	6/4/2001	6/25/2003
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	6/4/2001	6/25/2003
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	6/4/2001	6/25/2003
Inactive	LM General Insurance Company	300133	Agent - Casualty	3/19/2010	8/25/2011
Inactive	LM General Insurance Company	300133	Agent - Property	3/19/2010	8/25/2011
Inactive	LM Insurance Corporation	301061	Agent - Casualty	3/19/2010	8/25/2011
Inactive	LM Insurance Corporation	301061	Agent - Property	3/19/2010	8/25/2011
Inactive	Liberty Insurance Corporation	300444	Agent - Casualty	5/20/2004	8/25/2011
Inactive	Liberty Insurance Corporation	300444	Agent - Property	5/20/2004	8/25/2011
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	5/20/2004	8/25/2011
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Property	5/20/2004	8/25/2011
Inactive	Lincoln Life Assurance Company of Boston	301915	Agent - Health	12/22/2003	8/25/2011
Inactive	Lincoln Life Assurance Company of Boston	301915	Agent - Life	12/22/2003	8/25/2011
Inactive	Response Insurance Company	300240	Agent - Casualty	4/22/2010	8/22/2011
Inactive	Response Insurance Company	300240	Agent - Property	4/22/2010	8/22/2011
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	2/25/2004	8/23/2011
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	2/25/2004	8/4/2009
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	2/25/2004	8/23/2011
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	2/25/2004	8/23/2011
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	1/25/2011	8/25/2011
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	1/25/2011	8/25/2011
Inactive	Trumbull Insurance Company	300242	Agent - Casualty	6/4/2001	6/25/2003
Inactive	Trumbull Insurance Company	300242	Agent - Property	6/4/2001	6/25/2003
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	6/4/2001	6/25/2003
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	6/4/2001	6/25/2003
Inactive	Unitrin Direct Property & Casualty Company	637443	Agent - Casualty	6/6/2007	8/22/2011
Inactive	Unitrin Direct Property & Casualty Company	637443	Agent - Property	6/6/2007	8/22/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Citi Assurance Services, Inc	569582	Agent - Property	10/28/2008	7/31/2009
Inactive	Citi Assurance Services, Inc	569582	Agent - Casualty	10/28/2008	7/31/2009
Inactive	CoMa Insurance Agency Inc	526746	Agent - Property	6/18/2001	8/9/2011
Inactive	CoMa Insurance Agency Inc	526746	Agent - Casualty	6/18/2001	8/9/2011
Inactive	CoMa Insurance Agency Inc	526746	Agent - Health	9/27/2004	8/9/2011
Inactive	CoMa Insurance Agency Inc	526746	Agent - Life	9/27/2004	8/9/2011
Inactive	IC Insurance Services, LLC	534848	Agent - Property	1/5/2004	5/31/2005
Inactive	IC Insurance Services, LLC	534848	Agent - Casualty	1/5/2004	5/31/2005
Inactive	IC Insurance Services, LLC	534848	Agent - Health	1/5/2004	5/31/2005
Inactive	IC Insurance Services, LLC	534848	Agent - Life	1/5/2004	5/31/2005