DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Samples, Jason	DOIID	640503	NAIC NPN	8917843

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Adjuster	Independent	10/24/2006	7/1/2010
Inactive	Resident	Apprentice Adjuster	Not Applicable	10/17/2006	10/24/2006
Active	Non Resident	Staff Adjuster	Workers' Compensation	10/6/2025		9/30/2028
Active	Non Resident	Staff Adjuster	Property & Casualty	10/6/2025		9/30/2028
* 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
Active	Auto-Owners Insurance Company	301480	Staff Adjuster - Property & Casualty	10/21/2025
Active	Auto-Owners Insurance Company	301480	Staff Adjuster - Workers' Compensation	10/21/2025

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Herridge, Todd Edward	604806	Apprentice Adjuster - Not Applicable	10/17/2006	10/24/2006