DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Adams, Sam J	DOIID	656328	NAIC NPN	9318734

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	3/11/2008	12/31/2012
Inactive	Non Resident	Agent	Health	9/8/2011	12/31/2012
* 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	Allianz Life Insurance Company of North America	301791	Agent - Life	5/27/2008	9/1/2011
Inactive	American General Life Insurance Company	301585	Agent - Life	4/9/2008	12/31/2012
Inactive	Assurity Life Insurance Company	301099	Agent - Life	8/6/2008	5/5/2010
Inactive	Athene Annuity and Life Company	301893	Agent - Life	10/8/2009	4/28/2011
Inactive	Banner Life Insurance Company	301696	Agent - Life	9/9/2011	12/31/2012
Inactive	Genworth Life Insurance Company	300623	Agent - Life	2/25/2010	12/7/2012
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	7/20/2011	12/31/2012
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	4/10/2008	10/5/2012
Inactive	Security Life of Denver Insurance Company	300648	Agent - Life	4/10/2008	9/29/2012
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	5/22/2008	3/31/2009
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	4/29/2011	12/31/2012
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	8/29/2011	12/31/2012
Inactive	United Home Life Insurance Company	300421	Agent - Life	8/5/2011	12/19/2012
Inactive	West Coast Life Insurance Company	301607	Agent - Life	10/27/2008	11/16/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Future Assurance, Inc.	652213	Agent - Life	6/4/2010	12/31/2012