DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bennett, Samantha Jill	DOIID	674990	NAIC NPN	10361407

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Limited Line Credit	2/25/2008	7/31/2014
Inactive	Resident	Agent	Property	6/11/2019	8/1/2022
Inactive	Resident	Agent	Health	5/13/2008	8/1/2014
Inactive	Resident	Agent	Life	8/20/2008	8/1/2014
Inactive	Resident	Agent	Casualty	6/13/2019	8/1/2022
* 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	Merit Life Insurance Co.	300150	Agent - Health	5/13/2008	6/3/2013
Inactive	Merit Life Insurance Co.	300150	Agent - Life	8/20/2008	6/3/2013
Inactive	Merit Life Insurance Co.	300150	Agent - Limited Line Credit	2/25/2008	6/3/2013
Inactive	Old Guard Insurance Company	533854	Agent - Casualty	6/1/2021	6/9/2021
Inactive	Old Guard Insurance Company	533854	Agent - Property	6/1/2021	6/9/2021
Inactive	State Farm Fire and Casualty Company	301809	Agent - Casualty	7/5/2019	7/16/2020
Inactive	State Farm Fire and Casualty Company	301809	Agent - Property	7/5/2019	7/16/2020
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	7/5/2019	7/16/2020
Inactive	Westfield Champion Insurance Company	1054839	Agent - Casualty	6/1/2021	6/9/2021
Inactive	Westfield Champion Insurance Company	1054839	Agent - Property	6/1/2021	6/9/2021
Inactive	Westfield Insurance Company	301950	Agent - Casualty	8/6/2020	8/1/2022
Inactive	Westfield Insurance Company	301950	Agent - Property	8/6/2020	8/1/2022
Inactive	Westfield Premier Insurance Company	1055055	Agent - Casualty	6/1/2021	6/9/2021
Inactive	Westfield Premier Insurance Company	1055055	Agent - Property	6/1/2021	6/9/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Casualty	6/1/2021	6/9/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Property	6/1/2021	6/9/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Casualty	6/1/2021	6/9/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Property	6/1/2021	6/9/2021
Inactive	Yosemite Insurance Company	301519	Agent - Limited Line Credit	2/25/2008	6/3/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Chas. M. Moore Insurance Agency Inc.	400317	Agent - Casualty	8/6/2020	8/1/2022
Inactive	Chas. M. Moore Insurance Agency Inc.	400317	Agent - Property	8/6/2020	8/1/2022