DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burden, Samuel Adam	DOIID	747980	NAIC NPN	16150503

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Self-Service Storage Space	8/20/2020		5/31/2026
Active	Resident	Agent	Casualty	6/7/2024		5/31/2026
Active	Resident	Agent	Property	6/7/2024		5/31/2026
* 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	ACUITY, A Mutual Insurance Company	300095	Agent - Casualty	4/1/2011	6/1/2024
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Property	4/1/2011	6/1/2024
Inactive	Amerisure Insurance Company	300298	Agent - Casualty	4/13/2018	6/1/2024
Inactive	Amerisure Insurance Company	300298	Agent - Property	4/13/2018	6/1/2024
Inactive	Amerisure Mutual Insurance Company	301576	Agent - Casualty	4/13/2018	6/1/2024
Inactive	Amerisure Mutual Insurance Company	301576	Agent - Property	4/13/2018	6/1/2024
Inactive	Amerisure Partners Insurance Company	760791	Agent - Casualty	4/13/2018	6/1/2024
Inactive	Amerisure Partners Insurance Company	760791	Agent - Property	4/13/2018	6/1/2024
Inactive	Country Mutual Insurance Company	301024	Agent - Casualty	1/1/2017	6/1/2024
Inactive	Country Mutual Insurance Company	301024	Agent - Property	1/1/2017	6/1/2024
Inactive	Middlesex Mutual Assurance Company	569442	Agent - Casualty	6/29/2016	12/31/2016
Inactive	Middlesex Mutual Assurance Company	569442	Agent - Property	6/29/2016	12/31/2016
Active	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Self-Service Storage Space	8/24/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Houchens Insurance Group, Inc.	637099	Agent - Casualty	4/1/2011	6/1/2024
Inactive	Houchens Insurance Group, Inc.	637099	Agent - Property	4/1/2011	6/1/2024
Inactive	Sky Property Management, LLC	1091887	Agent - Self-Service Storage Space	9/3/2020	3/31/2024