DEPARTMENT OF INSURANCE

Affiliations

Name	Wallace-Corbin, Samantha Jo	DOIID	749438	NAIC NPN	16166075

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Casualty	4/8/2011	4/30/2020
Inactive	Resident	Agent	Health	1/17/2012	4/30/2020
Inactive	Resident	Agent	Property	4/8/2011	4/30/2020
Inactive	Resident	Agent	Life	1/17/2012	4/30/2020
* 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	11/4/2015	3/10/2016
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Property	11/4/2015	3/10/2016
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	9/8/2015	3/28/2016
Inactive	American Fire and Casualty Company	300567	Agent - Property	9/8/2015	3/28/2016
Inactive	Auto Club Property-Casualty Insurance Company	650781	Agent - Casualty	8/24/2015	5/11/2016
Inactive	Auto Club Property-Casualty Insurance Company	650781	Agent - Property	8/24/2015	5/11/2016
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	11/21/2016	12/7/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	11/21/2016	12/7/2017
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	9/8/2015	3/28/2016
Inactive	Consolidated Insurance Company	300943	Agent - Property	9/8/2015	3/28/2016
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	8/16/2017	5/20/2020
Inactive	Encompass Indemnity Company	546376	Agent - Property	8/16/2017	5/20/2020
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	8/16/2017	12/13/2018
Inactive	Encompass Insurance Company of America	556578	Agent - Property	8/16/2017	12/13/2018
Inactive	Erie Family Life Insurance Company	301400	Agent - Health	2/22/2019	2/17/2020
Inactive	Erie Family Life Insurance Company	301400	Agent - Life	10/20/2016	1/10/2020
Inactive	Erie Insurance Company	300230	Agent - Casualty	10/20/2016	1/10/2020
Inactive	Erie Insurance Company	300230	Agent - Property	10/20/2016	1/10/2020
Inactive	Erie Insurance Exchange	300789	Agent - Casualty	10/20/2016	1/10/2020
Inactive	Erie Insurance Exchange	300789	Agent - Property	10/20/2016	1/10/2020
Inactive	FB Insurance Company (The)	301763	Agent - Casualty	4/8/2011	7/29/2011
Inactive	FB Insurance Company (The)	301763	Agent - Property	4/8/2011	7/29/2011
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	5/8/2019	10/19/2019
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	5/8/2019	10/19/2019
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	11/21/2016	4/30/2020
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	11/21/2016	4/30/2020
Inactive	Indiana Insurance Company	301909	Agent - Casualty	9/8/2015	3/28/2016
Inactive	Indiana Insurance Company	301909	Agent - Property	9/8/2015	3/28/2016
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	4/8/2011	7/29/2011
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	4/8/2011	7/29/2011
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	1/21/2016	5/16/2018
Inactive	Motorists Mutual Insurance Company	300963	Agent - Casualty	9/15/2015	11/21/2016
Inactive	Motorists Mutual Insurance Company	300963	Agent - Property	9/15/2015	11/21/2016
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	9/8/2015	3/28/2016
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	9/8/2015	3/28/2016
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	10/12/2015	3/8/2016
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	9/8/2015	3/28/2016
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	9/8/2015	3/28/2016
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	9/8/2015	3/28/2016
Inactive	Ohio Security Insurance Company	300622	Agent - Property	9/8/2015	3/28/2016
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	9/8/2015	3/28/2016
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	9/8/2015	3/28/2016
Inactive	Peerless Insurance Company	301910	Agent - Casualty	9/8/2015	3/28/2016
Inactive	Peerless Insurance Company	301910	Agent - Property	9/8/2015	3/28/2016
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	8/27/2015	2/20/2017
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	8/27/2015	2/20/2017
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	9/10/2015	3/28/2016
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	9/10/2015	3/28/2016
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	9/10/2015	3/28/2016
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	9/10/2015	3/28/2016
Inactive	State Farm Fire and Casualty Company	301809	Agent - Casualty	8/22/2011	9/8/2015
Inactive	State Farm Fire and Casualty Company	301809	Agent - Property	8/22/2011	9/8/2015
Inactive	State Farm Life Insurance Company	301810	Agent - Life	1/17/2012	9/8/2015
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	8/22/2011	9/8/2015
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Health	1/17/2012	9/8/2015
Inactive	Time Insurance Company	300683	Agent - Health	8/28/2012	9/8/2015
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	3/2/2016	12/9/2016
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	3/2/2016	12/9/2016
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	3/2/2016	12/9/2016
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	3/2/2016	12/9/2016
Inactive	West American Insurance Company	301112	Agent - Casualty	9/8/2015	3/28/2016
Inactive	West American Insurance Company	301112	Agent - Property	9/8/2015	3/28/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Independent Agents of KY, Inc.	610901	Agent - Casualty	2/18/2019	1/14/2020
Inactive	Independent Agents of KY, Inc.	610901	Agent - Property	2/18/2019	1/14/2020
Inactive	Independent Agents of KY, Inc.	610901	Agent - Life	2/18/2019	1/10/2020
Inactive	Independent Agents of KY, Inc.	610901	Agent - Health	2/22/2019	1/14/2020
Inactive	Old Kentucky Insurance Inc.	399452	Agent - Casualty	8/26/2015	4/12/2016
Inactive	Old Kentucky Insurance Inc.	399452	Agent - Property	8/26/2015	4/12/2016
Inactive	Old Kentucky Insurance Inc.	399452	Agent - Life	8/26/2015	9/8/2015
Inactive	Old Kentucky Insurance Inc.	399452	Agent - Health	8/26/2015	9/8/2015