DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Gholson, Samuel Lee	DOIID	751890	NAIC NPN	16197126

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Property	6/27/2011	8/1/2014
Inactive	Resident	Agent	Casualty	6/27/2011	8/1/2014
* 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	Bristol West Insurance Company	301655	Agent - Casualty	6/30/2011	10/19/2012
Inactive	Bristol West Insurance Company	301655	Agent - Property	6/30/2011	10/19/2012
Inactive	Farmers Insurance Exchange	300336	Agent - Casualty	6/30/2011	8/21/2012
Inactive	Farmers Insurance Exchange	300336	Agent - Property	6/30/2011	8/21/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/30/2011	10/19/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/30/2011	10/19/2012
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	7/6/2011	7/1/2013
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	7/6/2011	7/1/2013
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	1/3/2012	8/1/2014
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	1/3/2012	8/1/2014
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	1/3/2012	8/1/2014
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	1/3/2012	8/1/2014
Inactive	Truck Insurance Exchange	300335	Agent - Casualty	6/30/2011	8/21/2012
Inactive	Truck Insurance Exchange	300335	Agent - Property	6/30/2011	8/21/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Advantage Insurance Services LLC	687255	Agent - Casualty	6/30/2011	9/28/2012
Inactive	Advantage Insurance Services LLC	687255	Agent - Property	6/30/2011	9/28/2012