DEPARTMENT OF INSURANCE
Affiliations
NameSamuelsen, David AndrewDOIID808759NAIC NPN7108267
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentLife4/24/201311/30/2018 
InactiveNon ResidentAgentVariable Life and Variable Annuities4/24/201311/30/2018 
InactiveNon ResidentAgentHealth4/24/201311/30/2018 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveLincoln National Life Insurance Company (The)301382Agent - Health4/24/20135/1/2017
InactiveLincoln National Life Insurance Company (The)301382Agent - Life4/24/20135/1/2017
InactiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities4/24/20135/1/2017
InactiveNationwide Life Insurance Company300495Agent - Health11/21/20134/7/2017
InactiveNationwide Life Insurance Company300495Agent - Life11/21/20134/7/2017
InactiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities11/21/20134/7/2017
InactiveProtective Life Insurance Company300638Agent - Life1/29/201511/30/2018
InactiveProtective Life Insurance Company300638Agent - Variable Life and Variable Annuities1/29/201511/30/2018
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveUbs Financial Services Ins Agency Inc399373Agent - Health4/24/20135/1/2017
InactiveUbs Financial Services Ins Agency Inc399373Agent - Variable Life and Variable Annuities4/24/201311/30/2018
InactiveUbs Financial Services Ins Agency Inc399373Agent - Life4/24/201311/30/2018

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