DEPARTMENT OF INSURANCE

Affiliations

Name	Dalbey, Samantha Lou	DOIID	840264	NAIC NPN	17260689

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Casualty	5/9/2014	6/30/2025
Active	Non Resident	Agent	Life	5/9/2014	6/30/2025
Active	Non Resident	Agent	Property	5/9/2014	6/30/2025
Active	Non Resident	Agent	Health	5/9/2014	6/30/2025
* 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
Active	AmTrust Insurance Company	300179	Agent - Casualty	7/30/2014
Active	AmTrust Insurance Company	300179	Agent - Property	7/30/2014
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	7/13/2017	12/5/2018
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	7/13/2017	12/5/2018
Active	Hartford Underwriters Insurance Company	301064	Agent - Casualty	10/31/2022
Active	Hartford Underwriters Insurance Company	301064	Agent - Property	10/31/2022
Active	Milford Casualty Insurance Company	301460	Agent - Casualty	7/30/2014
Active	Milford Casualty Insurance Company	301460	Agent - Property	7/30/2014
Active	Park National Insurance Company	692514	Agent - Casualty	7/30/2014
Active	Park National Insurance Company	692514	Agent - Property	7/30/2014
Active	Security National Insurance Company	301151	Agent - Casualty	7/30/2014
Active	Security National Insurance Company	301151	Agent - Property	7/30/2014
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	8/11/2015	8/16/2017
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	8/11/2015	8/16/2017
Active	Technology Insurance Company	613278	Agent - Casualty	7/30/2014
Active	Technology Insurance Company	613278	Agent - Property	7/30/2014
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	2/20/2018	12/23/2019
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	2/20/2018	12/23/2019
Active	United States Fire Insurance Company	582240	Agent - Health	10/9/2017
Active	Wesco Insurance Company	300534	Agent - Casualty	7/30/2014
Active	Wesco Insurance Company	300534	Agent - Property	7/30/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Denied	Sebrite Agcy Inc	526312	Agent - Health
Active	Sebrite Agcy Inc	526312	Agent - Property	7/30/2014
Active	Sebrite Agcy Inc	526312	Agent - Casualty	7/30/2014