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	6/30/2027
Active	Non Resident	Agent	Health	5/9/2014	6/30/2027
Active	Non Resident	Agent	Life	5/9/2014	6/30/2027
Active	Non Resident	Agent	Property	5/9/2014	6/30/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2025	06/30/2025	04/01/2025	04/01/2025	Yes

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
Inactive	Park National Insurance Company	692514	Agent - Casualty	7/30/2014	3/29/2025
Inactive	Park National Insurance Company	692514	Agent - Property	7/30/2014	3/29/2025
Active	Property and Casualty Insurance Company of Hartford	301409	Agent - Casualty	5/27/2025
Active	Property and Casualty Insurance Company of Hartford	301409	Agent - Property	5/27/2025
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