DEPARTMENT OF INSURANCE

Affiliations

Name	Forcht, Marion C	DOIID	331728	NAIC NPN	7179133

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Mortgage Redemption	12/30/1998	8/7/2000
Inactive	Resident	Agent	Health	7/11/1984	12/31/2008
Inactive	Resident	Agent	Health Maintenance Organization	10/27/1999	11/1/2000
Inactive	Resident	Agent	Casualty	8/15/2000	12/31/2008
Inactive	Resident	Agent	Life	7/11/1984	12/31/2008
Inactive	Resident	Agent	General Lines	2/1/1984	8/15/2000
Inactive	Resident	Agent	Property	8/15/2000	12/31/2008
Inactive	Resident	Agent	Limited Line Credit	8/7/2000	1/16/2002
AFFIDAVIT ON FILE
* 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	AIG Assurance Company	300897	Agent - Casualty	5/26/2005	12/31/2008
Inactive	AIG Assurance Company	300897	Agent - Property	5/26/2005	12/31/2008
Inactive	AIU Insurance Company	300729	Agent - General Lines	2/1/1984	3/31/1996
Inactive	Allstate Indemnity Company	300778	Agent - Casualty	8/5/2003	3/8/2007
Inactive	Allstate Indemnity Company	300778	Agent - Property	8/5/2003	3/8/2007
Inactive	Allstate Insurance Company	300773	Agent - Casualty	8/5/2003	3/8/2007
Inactive	Allstate Insurance Company	300773	Agent - Property	8/5/2003	3/8/2007
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	8/12/2005	3/8/2007
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Property	8/12/2005	3/8/2007
Inactive	American Bankers Life Assurance Company of Florida	300171	Agent - Health	7/31/1995	12/16/1996
Inactive	American Bankers Life Assurance Company of Florida	300171	Agent - Life	7/31/1995	12/16/1996
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	5/12/1998	12/31/2008
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	5/12/1998	12/31/2008
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	10/7/2008	12/31/2008
Inactive	American Fire and Casualty Company	300567	Agent - Property	10/7/2008	12/31/2008
Inactive	American General Assurance Company	300586	Agent - Health	12/28/1995	12/31/2008
Inactive	American General Assurance Company	300586	Agent - Life	12/28/1995	12/31/2008
Inactive	American General Life Insurance Company	301585	Agent - Health	9/3/2002	10/12/2006
Inactive	American General Life Insurance Company	301585	Agent - Life	9/3/2002	10/12/2006
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	5/31/1994	11/4/2002
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	5/31/1994	11/4/2002
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	8/15/2000	12/31/2008
Inactive	American Modern Home Insurance Company	300791	Agent - General Lines	8/19/1991	8/15/2000
Inactive	American Modern Home Insurance Company	300791	Agent - Property	8/15/2000	12/31/2008
Inactive	American National Insurance Company	301861	Agent - Health	4/15/1998	12/31/2008
Inactive	American National Insurance Company	301861	Agent - Life	4/15/1998	12/31/2008
Inactive	American Resources Insurance Company, Inc.	300454	Agent - Casualty	8/15/2000	4/23/2007
Inactive	American Resources Insurance Company, Inc.	300454	Agent - General Lines	6/8/1995	8/15/2000
Inactive	American Resources Insurance Company, Inc.	300454	Agent - Property	8/15/2000	4/23/2007
Inactive	American States Life Insurance Company	301884	Agent - Health	11/1/1998	12/4/2001
Inactive	American States Life Insurance Company	301884	Agent - Life	11/1/1998	12/4/2001
Inactive	Assurance Company of America	300432	Agent - Casualty	10/28/2002	12/31/2008
Inactive	Assurance Company of America	300432	Agent - Property	10/28/2002	12/31/2008
Inactive	Blackboard Insurance Company	301640	Agent - Casualty	10/28/2002	11/30/2007
Inactive	Blackboard Insurance Company	301640	Agent - Property	10/28/2002	11/30/2007
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	9/8/1987	4/8/2003
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	9/8/1987	4/8/2003
Inactive	Canada Life Assurance Company	301192	Agent - Health	5/15/2002	12/14/2004
Inactive	Canada Life Assurance Company	301192	Agent - Life	5/15/2002	12/14/2004
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Health	9/10/2001	12/5/2005
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Life	9/10/2001	12/5/2005
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	10/7/2008	12/31/2008
Inactive	Consolidated Insurance Company	300943	Agent - Property	10/7/2008	12/31/2008
Inactive	Everlake Life Insurance Company	300873	Agent - Health	8/5/2003	3/8/2007
Inactive	Everlake Life Insurance Company	300873	Agent - Life	8/5/2003	3/8/2007
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	5/4/1998	12/31/2008
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	2/13/1995	4/13/2001
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	2/13/1995	4/13/2001
Inactive	First National Insurance Company of America	301690	Agent - General Lines	4/27/1993	5/9/1996
Inactive	General Insurance Company of America	300261	Agent - General Lines	4/27/1993	5/9/1996
Inactive	Golden Rule Insurance Company	301943	Agent - Health	5/20/1986	3/31/1997
Inactive	Golden Rule Insurance Company	301943	Agent - Life	5/20/1986	3/31/1997
Inactive	Granite State Insurance Company	300818	Agent - Casualty	5/26/2005	12/31/2008
Inactive	Granite State Insurance Company	300818	Agent - Property	5/26/2005	12/31/2008
Inactive	Great American Insurance Company	301586	Agent - General Lines	3/31/1994	3/31/1996
Inactive	Great American Insurance Company of New York	301897	Agent - General Lines	3/31/1994	3/31/1996
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/21/2001	12/31/2008
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	10/27/1999	11/1/2000
Inactive	Humana Insurance Company	301104	Agent - Health	12/27/2001	12/31/2008
Inactive	Humana Insurance Company	301104	Agent - Life	12/21/2001	12/31/2008
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	10/16/1992	12/19/2002
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	10/16/1992	12/19/2002
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	5/26/2005	12/31/2008
Inactive	Illinois National Insurance Company	301367	Agent - Property	5/26/2005	12/31/2008
Inactive	Indiana Insurance Company	301909	Agent - Casualty	10/7/2008	12/31/2008
Inactive	Indiana Insurance Company	301909	Agent - Property	10/7/2008	12/31/2008
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	12/31/2008
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	12/31/2008
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Health	1/6/2005	12/31/2008
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	1/6/2005	12/31/2008
Inactive	Kentucky National Insurance Company	301625	Agent - Casualty	8/15/2000	12/31/2008
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	6/1/1984	8/15/2000
Inactive	Kentucky National Insurance Company	301625	Agent - Property	8/15/2000	12/31/2008
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Health	6/4/1998	12/31/2008
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Life	6/4/1998	12/31/2008
Inactive	Lyndon Southern Insurance Company	609602	Agent - Casualty	10/4/2005	12/31/2008
Inactive	Lyndon Southern Insurance Company	609602	Agent - Property	10/4/2005	12/31/2008
Inactive	Maryland Casualty Company	301719	Agent - Casualty	10/28/2002	12/31/2008
Inactive	Maryland Casualty Company	301719	Agent - Property	10/28/2002	12/31/2008
Inactive	Metropolitan General Insurance Company	300709	Agent - Casualty	8/15/2000	5/13/2003
Inactive	Metropolitan General Insurance Company	300709	Agent - General Lines	5/5/1998	8/15/2000
Inactive	Metropolitan General Insurance Company	300709	Agent - Property	8/15/2000	5/13/2003
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	2/14/2000	12/31/2008
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	8/9/1993	3/31/1999
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	8/9/1993	3/31/1999
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	10/7/2008	12/31/2008
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	10/7/2008	12/31/2008
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	10/28/2002	12/31/2008
Inactive	Northern Insurance Company of New York	301317	Agent - Property	10/28/2002	12/31/2008
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	10/7/2008	12/31/2008
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	10/7/2008	12/31/2008
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	10/7/2008	12/31/2008
Inactive	Ohio Security Insurance Company	300622	Agent - Property	10/7/2008	12/31/2008
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Health	6/29/2000	3/31/2003
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Life	6/29/2000	3/31/2003
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	10/7/2008	12/31/2008
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	10/7/2008	12/31/2008
Inactive	Peerless Insurance Company	301910	Agent - Casualty	10/7/2008	12/31/2008
Inactive	Peerless Insurance Company	301910	Agent - Property	10/7/2008	12/31/2008
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Casualty	9/10/2007	12/31/2008
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Property	9/10/2007	12/31/2008
Inactive	Protective Property & Casualty Insurance Company	300393	Agent - Casualty	8/15/2000	11/21/2006
Inactive	Protective Property & Casualty Insurance Company	300393	Agent - General Lines	11/17/1993	8/15/2000
Inactive	Protective Property & Casualty Insurance Company	300393	Agent - Property	8/15/2000	11/21/2006
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	4/18/2000	12/31/2008
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	4/18/2000	12/31/2008
Inactive	Reliance Insurance Company	300785	Agent - Health	5/8/1995	4/12/1996
Inactive	SAFECO Insurance Company of America	300159	Agent - General Lines	4/27/1993	5/9/1996
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - General Lines	4/27/1993	5/16/1996
Inactive	SAFECO National Insurance Company	300989	Agent - General Lines	4/27/1993	3/31/1998
Inactive	Security Life Insurance Company of America	300936	Agent - Health	2/10/1997	11/5/2001
Inactive	Security Life Insurance Company of America	300936	Agent - Life	2/10/1997	11/5/2001
Inactive	Shenandoah Life Insurance Company	300130	Agent - Health	4/16/1990	3/31/1997
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	4/16/1990	3/31/1997
Inactive	South Carolina Insurance Company	300080	Agent - General Lines	4/18/1998	6/7/2000
Inactive	Symetra Life Insurance Company	301691	Agent - Health	10/10/1989	12/4/2001
Inactive	Symetra Life Insurance Company	301691	Agent - Life	10/10/1989	12/4/2001
Inactive	West American Insurance Company	301112	Agent - Casualty	10/7/2008	12/31/2008
Inactive	West American Insurance Company	301112	Agent - Property	10/7/2008	12/31/2008
Inactive	Wilco Life Insurance Company	300122	Agent - Health	9/2/1993	4/27/2001
Inactive	Wilco Life Insurance Company	300122	Agent - Life	9/2/1993	4/27/2001

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	12/14/2001	12/31/2008
Inactive	Forcht Insurance Agency	398469	Agent - Life	7/11/1984	12/31/2008
Inactive	Forcht Insurance Agency	398469	Agent - Health	7/11/1984	12/31/2008
Inactive	Forcht Insurance Agency	398469	Agent - General Lines	7/11/1984	8/15/2000
Inactive	Forcht Insurance Agency	398469	Agent - Property	8/15/2000	12/31/2008
Inactive	Forcht Insurance Agency	398469	Agent - Casualty	8/15/2000	12/31/2008
Inactive	PRP National Bank	399291	Agent - Mortgage Redemption	12/30/1998	8/7/2000
Inactive	PRP National Bank	399291	Agent - Limited Line Credit	8/7/2000	1/16/2002

Sponsorships

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Forcht, Nancy Brock	361207	Solicitor - General Lines	12/4/1984	12/4/1984