DEPARTMENT OF INSURANCE

Affiliations

Name	Forney, Charles Anthony	DOIID	352709	NAIC NPN	6413553

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Adjuster	Independent	7/23/1998	8/4/1999
Inactive	Non Resident	Apprentice Adjuster	Not Applicable	2/27/1998	7/23/1998
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Farmers Property and Casualty Insurance Company	301237	Adjuster - Independent	7/23/1998	8/4/1999