DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Formyduval, Sibyl Ann	DOIID	503478	NAIC NPN	3320981

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	8/9/2004	7/1/2010
Inactive	Non Resident	Apprentice Adjuster	Not Applicable	2/21/2000	2/21/2001
Inactive	Non Resident	Staff Adjuster	Property & Casualty	7/1/2010	2/28/2023
* 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	Founders Insurance Company	518816	Adjuster - Independent	7/27/2006	11/2/2006
Inactive	Globe American Casualty Company	301033	Adjuster - Independent	2/28/2001	8/21/2003

Sponsorships

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Carden, Michael Blythe	383932	Apprentice Adjuster - Not Applicable	12/14/2005	12/14/2006
Denied	Cave, Arlie G	503535	Apprentice Adjuster - Not Applicable
Inactive	Santangelo, Richard V	327849	Apprentice Adjuster - Not Applicable	12/14/2005	12/14/2006
Denied	Tomlinson, James G	503702	Apprentice Adjuster - Not Applicable

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Burns, John Marshall	327990	Apprentice Adjuster - Not Applicable	2/21/2000	2/21/2001