DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Forrest, Jana M	DOIID	611744	NAIC NPN	2944680

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	7/12/2005	2/28/2015
Inactive	Non Resident	Agent	Casualty	7/12/2005	2/28/2015
* 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	Atlantic Specialty Insurance Company	518595	Agent - Casualty	9/10/2014	2/28/2015
Inactive	Atlantic Specialty Insurance Company	518595	Agent - Property	9/10/2014	2/28/2015
Inactive	Capitol Indemnity Corporation	301030	Agent - Casualty	4/12/2011	3/13/2012
Inactive	Capitol Indemnity Corporation	301030	Agent - Property	4/12/2011	3/13/2012
Inactive	Colonial American Casualty & Surety Company	300769	Agent - Casualty	3/15/2006	9/30/2014
Inactive	Colonial American Casualty & Surety Company	300769	Agent - Property	3/15/2006	9/30/2014
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Casualty	3/15/2006	9/30/2014
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Property	3/15/2006	9/30/2014
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	11/20/2012	2/28/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	11/20/2012	2/28/2015
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	11/20/2012	2/28/2015
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	11/20/2012	2/28/2015
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	11/20/2012	2/28/2015
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	11/20/2012	2/28/2015
Inactive	Merchants Bonding Company (Mutual)	300170	Agent - Casualty	1/5/2006	10/5/2012
Inactive	Platte River Insurance Company	301089	Agent - Casualty	4/12/2011	3/13/2012
Inactive	Platte River Insurance Company	301089	Agent - Property	4/12/2011	3/13/2012
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	10/9/2013	2/28/2015
Inactive	Zurich American Insurance Company	301121	Agent - Property	10/9/2013	2/28/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	IMA Inc	766098	Agent - Property	1/12/2012	9/26/2014
Inactive	IMA Inc	766098	Agent - Casualty	1/12/2012	9/26/2014
Inactive	Ima Of Kansas Inc	583037	Agent - Property	3/30/2006	1/24/2012
Inactive	Ima Of Kansas Inc	583037	Agent - Casualty	3/30/2006	1/24/2012