DEPARTMENT OF INSURANCE

Affiliations

Name	Forman, Christopher Michael	DOIID	769754	NAIC NPN	2813662

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	11/29/2011	10/31/2025
Active	Non Resident	Agent	Casualty	11/29/2011	10/31/2025
* 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	08/15/2025	10/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019	3/29/2024
Inactive	American Economy Insurance Company	300315	Agent - Property	11/9/2019	3/29/2024
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	1/4/2012	12/7/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	1/4/2012	12/7/2017
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/4/2012	6/3/2025
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/4/2012	6/3/2025
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	3/19/2015	8/29/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	3/19/2015	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	3/19/2015	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	3/19/2015	8/29/2018
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	11/1/2018	12/11/2020
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	11/1/2018	12/11/2020
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	12/22/2020	7/19/2023
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	12/22/2020	7/19/2023
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	3/13/2019	10/15/2021
Inactive	Ohio Security Insurance Company	300622	Agent - Property	3/13/2019	10/15/2021
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	12/5/2011	3/29/2024
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	12/5/2011	3/29/2024
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	12/5/2011	3/29/2024
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	12/5/2011	3/29/2024
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	8/5/2016	12/13/2017
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	8/5/2016	12/13/2017
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	5/23/2017	12/2/2018
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	5/23/2017	12/2/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	TWFG Insurance Services, LLC	675713	Agent - Property	12/18/2012	6/3/2025
Inactive	TWFG Insurance Services, LLC	675713	Agent - Casualty	12/18/2012	6/3/2025