DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Forech, Shantasia Olympia	DOIID	781298	NAIC NPN	3746751

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	5/28/2021	1/31/2024
Inactive	Non Resident	Agent	Property	5/28/2021	1/31/2024
Active	Non Resident	Independent Adjuster	Property & Casualty	6/15/2023		1/31/2026
Inactive	Non Resident	Staff Adjuster	Property & Casualty	5/8/2012	1/31/2014
* 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	National General Insurance Company	300152	Agent - Casualty	6/1/2021	8/30/2021
Inactive	National General Insurance Company	300152	Agent - Property	6/1/2021	8/30/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AFICS, Inc	1122840	Independent Adjuster - Property & Casualty	6/23/2023	12/6/2023