DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Independent Adjuster	11/15/2025	01/31/2026

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