Search → WAYNE J. FORMAN
DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE
WAYNE J. FORMAN
PRODUCER NON-RESIDENT
License Number:
PRN78192
Status:
First Licensure:
05/03/2001
Cancel Date:
None
Mailing:
NEW YORK, NY 10128
Phone:
+1 (917) 215-4785
Email:
wforman@leglegal.com
| License Type | Start Date | End Date |
|---|---|---|
| PRODUCER NON-RESIDENT | 08/27/2021 | |
| *** NOT ACTIVE *** | 06/28/2005 | 08/26/2021 |
| PRODUCER NON-RESIDENT | 05/03/2001 | 06/27/2005 |
| Name | Issue Date | License Number | Expiration Date | Cancel Date |
|---|---|---|---|---|
| FORMAN INTERNATIONAL LTD |
05/03/2001 | AGN78236 | 06/28/2005 |
| Name | Issue Date | License Number | Expiration Date | Cancel Date |
|---|---|---|---|---|
| NATIONAL SPECIALTY INSURANCE COMPANY |
12/21/2022 | PCF94585 | ||
| STATE NATIONAL INSURANCE COMPANY INC. |
12/21/2022 | PCF75933 |
| Description | Issue Date | Termination Date | Status |
|---|---|---|---|
| CASUALTY | 08/27/2021 | Active | |
| PERSONAL LINES | 08/27/2021 | Active | |
| PROPERTY | 08/27/2021 | Active | |
| PROPERTY AND CASUALTY | 05/03/2001 | 06/28/2005 | Terminated |
License/Disciplinary Action
None.
GENERAL INFORMATION
NAIC Information
National Producer Number (NPN):
1007374
| Address | Type |
|---|---|
| NEW YORK, NY 10128 |
Office |
An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.
Date: 03/29/2026 01:31:05 PM
