black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

DAVID MICHAEL FORKER

PRODUCER NON-RESIDENT

License Number:
PRN224687
Status:
First Licensure:
11/01/2013
Cancel Date:
None

Mailing:
AMARILLO, TX 79109
Phone:
+1 (614) 677-2321
Fax:
+1 (614) 417-9470
Email:
forkerd1@nationwide.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 11/01/2013

Agency

Name Issue Date License Number Expiration Date Cancel Date
NATIONWIDE SALES SOLUTIONS, INC
05/17/2017 AGN126911

Employer

Name Issue Date License Number Expiration Date Cancel Date
ALLIED INSURANCE COMPANY OF AMERICA
01/01/2020 PCF216138
NATIONWIDE ASSURANCE COMPANY
11/04/2013 PCF38952
NATIONWIDE GENERAL INSURANCE COMPANY
08/28/2018 PCF30
NATIONWIDE INSURANCE COMPANY OF AMERICA
01/01/2020 PCF422
NATIONWIDE MUTUAL FIRE INSURANCE COMPANY
02/07/2014 PCF31 01/01/2023
NATIONWIDE MUTUAL INSURANCE COMPANY
09/19/2016 PCF32
NATIONWIDE PROPERTY & CASUALTY INSURANCE COMPANY
11/04/2013 PCF151089
TITAN INDEMNITY COMPANY
11/04/2013 PCF38950 10/06/2018

Authority

Description Issue Date Termination Date Status
CASUALTY 11/01/2013 Active
PROPERTY 11/01/2013 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
8485943

Other Addresses

Address Type
1 NATIONWIDE PLZ
COLUMBUS, OH 43215-2226
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: 10/21/2025 03:49:21 PM