black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

MACLAIN FORSETH

PRODUCER NON-RESIDENT

License Number:
PRN500750
Status:
First Licensure:
11/07/2024
Cancel Date:
None

Mailing:
TEMPE, AZ 85282
Phone:
+1 (888) 380-6623
Email:
agentlicensing@matic.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 11/07/2024

Agency

None.

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN ECONOMY INSURANCE COMPANY
08/05/2025 PCF363
AMERICAN MODERN PROPERTY & CASUALTY INSURANCE COMPANY
06/25/2025 PCF234561
AMERICAN STRATEGIC INSURANCE CORP
11/15/2024 PCF258492
BRISTOL WEST INSURANCE COMPANY
12/17/2024 PCF78370
FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN
12/17/2024 PCF445
PROGRESSIVE NORTHERN INSURANCE COMPANY
11/21/2024 PCF51006
PROGRESSIVE NORTHWESTERN INSURANCE COMPANY
11/21/2024 PCF27738

Authority

Description Issue Date Termination Date Status
PERSONAL LINES 11/07/2024 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
21112331

Other Addresses

Address Type
777 E MISSOURI AVE STE 210
PHOENIX, AZ 85014-2832
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: 10/29/2025 07:40:30 AM