{"entity":{"id":9389609,"state":"FL","state_id":"821423","entity_name":"FORUM INSURANCE COMPANY","entity_type":"FORP","entity_type_normalized":"foreign_profit","status":"I","filing_date":"1968-05-08","filing_year":1968,"business_age_years":58,"principal_address1":"200 N MARTINGALE ROAD","principal_address2":"","principal_city":"SCHAUMBURG","principal_state":"IL","principal_zip":"60194","principal_country":"","mail_address1":"200 N MARTINGALE ROAD","mail_address2":"","mail_city":"SCHAUMBURG","mail_state":"IL","mail_zip":"60194","mail_country":"","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"050303803","jurisdiction":null,"county":null,"last_transaction_date":"05091986","report_year_1":"1985","report_date_1":"04261985","report_year_2":"1985","report_date_2":"04261985","report_year_3":"1984","report_date_3":"06211984","agent_name":"Financial Officer Chief","agent_type":"C","agent_address":"P O BOX 6200 (32314-6200)","agent_city":"TALLAHASSEE","agent_state":"FL","agent_zip":"323990000","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata3.txt","fetched_at":"2026-05-09 11:30:31","updated_at":"2026-05-09 11:30:31","last_accessed":null,"status_reason":null,"agent_name_raw":"CHIEF FINANCIAL OFFICER"},"officers":[{"name":"Roland Baker","first_name":"Roland","last_name":"Baker","title":"Chairman, Director","title_roles":["Chairman","Director"],"title_code":"cd","is_registered_agent":false,"address":"200 N MARTINGALE RD","city":"SCHAUMBURG, ILL    00000","state":"","zip":"","name_raw":"BAKER, ROLAND"},{"name":"Robert S Bartlow","first_name":"Robert","last_name":"Bartlow","title":"Treasurer, Director","title_roles":["Treasurer","Director"],"title_code":"td","is_registered_agent":false,"address":"200 N MARTINGALE RD","city":"SCHAUMBURG, ILL    00000","state":"","zip":"","name_raw":"BARTLOW, ROBERT S"},{"name":"Gerald E Dennis","first_name":"Gerald","last_name":"Dennis","title":"Secretary, Director","title_roles":["Secretary","Director"],"title_code":"sd","is_registered_agent":false,"address":"200 N MARTINGALE RD","city":"SCHAUMBURG, ILL    00000","state":"","zip":"","name_raw":"DENNIS, GERALD E"},{"name":"Barbara J Lautzenheiser","first_name":"Barbara","last_name":"Lautzenheiser","title":"President, Director","title_roles":["President","Director"],"title_code":"pd","is_registered_agent":false,"address":"200 N MARTINGALE RD","city":"SCHAUMBURG","state":"IL","zip":"","name_raw":"LAUTZENHEISER, BARBARA J"},{"name":"Walter T Liptak","first_name":"Walter","last_name":"Liptak","title":"Vice President, Director","title_roles":["Vice President","Director"],"title_code":"vd","is_registered_agent":false,"address":"200 N MARTINGALE RD","city":"SCHAUMBURG, ILL    00000","state":"","zip":"","name_raw":"LIPTAK, WALTER T"},{"name":"Edward W. Pell","first_name":"Edward","last_name":"Pell","title":"Vice President, Director","title_roles":["Vice President","Director"],"title_code":"vd","is_registered_agent":false,"address":"200 N MARTINGALE RD","city":"SCHAUMBURG, ILL    00000","state":"","zip":"","name_raw":"PELL, EDWARD W."}],"filing_history":[],"status_history":[],"unknown":["status_history: we do not collect status-change histories from the source feeds, so this empty list means we hold none — NOT that this company's status has never changed. Observed changes we DID see are under `history`."],"verified_domains":[],"history":null,"web_contact":null,"provenance_url":"https://private.rootz.global/api/provenance/FL/821423"}