Department Personnel
Underwriting Manager
Woodrow White
ext. 43439
Woodrow.B.White@wv.gov
Underwriter
Jeffrey Lawrentz
ext. 20234
Jeff.P.Lawrentz@wv.gov
Underwriter
Tonya Martinez
ext. 20236
Tonya.J.Martinez@wv.gov
Administrative Services Assistant I
Deanne Stevens
ext. 20240
Deanne.R.Stevens@wv.gov
Online Forms
Renewal Questionnaire
(Authorized Agents Only)
Instructions
Certificate Request Form (PDF)
(Please allow 48 hours)
State of West Virginia Auto Insurance
Please print a duplicate copy of the certificate and submit to BRIM.
Supplemental Forms
Click here to access supplemental forms.