Underwriting

Department Personnel

Underwriting Manager

Vacant

ext

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

Office Assistant II

Jason Stover

ext. 20243

Jason.M.Stover@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.

Workbased Learning Program
(Work-Based Coordinators Only)

Supplemental Forms

Click HERE to access supplemental forms.