Notification of Changes for Business Entity
General Information
Business Entity Name:	MORGAN STANLEY INSURANCE SERVICES INC
Incorporation / Formation Date:	09/15/1972
FEIN:	510116113
Ohio License Number:	35488
NPN:
DBA / Trade Name:
State of Domicile:	DE
County:	NEW CASTLE
Business Address
Address 1:	1209 MARKET STREET
Address 2:
City:	WILMINGTON
State:	DE
Zip:	19801
Phone:	4436274934
Fax:	4439224225
Business Web Site Address:
Business Email Address:	SB_LICENSING@MORGANSTANLEY.COM
Mailing Address
Address 1:	1300 THAMES STREET
Address 2:	COMPLANCE 7TH FLOOR
City:	BALTIMORE
State:	MD
Zip:	21231
Indicate the type of change you are seeking
Address Change:	NO
Business Entity Name Change:	NO	Old Business Entity Name:
New DBA/Trade Name:	NO	New DBA/Trade Name:
Amend DBA/Trade Name:	NO	Old DBA/Trade Name:
Add/Delete Producers, Members, Owners, Partners, Officers and/or Directors:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
MARY WILLIAMS	PRODUCER	1122606	YES		09-22-2016
BRANDON SWAN	PRODUCER	1112861	YES		09-22-2016
TRAVIS WICHMAN	PRODUCER	1122625	YES		09-22-2016

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date

Title Business Entities Only
1. Is any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance? (i.e. banking, auto dealer, mortgage company)
2. Has any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance since the filing of the previous CN-65 or the original application?
3. If the answer to questions #1 or #2 is yes, identify the business or profession and the nature of person's involvement

Submitted By
Submitted By:	HANY YOUNIS
Title:	VICE PRESIDENT
Phone Number:	4436274934
Email Address:	SB_LICENSING@MORGANSTANLEY.COM