Notification of Changes for Business Entity
General Information
Business Entity Name:	MYLO, LLC
Incorporation / Formation Date:
FEIN:	822576713
Ohio License Number:	1171106
NPN:
DBA / Trade Name:
State of Domicile:	MO
County:	JACKSON
Business Address
Address 1:	8880 WARD PARKWAY, SUITE 200
Address 2:
City:	KANSAS CITY
State:	MO
Zip:	64114
Phone:	9139045300
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	8880 WARD PARKWAY, SUITE 200
Address 2:
City:	KANSAS CITY
State:	MO
Zip:	64114
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:	YES

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
JUSTIN L LOHMEYER	AGENT	17823833	YES		08/06/2018
ALEXANDER P GASCA	AGENT	18856697	YES		08/06/2018
MOLLY P MYERS	AGENT	6086908	YES		08/06/2018

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:	JASON L GIBSON
Title:	AUTHORIZED PERSON / MANAGER OF CALL CENTER
Phone Number:	9139045300
Email Address:	KCLICENSING@LOCKTON.COM