Notification of Changes for Business Entity
General Information
Business Entity Name:	PROCTOR FINANCIAL, INC.
Incorporation / Formation Date:	10/04/1954
FEIN:	38-1457868
Ohio License Number:	36483
NPN:
DBA / Trade Name:
State of Domicile:	MI
County:	OAKLAND
Business Address
Address 1:	5225 CROOKS RD.
Address 2:
City:	TROY
State:	MI
Zip:	48098
Phone:	248-269-5700
Fax:
Business Web Site Address:
Business Email Address:	LICENSING@PFIC.COM
Mailing Address
Address 1:	5225 CROOKS RD.
Address 2:
City:	TROY
State:	MI
Zip:	48098
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
MICHAEL COX	PRODUCER	989792	YES		12/04/2018

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:	DEANNA STANLEY
Title:	PRESIDENT OF KLS
Phone Number:	214-855-0737
Email Address:	DSTANLEY@KENNEDYLICENSING.COM