Notification of Changes for Business Entity
General Information
Business Entity Name:	TRG UNITED
Incorporation / Formation Date:
FEIN:	47-1294888
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	DELAWARE
Business Address
Address 1:	15 MIDDLE ST
Address 2:
City:	GALENA
State:	OH
Zip:	43021
Phone:	740-965-1972
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	PO BOX 277
Address 2:
City:	GALENA
State:	OH
Zip:	43021
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
SETH HOLDSWORTH	SALES DIRECTOR	16467315	YES		02/20/2018
LINDA RESCH	PRODUCER	2449402	YES		02/20/2018

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:	SETH HOLDSWORTH
Title:	SALES DIRECTOR
Phone Number:	740-965-1972
Email Address:	SETH@TRGUNITED.COM