Notification of Changes for Business Entity
General Information
Business Entity Name:	MYLO, LLC
Incorporation / Formation Date:
FEIN:	822576713
Ohio License Number:	1171106
NPN:	18590034
DBA / Trade Name:
State of Domicile:	KS
County:	JOHNSON
Business Address
Address 1:	14425 COLLEGE BLVD STE 180
Address 2:
City:	LENEXA
State:	KS
Zip:	66215
Phone:	9139045300
Fax:
Business Web Site Address:
Business Email Address:	KCLICENSING@LOCKTON.COM
Mailing Address
Address 1:	14425 COLLEGE BLVD STE 180
Address 2:
City:	LENEXA
State:	KS
Zip:	66215
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
CHRISTOPHER M MILLER	AGENT	18612629	YES		04/11/2018
TIMOTHY L NEWTON	AGENT	8026166	YES		04/11/2018
KAREN A NILSEN	AGENT	4873025	YES		04/11/2018
JOHN W OREILLY	AGENT	4891733	YES		04/11/2018
MOLLY H PERDUE	AGENT	18510222	YES		04/11/2018
SHIVAUN R PERDUE	AGENT	16553532	YES		04/11/2018
SEAN E PHIPPS	AGENT	17290484	YES		04/11/2018
WADE A PLADSON	AGENT	9176894	YES		04/11/2018
MARIA G CASTILLO-QUARTARA	AGENT	18614355	YES		04/11/2018
STEVEN L REDMOND	AGENT	16471708	YES		04/11/2018
MIREYA RODRIGUEZ	AGENT	17714791	YES		04/11/2018
ANDREA D ROSEN	AGENT	7553082	YES		04/11/2018
MICHAEL E SCHNEGELBERGER	AGENT	16532759	YES		04/11/2018
AMY K SMITHER	AGENT	5074838	YES		04/11/2018
GABRIEL J STUEVE	AGENT	18725149	YES		04/11/2018

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