Notification of Changes for Business Entity
General Information  
Business Entity Name: THE KEENAN AGENCY, INC.
Incorporation / Formation Date: 09/03/1981
FEIN: 31-1016723
Ohio License Number: 1529
NPN: 1702259
DBA / Trade Name:  
State of Domicile: OH
County: FRANKLIN
Business Address  
Address 1: 6805 AVERY MUIRFIELD DR.
Address 2: SUITE 200
City: DUBLIN
State: OH
Zip: 43016
Phone: 614-764-7000
Fax:  
Business Web Site Address:  
Business Email Address: MKEENAN@KEENANINS.COM
Mailing Address  
Address 1: 6805 AVERY MUIRFIELD DR.
Address 2: SUITE 200
City: DUBLIN
State: OH
Zip: 43016
   
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
           
Members, Owners, Partners, Officers and Directors
Name Title Identifying # Add Delete Eff. Date
MICHAEL H KEENAN PRESIDENT 33 1/3% 359334 YES   01/01/2017
JILL L KEENAN SEC. TREASURER 33 1/3% 2342344 YES   01/01/2017
RYAN M KEENAN VICE PRESIDENT 33 1/3% 16153662 YES   01/01/2017
CHANGES ABOVE REPRESENT    
OWNERSHIP OF THE STOCK OF    
THE KEENAN AGENCY, INC.    
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: MICHAEL H KEENAN
Title: PRESIDENT
Phone Number: 614-764-7000
Email Address: MKEENAN@KEENANINS.COM