Notification of Changes for Business Entity
General Information
Business Entity Name:	TRIMMER INS AGENCY LLC
Incorporation / Formation Date:	01/04/2006
FEIN:	20-3998946
Ohio License Number:	33851
NPN:	8684820
DBA / Trade Name:
State of Domicile:	OH
County:	FAIRFIELD
Business Address
Address 1:	400 N. MEMORIAL DRIVE
Address 2:
City:	LANCASTER
State:	OH
Zip:	43130
Phone:	740-654-0532
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	1200 GRAHAM ROAD
Address 2:
City:	CUYAHOGA FALLS
State:	OH
Zip:	44224
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
SANDRA HINTZ	AGENT	2234506		YES	08/25/2017
BRAD BUSH	AGENT	2223247	YES		08/30/2017
ROGER PERRY	AGENT	2441184	YES		08/30/2017
JEFFERY CASHMAN	AGENT	1809092	YES		08/30/2017
HEATHER TACKETT	AGENT	2827328	YES		08/30/2017
LINDA SULLIVAN	AGENT	3238563	YES		08/30/2017
DON CROUCHER	AGENT	998505	YES		08/30/2017
PAMALA BEVIER	AGENT	2348577	YES		08/30/2017
TRACEY HEISE	AGENT	3236846	YES		08/30/2017
KELLIE SNYDER	AGENT	18478672	YES		08/30/2017
DEBORAH SMITH	AGENT	3237232	YES		08/30/2017
TRAVIS JORDAN	AGENT	2432830	YES		08/30/2017
KATHY THUENER	AGENT	2772280	YES		08/30/2017
KELLIE LIGHT	AGENT	2769582	YES		08/30/2017
SUSAN SHAW	AGENT	2207825	YES		08/30/2017

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)	NO
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?	NO
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:	MARY MACKEY
Title:	ACCOUNTING MANAGER
Phone Number:	330-920-8629
Email Address:	MARY@WICHERT.COM