Notification of Changes for Business Entity
General Information
Business Entity Name:	THE GENERAL AUTOMOBILE INS SVCS INC
Incorporation / Formation Date:
FEIN:	62-1684225
Ohio License Number:	36214
NPN:	6539339
DBA / Trade Name:
State of Domicile:	CA
County:	SAN BERNARDINO
Business Address
Address 1:	4141 E INLAND EMPIRE BLVD #290
Address 2:
City:	ONTARIO
State:	OH
Zip:	91764
Phone:	800-280-1466
Fax:
Business Web Site Address:	WWW.THEGENERAL.COM
Business Email Address:	MBARNETT@THEGENERAL.COM
Mailing Address
Address 1:	2636 ELM HILL PIKE
Address 2:
City:	NASHVILLE
State:	TN
Zip:	37214
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
REGALADO, ANA	PRODUCER	10028179	YES		12/27/2016
RILEY, JORDAN TANNER	PRODUCER	16506778	YES		12/27/2016
RODGERS, MARK ALLEN	PRODUCER	2189270	YES		12/27/2016
RYAN, WILLIAM	PRODUCER	15946119	YES		12/27/2016
SALAS, MARCELLA E	PRODUCER	17882334	YES		12/27/2016
SHERROD, AARON KELLEY	PRODUCER	17315892	YES		12/27/2016
SMITH, SHANE ADAM	PRODUCER	16910780	YES		12/27/2016
SOLIMAN, JUDITH A	PRODUCER	7123319	YES		12/27/2016
TABAREZ, ROMAN	PRODUCER	18242840	YES		12/27/2016
TAYLOR, BRITTANY LYNN	PRODUCER	17629531	YES		12/27/2016
TOLEDO, RICARDO	PRODUCER	10660659	YES		12/27/2016
VALLERY, SHEVON BRANDY	PRODUCER	17284690	YES		12/27/2016
VOLK, TIMOTHY BRIAN	PRODUCER	2338219	YES		12/27/2016
WECHT, PAMELA SUSAN	PRODUCER	8047552	YES		12/27/2016
WHITEHEAD, GARY	PRODUCER	8987828	YES		12/27/2016

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:	MEGAN BARNETT
Title:	LICENSING ADMIN
Phone Number:	800-257-0263 #3248
Email Address:	MBARNETT@THEGENERAL.COM