Notification of Changes for Business Entity
General Information
Business Entity Name:	THE ENTRECOR GROUP INC
Incorporation / Formation Date:
FEIN:	51-0422484
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	IA
County:	POLK
Business Address
Address 1:	601 6TH AVE
Address 2:
City:	DES MOINES
State:	IA
Zip:	50334
Phone:	5152452081
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	PO BOX 9393
Address 2:
City:	DES MOINES
State:	IA
Zip:	50306
Indicate the type of change you are seeking
Address Change:	YES
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
KATHRYN K LEE	UNDERWRITING DIRECTOR, DRLP	17407413	YES		04/01/2016
JOSEPH F ROTH	DIRECTOR SALES CALL CTR, DRLP	3153280		YES	03/31/2016

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:	BRENDA STONEBERG
Title:	AGENCY ADMINISTRATION TEAM COORDINATOR
Phone Number:	5152452084
Email Address:	BRENDA.STONEBERG@AMERICANENTERPRISE.COM