Notification of Changes for Business Entity
General Information
Business Entity Name:	J. CRAIG RIDDLE COMPANY
Incorporation / Formation Date:	09/03/1968
FEIN:	610675084
Ohio License Number:	24882
NPN:	2329620
DBA / Trade Name:	DBA RIDDLE INSURANCE DBA R. BARGA AND COMPANY
State of Domicile:	KY
County:	HOPKINS
Business Address
Address 1:	245 S MAIN ST
Address 2:
City:	MADISONVILLE
State:	KY
Zip:	42431
Phone:	2708213122
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	P O BOX 549
Address 2:
City:	MADISONVILLE
State:	KY
Zip:	42431
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
CRYSTAL REID	PRODUCER	7215283	YES		02/07/2017

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:	KELLEY CRASE
Title:	LICENSING ADMINISTRATOR
Phone Number:	270-821-3122
Email Address:	KELLEY@RIDDLEINS.COM