Notification of Changes for Business Entity
General Information
Business Entity Name:	TZ INSURANCE SOLUTIONS LLC
Incorporation / Formation Date:
FEIN:	271602268
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	NJ
County:	BELGRUM
Business Address
Address 1:	2200 FLETCHER AVE 4TH FLOOR
Address 2:
City:	FORT LEE
State:	NJ
Zip:	07024
Phone:	3049293257
Fax:	3049293259
Business Web Site Address:
Business Email Address:	LICENSING@TZINSURANCE.COM
Mailing Address
Address 1:	2200 FLETCHER AVE 4TH FLOOR
Address 2:
City:	FORT LEE
State:	NJ
Zip:	07024
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
AIESHA COOPER	PRODUCER	17261270		YES	01/10/2017
AKEEBA GIBBS	PRODUCER	17663965		YES	01/10/2017
ANGELA RICHARDSON	PRODUCER	6602248		YES	01/10/2017
ANGELLEN THOMPSON	PRODUCER	17038405		YES	01/10/2017
ANN MCINTOSH	PRODUCER	16229402		YES	01/10/2017
ANQUAN PATTERSON	PRODUCER	17957075		YES	01/10/2017
ARMONI NEILS	PRODUCER	18008190		YES	01/10/2017
AETAVIOUS BARRINGER	PRODUCER	17856627		YES	01/10/2017
ARUNABH JAYWANT	PRODUCER	9673589		YES	01/10/2017
BARRINGTON CUMMINGS	PRODUCER	8733772		YES	01/10/2017
BARRY RICHARDS	PRODUCER	7366529		YES	01/10/2017
BEVERLY LINDQUIST	PRODUCER	17708268		YES	01/10/2017
BIANCA NAVARRO	PRODUCER	17098898		YES	01/10/2017
CHARLENE PHILLIP	PRODUCER	17631741		YES	01/10/2017

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)
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:	MICHELE LEASURE
Title:	LICENSING SPECIALIST
Phone Number:	2014826210
Email Address:	LICENSING@TZINSURANCE.COM