Notification of Changes for Business Entity
General Information
Business Entity Name:	WATERFORD FINANCIAL SERVICES LLC
Incorporation / Formation Date:
FEIN:	30 0509451
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	WASHINGTON
Business Address
Address 1:	20115 RT 339
Address 2:
City:	WATERFORD
State:	OH
Zip:	45786
Phone:	7409842357
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	PO BOX 65
Address 2:
City:	WATERFORD
State:	OH
Zip:	45786
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
MELINDA HARRA	CREDIT PRODUCER	294620012	YES		8/1/2018
AMY HARTLEY	CREDIT PRODUCER	299824270	YES		8/1/2018

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
CHRISTINA MARIE COMBS	PRESIDENT	297662172	YES		8/1/2018
LORETTA MURPHY	SEC/TRESURER	289 64 1516	YES		8/1/2018

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:	AZA BITTINGER
Title:	RDA
Phone Number:	614 846 2238
Email Address:	AHBITTINGER@CBAO.COM