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:
NPN:
DBA / Trade Name:
State of Domicile:	CA
County:	RIVERDALE
Business Address
Address 1:	3610 CENTRAL AVENUE SUITE 204
Address 2:
City:	RIVERSIDE
State:	CA
Zip:	92506
Phone:	800-280-1466
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	3610 CENTRAL AVENUE SUITE 204
Address 2:
City:	RIVERSIDE
State:	CA
Zip:	92506
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
MICHAELA JORDAN	PRODUCER	18341867	YES		04/27/2017
AARON WOODCOX	PRODUCER	8766398	YES		04/27/2017
JOSHUA GIAMPIETRO	PRODUCER	18355431	YES		04/27/2017
AMBER NUNES	PRODUCER	18350573	YES		04/27/2017
NABIL ANWAR	PRODUCER	18294237	YES		04/27/2017
LENOX WEBER	PRODUCER	18371899	YES		04/27/2017
ANDREW MCCABE	PRODUCER	17516682	YES		04/27/2017

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:	MEGAN BARNETT
Title:	RETAIL LICENSING ADMINISTRATOR
Phone Number:	800-280-1466
Email Address:	MBARNETT@THEGENERAL.COM