Notification of Changes for Business Entity
General Information
Business Entity Name:	CHALICE CAPITAL PARTNERS, LLC
Incorporation / Formation Date:	12/15/2017
FEIN:	81-4245023
Ohio License Number:	1187643
NPN:	18722623
DBA / Trade Name:
State of Domicile:	CA
County:	USA
Business Address
Address 1:	16935 WEST BERNARDO DRIVE
Address 2:	SUITE 140
City:	SAN DIEGO
State:	CA
Zip:	92127
Phone:	800-535-6981
Fax:
Business Web Site Address:
Business Email Address:	CPRIEST@CHALICECAPITALPARTNERS.COM
Mailing Address
Address 1:	16935 WEST BERNARDO DRIVE
Address 2:	SUITE 140
City:	SAN DIEGO
State:	CA
Zip:	92127
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:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
KARLA ELOISA THOMPSON	DRLP	18761842	YES		5/22/2018

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:	CINDY PRIEST
Title:	LICENSING & REGISTRATION MANAGER
Phone Number:	800-535-6981 EXT. 117
Email Address:	CPRIEST@CHALICECAPITALPARTNERS.COM