Notification of Changes for Business Entity
General Information
Business Entity Name:	RAYMOND JAMES INSURANCE GROUP
Incorporation / Formation Date:
FEIN:	591199408
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	FL
County:	PINELLAS
Business Address
Address 1:	880 CARILLON PARKWAY
Address 2:
City:	ST. PETERSBURD
State:	FL
Zip:	33716
Phone:	727-567-5244
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	880 CARILLON PARKWAY
Address 2:
City:	ST. PETERSBURG
State:	FL
Zip:	33716
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
RALPH W. SEVELIUS	FINANCIAL ADVISOR	9652343	YES		12/07/15

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:	CHRISTINE PEREIRA
Title:	LICENSING LIASON
Phone Number:	727-567-5244
Email Address:	CHRISTINE.PEREIRA@RAYMONDJAMES.COM