Notification of Changes for Business Entity
General Information
Business Entity Name:	MGK TITLE, LLC
Incorporation / Formation Date:	7/29/2015
FEIN:	20-1826903
Ohio License Number:	1 071 851
NPN:	8326225
DBA / Trade Name:
State of Domicile:	MD
County:	MONTGOMERY
Business Address
Address 1:	11409 FLINTS GROVE LN
Address 2:
City:	NORTH POTOMAC
State:	MD
Zip:	20878
Phone:	2404763154
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	11409 FLINTS GROVE LN
Address 2:
City:	NORTH POTOMAC
State:	MD
Zip:	20878
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
MGK TITLE, LLC	PRODUCER ENTITY	20-1826903	YES		8/17/17

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
DANIEL P. MURPHY	PRODUCER	1063759	YES		8/17/17

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)	NO
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?	NO
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:	DANIEL P. MURPHY
Title:	PRODUCER
Phone Number:	2404763154
Email Address:	DAN@MASTERSTITLE.COM