Notification of Changes for Business Entity
General Information
Business Entity Name:	LINDEN STOP-N-LOCK
Incorporation / Formation Date:
FEIN:	20-0477372
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	MONTGOMERY
Business Address
Address 1:	3636 LINDEN AVE.
Address 2:
City:	DAYTON
State:	MI
Zip:	45410
Phone:	937-253-3441
Fax:
Business Web Site Address:
Business Email Address:	JBAYLEY@POGODACO.COM
Mailing Address
Address 1:	30500 NORTHWESTERN HWY, SUITE
Address 2:	SUITE 525
City:	FARMINGTON HILLS
State:	MI
Zip:	48334
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
BADER COMPANY	RDA	3122916		YES	7/31/17
XERCOR INSURANCE SERVICES	RDA	17687370	YES		7/31/17

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:	JULIE BAYLEY
Title:	PROJECT MANAGER
Phone Number:	248-715-1105
Email Address:	JBAYLEY@POGODACO.COM