Notification of Changes for Business Entity
General Information
Business Entity Name:	VSR FINANCIAL SERVICES
Incorporation / Formation Date:
FEIN:	431302302
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	KS
County:	N/A
Business Address
Address 1:	8620 W 110TH STREET
Address 2:
City:	OVERLAND PARK
State:	KS
Zip:	66210
Phone:	9134982900
Fax:
Business Web Site Address:
Business Email Address:	LICENSING@VSRFS.COM
Mailing Address
Address 1:	8620 W 110TH STREET
Address 2:
City:	OVERLAND PARK
State:	KS
Zip:	66210
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
LISA ALLEN	REGISTERED REP	1175677		YES	8/15/2016

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:	KORY BORCHERDING
Title:	REGISTRATION COORDINATOR
Phone Number:	5155644626
Email Address:	LICENSING@VSRFS.COM