Notification of Changes for Business Entity
General Information
Business Entity Name:	ARMFIELD HARRISON & THOMAS INC
Incorporation / Formation Date:
FEIN:	54-0654623
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	VA
County:	LOUDOUN
Business Address
Address 1:	20 S. KING ST
Address 2:
City:	LEESBURG
State:	VA
Zip:	20175
Phone:	703-777-2341
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	20 S. KING ST
Address 2:
City:	LEESBURG
State:	VA
Zip:	20175
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
THOMAS CHINYANI	EMPLOYEE	7927717	YES		09-06-2017

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:	KARI SMITH
Title:	LICENSING ADMIN.
Phone Number:	812-886-0191
Email Address:	KNSMITH@SUPPORTIVEIS.COM