Notification of Changes for Business Entity
General Information
Business Entity Name:	RIEMENSCHNEIDER INSURANCE AGECNY
Incorporation / Formation Date:
FEIN:	814088015
Ohio License Number:	950010
NPN:	7735855
DBA / Trade Name:
State of Domicile:	PA
County:	MONTGOMERTY
Business Address
Address 1:	642 E MAIN STREET
Address 2:
City:	LANSDALE
State:	PA
Zip:	19446
Phone:	2158554995
Fax:	2158559941
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	642 E MAIN STREET
Address 2:
City:	LANSDALE
State:	PA
Zip:	19446
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
ROY RIEMENSCHNEIDER	OWNER/AGENT	211485946		YES	03/04/2017
KRISTA MARIA SPILLANE	OWNER/AGENT	16354146	YES		03/23/2017

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)	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:	KRISTA SPILLANE
Title:	OWNER
Phone Number:	2158554995
Email Address:	KRISTA9@RIEMENSCHNEIDERINSURANCE.COM