Notification of Changes for Business Entity
General Information
Business Entity Name:	CHICAGO TITLE AGENCY OF ROSS CO., LLC
Incorporation / Formation Date:
FEIN:	31-1758914
Ohio License Number:	26442
NPN:	16722191
DBA / Trade Name:
State of Domicile:	OH
County:	ROSS
Business Address
Address 1:	27 W 2ND STREET, SUITE 107
Address 2:
City:	CHILLICOTHE
State:	OH
Zip:	45601
Phone:	740/774-9423
Fax:	740/774-9422
Business Web Site Address:
Business Email Address:	NANCY59@HORIZONVIEW.NET
Mailing Address
Address 1:	27 W 2ND STREET, SUITE 107
Address 2:
City:	CHILLICOTHE
State:	OH
Zip:	45601
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
JOSEPH E MOTES	PRESIDENT	3237056		YES	07/31/2013
JOSEPH E MOTES	RDA	3237056		YES	07/31/2013

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:	NANCY ANN CLARK
Title:	OWNER
Phone Number:	740/774-9423
Email Address:	NANCY59@HORIZONVIEW.NET