Notification of Changes for Business Entity
General Information  
Business Entity Name: WORLD FINANCIAL GROUP INSURANCE AGENCY, INC.
Incorporation / Formation Date:  
FEIN: 95-3809372
Ohio License Number:
NPN:
DBA / Trade Name:  
State of Domicile: CA
County: ORANGE
Business Address  
Address 1: 145 S. STATE COLLEGE
Address 2: SUITE 115-G
City: BREA
State: CA
Zip: 92821
Phone: 770-453-9300
Fax:  
Business Web Site Address:  
Business Email Address:  
Mailing Address  
Address 1: 11315 JOHNS CREEK PARKWAY
Address 2:  
City: DULUTH
State: GA
Zip: 30097
   
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
TIMOTHY P CORRIGAN 46JQX AGENT 8751540 YES   5/27/16
GREGORY SCOTT LUDWICK 8767W AGENT 842773 YES   5/27/16
JIAN SONG ZHANG 13KMI AGENT 13413008 YES   5/27/16
           
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: STEPHANIE HOSIER 5/27/16
Title: ASSISTANT SECRETARY
Phone Number: 770-453-9300
Email Address: DANIELLE.SIMS@TRANSAMERICA.COM