Notification of Changes for Business Entity
General Information
Business Entity Name:	H. J. SPIER CO., INC.
Incorporation / Formation Date:	06/01/1967
FEIN:	351133454
Ohio License Number:	23934
NPN:	2012668
DBA / Trade Name:
State of Domicile:	IN
County:	MARION
Business Address
Address 1:	8250 WOODFIELD X-ING BLVD., STE 330
Address 2:
City:	INDIANAPOLIS
State:	IN
Zip:	46240
Phone:	317-815-2800
Fax:	317-815-2857
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	8250 WOODFIELD X-ING BLVD., STE. 330
Address 2:
City:	INDIANAPOLIS
State:	IN
Zip:	46240
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
HERBERT J. SPIER	VICE PRESIDENT	232601	YES		03/0/2017

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:	COLLEEN WRIGHT
Title:	COMPTROLLER
Phone Number:	317-815-2808
Email Address:	CWRIGHT@HJSPIER.COM