Notification of Changes for Business Entity
General Information
Business Entity Name:	WUNDERLICH SECURITIES
Incorporation / Formation Date:
FEIN:	621518255
Ohio License Number:	29847
NPN:	2753779
DBA / Trade Name:
State of Domicile:	TN
County:	USA
Business Address
Address 1:	40 SOUTH MAIN ST
Address 2:	SUITE 1800
City:	MEMPHIS
State:	TN
Zip:	38103
Phone:	901-251-1330
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	40 SOUTH MAIN
Address 2:	STE 1800
City:	MEMPHIS
State:	TN
Zip:	38103
Indicate the type of change you are seeking
Address Change:	YES
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

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:	CLARICE KELLER
Title:	INSUARNCE COODINATOR
Phone Number:	901-251-1330
Email Address:	CLARICEKELLER@WUNDERNET.COM