Notification of Changes for Business Entity
General Information
Business Entity Name:	FINANCIAL INSURANCE SERVICEWS INC
Incorporation / Formation Date:
FEIN:	470791671
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	NE
County:	DOUGLAS
Business Address
Address 1:	5601 N 103RD ST
Address 2:
City:	OMAHA
State:	NE
Zip:	68134
Phone:	4029632361
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	5601 N 103RD ST
Address 2:
City:	OMAHA
State:	NE
Zip:	68134
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
ROSE MCCANN	AGENT	1075102		YES	3-25-16
LEA RAMSEY	AGENT	1091580		YES	3-25-16
KAYLA EVANS	AGENT	1072085		YES	3-25-16
MARCELLUS SHAW	AGENT	1095089		YES	3-25-16
RYAN GRIFFETH	AGENT	550000	YES		3-25-16
GLYNIS MURRAY	AGENT	1098670	YES		3-25-16
JENNIFER NOLAN	AGENT	1098711	YES		3-25-16
RODERICK TAYLOR	AGENT	1098682	YES		3-25-16
ZACKARY TEMPLIN	AGENT	1097792	YES		3-25-16
BRANDI BIVENS	AGENT	1099385	YES		3-25-16
RACQUEAL BROWN	AGENT	1099897	YES		3-25-16
DANIELLE COLE	AGENT	1099519	YES		3-25-16
JERRY CRAIGO	AGENT	1099960	YES		3-25-16
DYLAN DANIEL	AGENT	1099555	YES		3-25-16
MYLES FISHEL	AGENT	1099564	YES		3-25-16

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)
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:	JO WATERS
Title:	LICENSING SPECIALIST
Phone Number:	4029636973
Email Address:	JO.WATERS@SITEL.COM