Notification of Changes for Business Entity
General Information
Business Entity Name:	ALR INSURANCE SERVICES, INC.
Incorporation / Formation Date:	10/21/1974
FEIN:	31-0845909
Ohio License Number:	1078
NPN:	2831706
DBA / Trade Name:
State of Domicile:	OH
County:	MUSKINGUM
Business Address
Address 1:	3600 CLIFFHANGER WAY
Address 2:
City:	ZANESVILLE
State:	OH
Zip:	43701
Phone:	740-454-2531
Fax:	740-455-8178
Business Web Site Address:
Business Email Address:	M.YOUNG@ALRINS.COM
Mailing Address
Address 1:	P. O. BOX 2664
Address 2:
City:	ZANESVILLE
State:	OH
Zip:	43702-2664
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:	YES

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
LOWELL C. IRWIN	AGENT	517814	YES		09/01/2018
LAUREL L. PAUL	AGENT	1842353	YES		09/01/2018
RENA L. RIDENOUR	AGENT	17354496	YES		09/01/2018
BRIAN M. FARGUS	AGENT	1748693		YES	01/01/1978
CHARLENE B. SPENCE	AGENT	2342160		YES	03/26/2009
JAMES A. MARTIN	AGENT	2440895		YES	10/01/2009
JOHN T. HOOD	AGENT			YES	01/01/1980

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
MICHAEL C. YOUNG	PRESIDENT/TREASURER	2831455	YES		06/30/2009
NEDDENA L. YOUNG	VICE-PRESIDENT/SECRETARY	269566794	YES		06/30/2009
ALAN L. RANKIN	PRESIDENT			YES	01/01/1981
D. JUNE RANKIN	PRESIDENT			YES	01/01/1999
JAMES L. MCINTURF	VICE PRESIDENT	1794791		YES	12/01/1981
MARTIN D. YOUNG	SECRETARY			YES	06/29/2009

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:	LAUREL L. PAUL
Title:	AGENT
Phone Number:	740-454-2531
Email Address:	L.PAUL@ALRINS.COM