Notification of Changes for Business Entity
General Information  
Business Entity Name: WELLS FARGO WEALTH BROKERAGE INSURANCE AGENCY, LLC
Incorporation / Formation Date:  
FEIN: 54-0702835
Ohio License Number:
NPN:
DBA / Trade Name:  
State of Domicile: VA
County: INDEPENDENT CITY
Business Address  
Address 1: 1021 E CARY ST. 9TH FL.
Address 2:  
City: RICHMOND
State: VA
Zip: 23219
Phone: 6056799704
Fax:  
Business Web Site Address:  
Business Email Address: DUSTI.L.KATZER@WELLSFARGO.COM
Mailing Address  
Address 1: 3201 N 4TH AVE
Address 2:  
City: SIOUX FALLS
State: SD
Zip: 57104
   
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
VERONICA JOYNER AGENT 12559916   YES 12/12/2018
JEANNE GRILL AGENT 1480621   YES 12/12/2018
MAYA NIGMATULLINA AGENT 15969262   YES 12/12/2018
R DAVID MELFI AGENT 1609315   YES 12/12/2018
ANTHONY NEALEIGH AGENT 16412343   YES 12/12/2018
LEILANI MERRIAM AGENT 17179309   YES 12/12/2018
JESSICA PAGLIER AGENT 17280281   YES 12/12/2018
MARK CATRON AGENT 5546908 YES   12/12/2018
           
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: DUSTI KATZER
Title: SECURITIES SPECIALIST
Phone Number: 6056799704
Email Address: DUSTI.L.KATZER@WELLSFARGO.COM