Notification of Changes for Business Entity
General Information
Business Entity Name:	THRIVENT INSURANCE AGENCY
Incorporation / Formation Date:
FEIN:	411780150
Ohio License Number:	26090
NPN:	662734
DBA / Trade Name:
State of Domicile:	MN
County:	HENNEPIN
Business Address
Address 1:	625 FOURTH AVE S
Address 2:
City:	MINNEAPOLIS
State:	MN
Zip:	55415
Phone:	9206285808
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	625 FOURTH AVE S
Address 2:
City:	MINNEAPOLIS
State:	MN
Zip:	55415
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
MATTHEW BEATTY	AGENT	16836366		YES	5/4/18
GREG BOGGS	AGENT	18416608		YES	5/7/18
JEFFREY HAKALA	AGENT	6922490		YES	5/17/18
TIFFANY STANTON	AGENT	18672628	YES		4/19/2018
CHRISTINE SONSON	AGENT	18547869	YES		4/19/2018
DANIEL HAYES	AGENT	17276054	YES		4/20/2018
MARK LAURENT	AGENT	7306720	YES		5/1/2018
KATHLEEN CRAMER	AGENT	18666961	YES		5/1/2018
CARLOS TRAVIESO	AGENT	16002186	YES		5/1/2018
BETTY PENCE	AGENT	2438817	YES		5/10/2018
MATTHEW KLANDRUD	AGENT	8701159	YES		5/10/2018
CYNTHIA PLAZEK	AGENT	17094249	YES		5/17/18
JULIE MATTEK	AGENT	18558780	YES		5/17/18
MARK GRAHAM	AGENT	2067316	YES		5/17/18
MATTHEW DENDINGER	AGENT	8626703	YES		5/17/18

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:	RACHAEL STURM
Title:	SPECIALIST
Phone Number:	9206285808
Email Address:	RACHAEL.STURM@THRIVENT.COM