Notification of Changes for Business Entity
General Information
Business Entity Name:	THRIVENT INSURANCE AGENCY INC
Incorporation / Formation Date:
FEIN:	411780150
Ohio License Number:
NPN:
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
JOSHUA TREMMEL	AGENT	17438961		YES	1/27/2016
L KARSTEN LUNDRING	AGENT	230864		YES	1/20/2016
HEIDI CURREY	AGENT	8729407	YES		2/15/16
CHRISTOPHER HARRIS	AGENT	8750841	YES		2/11/16
ERIK CONSTANZER	AGENT	17805841	YES		2/8/16
PATRICIA HENRY	AGENT	9134887	YES		2/4/16
ANN ESCANDON	AGENT	1838500	YES		2/1/16
MATTHEW OLESON	AGENT	8090554	YES		1/29/16
ABIGAIL WILDER	AGENT	17604750	YES		1/29/16
JASON CARTER	AGENT	9304281	YES		1/27/16
DON GEORGE	AGENT	17827706	YES		1/21/16

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)	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:	COORDINATOR
Phone Number:	9206285808
Email Address:	RACHAEL.STURM@THRIVENT.COM