Notification of Changes for Business Entity
General Information
Business Entity Name:	ZINC
Incorporation / Formation Date:
FEIN:	20-8392046
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	CUYAHOGA
Business Address
Address 1:	3505 E ROYALTON RD. SUITE 110
Address 2:
City:	BROADVIEW HTS.
State:	OH
Zip:	44147
Phone:	440-526-2661
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	3505 E ROYALTON RD. SUITE 110
Address 2:
City:	BROADVIEW HTS.
State:	OH
Zip:	44147
Indicate the type of change you are seeking
Address Change:	NO
Business Entity Name Change:	NO	Old Business Entity Name:	L
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
CHRISTINA MCGOLDRICK	CSR	15471373	YES		08/18/2017
CHRISTOPHER SHAFFER	CSR	7128229	YES		08/18/2017
ALLEN JENKINS	CSR	17794928	YES		08/18/2017
STEPHANIE MERKEL	CSR	7929100	YES		08/18/2017
JACQUELINE GRINGLE	CSR	16569126	YES		08/18/2017
JENNIFER VALJATO	CSR	18328349	YES		08/18/2017
KRYSTAL NAMETH-CATLEY	PRODUCER	16784292	YES		08/18/2017
MIKE KERVEL	PRODUCER	17822893	YES		08/18/2017
GEOFREY EAGLE	PRODUCER	363196	YES		08/18/2017

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:	CHRISTINA MCGOLDRICK
Title:	AGENCY ADMINISTRATOR
Phone Number:	440-526-2661
Email Address:	CHRISTINA@ZINCINSURANCE.COM