Notification of Changes for Business Entity
General Information
Business Entity Name:	FINANCIAL INSURANCE SERVICES INC
Incorporation / Formation Date:
FEIN:	470791671
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	NE
County:	DOUGLAS
Business Address
Address 1:	5601 NORTH 103RD STREET
Address 2:
City:	OMAHA
State:	NE
Zip:	68134
Phone:	4029632361
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	5601 NORTH 103RD STREET
Address 2:
City:	OMAHA
State:	NE
Zip:	68134
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
JASMINE INGRAM	PRODUCER	18701205	YES		04/13/2018
BRIANA JACKSON	PRODUCER	18734830	YES		04/13/2018
SHANNON JAMES	PRODUCER	18733389	YES		04/13/2018
LATORIA JOHNSON	PRODUCER	18741367	YES		04/13/2018
PHATOZJA KENNEDY	PRODUCER	18677191	YES		04/13/2018
KELLY KINSLAND	PRODUCER	18343935	YES		04/13/2018
ROBIN LECROY	PRODUCER	18734781	YES		04/13/2018
TIKYRA LEWIS	PRODUCER	17977808	YES		04/13/2018
JESSICA LIGGINS	PRODUCER	18674327	YES		04/13/2018
TRACY LIPSCOMBE	PRODUCER	18708368	YES		04/13/2018
HENTRENIKA LOTT	PRODUCER	18674281	YES		04/13/2018
LASAUDIA LOVELACE	PRODUCER	18695412	YES		04/13/2018
LAPRECIOUS LOWERY	PRODUCER	18611629	YES		04/13/2018
TANAUGIA LUCIOUS	PRODUCER	18734245	YES		04/13/2018
IVAN MAZIE	PRODUCER	18695800	YES		04/13/2018

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
NATHAN MCCLAIN	PRODUCER	18727025	YES		04/13/2018
RAVEN MCDAVIS	PRODUCER	18698877	YES		04/13/2018
MELANIE MCINTYRE	PRODUCER	13750330	YES		04/13/2018
PAULA MENEAR	PRODUCER	18718079	YES		04/13/2018
TORIA MILLER	PRODUCER	18674289	YES		04/13/2018
ZENA MILLER	PRODUCER	18724147	YES		04/13/2018
AMY MINER	PRODUCER	18723972	YES		04/13/2018
ALIYAH MITCHELL	PRODUCER	18723935	YES		04/13/2018
ANASTASIA MONTELEONE	PRODUCER	18674322	YES		04/13/2018
VICTORIA MOORE	PRODUCER	18674286	YES		04/13/2018

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:	KATHERINE VEENSTRA-REYES
Title:	LICENSING SPECIALIST
Phone Number:	4029632361
Email Address:	KATHERINE.REYES@SITEL.COM