Notification of Changes for Business Entity
General Information
Business Entity Name:	WELLS FARGO ADVISORS INSURANCE AGENCY LLC.
Incorporation / Formation Date:
FEIN:	540910269
Ohio License Number:	28429
NPN:
DBA / Trade Name:
State of Domicile:	VA
County:	INDEPENDENT CITY
Business Address
Address 1:	901 E BYRD ST.
Address 2:
City:	RICHMOND
State:	VA
Zip:	23219
Phone:	6057825112
Fax:	8663548566
Business Web Site Address:	WWW.WELLSFARGO.COM
Business Email Address:	AGENCYLICENSING@WELLSFARGO.COM
Mailing Address
Address 1:	3201 N 4TH AVE
Address 2:
City:	SIOUX FALLS
State:	OH
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
BIELIAUSKAS, JONAS SCHRAND	AGENT	17985227	YES		07/05/2016
BORGATTA, LYDIA S	AGENT	765070		YES	07/04/2016
CLARK, RILEY	AGENT	16821994	YES		07/05/2016
CLARK, THOMAS	AGENT	380933	YES		07/06/2016
FLOYD, REBECCA	AGENT	16889151	YES		07/05/2016
JACOBOWITZ, SHAWN C	AGENT	694478		YES	07/05/2016
KOESTER, RYAN	AGENT	6899415		YES	07/04/2016
LATHAM, DANIEL	AGENT	2433990	YES		07/05/2016
LOVE, RYAN	AGENT	7681724		YES	07/04/2016
MARGOLIS, CHARLES	AGENT	2136177	YES		07/08/2016
MEYER, ANDREW	AGENT	11453103		YES	07/06/2016
MICKEY, PAUL	AGENT	1490524		YES	07/04/2016
NATHAN, MICAH	AGENT	15710451	YES		07/08/2016
NEED, LINDA	AGENT	574879		YES	07/04/2016
RUBIN, ANTHONY	AGENT	17769605	YES		07/07/2016

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:	MELISSA L SHUTT
Title:	SOSS2
Phone Number:	6057825112
Email Address:	MELISSA.L.SHUTT@WELLSFARGO.COM