Notification of Changes for Business Entity
General Information
Business Entity Name:	FX INSURANCE AGENCY, LLC
Incorporation / Formation Date:	12/19/2018
FEIN:	35-2281892
Ohio License Number:	1152464
NPN:	8963028
DBA / Trade Name:
State of Domicile:	DE
County:	NEW CASTLE
Business Address
Address 1:	3 BEAVER VALLEY RD
Address 2:
City:	WILMINGTON
State:	DE
Zip:	19803
Phone:	302-252-2165
Fax:	302-252-2455
Business Web Site Address:
Business Email Address:	JEANNIE.MCLARNON@FARMERSINSURANCE.COM
Mailing Address
Address 1:	3 BEAVER VALLEY RD
Address 2:
City:	WILMINGTON
State:	DE
Zip:	19803
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
THOMAS NORRIS	AGENT	15824490	YES		12/19/2018
MICHAEL NUNN	AGENT	9255486	YES		12/19/2018
RORY O HARE	AGENT	16097730	YES		12/19/2018
KRISTEN OFFENBAKER	AGENT	18592592	YES		12/19/2018
JESSICA RESNICK	AGENT	18872662	YES		12/19/2018
LINDA ROBINSON	AGENT	63826	YES		12/19/2018
MIGUEL ROSAS	AGENT	18532743	YES		12/19/2018
GLORIA ROSE	AGENT	16251802	YES		12/19/2018
EDUARDO RUIZ	AGENT	18858163	YES		12/19/2018
BRENDA SAMUELS	AGENT	240017	YES		12/19/2018
MICHELE SHEEDY	AGENT	15728466	YES		12/19/2018
RENISHA SMITH	AGENT	18898695	YES		12/19/2018
LUIS SOLIS VIRGEN	AGENT	16983873	YES		12/19/2018
STEVEN SOLOMON	AGENT	2266859	YES		12/19/2018
MARIA STAGNO	AGENT	7875139	YES		12/19/2018

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:	REGINA M. MCLARNON
Title:	ASSISTANT SECRETARY
Phone Number:	302-252-2165
Email Address:	JEANNIE.MCLARNON@FARMERSINSURANCE.COM