Notification of Changes for Business Entity
General Information
Business Entity Name:	JONES-HOXIE CORP.
Incorporation / Formation Date:
FEIN:	45-0480017
Ohio License Number:	988160
NPN:
DBA / Trade Name:
State of Domicile:	ME
County:	KENNEBEC
Business Address
Address 1:	116 COMMUNITY DRIVE
Address 2:
City:	AUGUSTA
State:	ME
Zip:	04330
Phone:	2079477345
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	PO BOX 1388
Address 2:
City:	BANGOR
State:	ME
Zip:	04402
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
JONATHAN M. CROSS	EVP	3682215	YES		12/17/2015
BRENT A. CROSS	EVP	3682979		YES	12/17/2015

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)
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?
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:	ROYCE M. CROSS
Title:	CHAIRMAN
Phone Number:	2079477345
Email Address:	LICENSING@CROSSAGENCY.COM