Notification of Changes for Business Entity
General Information
Business Entity Name:	CHC FINANCIAL LLC
Incorporation / Formation Date:
FEIN:	20-1933452
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	PA
County:	MONTGOMERY COUNTY
Business Address
Address 1:	7111 VALLEY GREEN ROAD
Address 2:
City:	FORT WASHINGTON
State:	PA
Zip:	19034
Phone:	215-381-3974
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	7111 VALLEY GREEN RD.
Address 2:
City:	FT. WASHINGTON
State:	PA
Zip:	19034
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
MARGARET SWEENEY LYON	SR. VICE PRESIDENT	2060462	YES		1/5/16
MICHAEL COBEN	SR. VICE PRESIDENT	1424034		YES	1/5/16

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:	MARGARET SWEENEY LYON
Title:	SR. VICE PRESIDENT
Phone Number:	215-381-3974
Email Address:	PLYON@COVENTRYFIRST.COM