Notification of Changes for Business Entity
General Information
Business Entity Name:	CRES INSURANCE SERVICES LLC
Incorporation / Formation Date:
FEIN:	33-0952901
Ohio License Number:	30034
NPN:	7872105
DBA / Trade Name:
State of Domicile:	CA
County:	SAN DIEGO
Business Address
Address 1:	12396 WORLD TRADE DR. STE. 303
Address 2:
City:	SAN DIEGO
State:	CA
Zip:	92128
Phone:	8586181648
Fax:	8586181655
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	PO BOX 500810
Address 2:
City:	SAN DIEGO
State:	CA
Zip:	92150
Indicate the type of change you are seeking
Address Change:	YES
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:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date

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:	STEVEN SARGENTI
Title:	PRESIDENT
Phone Number:	8586181648
Email Address:	SSARGENTI@CRESINSURANCE.COM