Notification of Changes for Business Entity
General Information
Business Entity Name:	ARMSTRONG TRAVEL INC
Incorporation / Formation Date:
FEIN:	34-1923400
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	PORTAGE
Business Address
Address 1:	153 E MAIN ST
Address 2:
City:	RAVENNA
State:	OH
Zip:	44266
Phone:	3302971105
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	153 E MAIN ST
Address 2:
City:	RAVENNA
State:	OH
Zip:	44266
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
BONNIE JENIOR	TRAVEL AGENT	16913560	YES		02/07/2017

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:	SHELLY MOATS
Title:	PRESIDENT
Phone Number:	3302971105
Email Address:	SHELLY@ARMSTRONGTRAVEL.US