Notification of Changes for Business Entity
General Information
Business Entity Name:	WELLS FARGO ADVISORS INSURANCE AGENCY LLC.
Incorporation / Formation Date:
FEIN:	540910269
Ohio License Number:	28429
NPN:
DBA / Trade Name:
State of Domicile:	VA
County:	INDEPENDENT CITY
Business Address
Address 1:	901 E BYRD ST.
Address 2:
City:	RICHMOND
State:	VA
Zip:	23219
Phone:	6057825112
Fax:	866354856
Business Web Site Address:	WWW.WELLSFARGO.COM
Business Email Address:	AGENCYLICENSING@WELLSFARGO.COM
Mailing Address
Address 1:	3201 N 4TH AVE
Address 2:
City:	SIOUX FALLS
State:	SD
Zip:	57104
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
KAUFFMAN, MITCHELL	AGENT	382542		YES	01/19/2016
MATHIAS, JOSEPH	AGENT - 2ND REQUEST	15126053	YES		01/12/16
ANTONELLI, BERNICE	AGENT	11759462	YES		01/22/2016
AZZARELLA, ROSS	AGENT - 2ND REQUEST			YES
BESS, MICHEL	AGENT		YES
BRALEY, THOMAS	AGENT - 2ND REQUEST	987747	YES
CARTER, ANDREW	AGENT - 2ND REQUEST	3152951	YES
DEMENT, ANGELA	AGENT	7200820	YES
GALLAGHER, MAUREEN	AGENT	17826538	YES
HON, ROBERT	AGENT - 2ND REQUEST	1496733	YES
KUHNERT, MONTE	AGENT - 2ND REQUEST	2133465	YES
KULICK, JONATHAN	AGENT	536662		YES	01/22/2016
LEBLOND, DAVID	AGENT - 3RD REQUEST	2353510			01/07/2016
LEONARD, TIMOTHY	AGENT	694020	YES		01/21/2016
LOSKILL, NANCY	AGENT	7276770	YES		01/19/2016

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:	MELISSA L SHUTT (1 OF THREE REQUESTS SENT TODAY 1/26/15)
Title:	SOSS2
Phone Number:	6057825112
Email Address:	MELISSA.L.SHUTT@WELLSFARGO.COM