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:
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:
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
HUNT, BRIAN	AGENT	2064556		YES	10/04/2016
APGAR, JOHN	AGENT	516505		YES	10/04/2016
FULMER, KURT	AGENT	1865796	YES		10/03/2016
ROVELLO, JULIA ANN	AGENT	1017781	YES		10/07/2016
SPEIZER, DARREN	AGENT	17255998		YES	10/04/2016
MARTIN, ANDREW J	AGENT	1489725		YES	10/04/2016
FRANCIS, MICHAEL D	AGENT	4593551	YES		10/03/2016
KERR, SUSAN D	AGENT	15818711			10/07/2016
STEVENSON,ROBERT FRANCIS	AGENT	1473625	YES		10/03/2016
TRAVIS, NATHAN LEE	AGENT	3205671		YES	10/04/2016
HACKETT, JEFFREY	AGENT	17394043	YES		10/07/2016
CRICHTON, SAMUEL	AGENT	17062657		YES	10/04/2016

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
Title:	SOSS2
Phone Number:	6057825112
Email Address:	MELISSA.L.SHUTT@WELLSFARGO.COM