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:	8663548566
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
HEFNER, AMY G	AGENT	11099360	YES		07/29/2016
TAYLOR, SABRINA MARIE	AGENT	18002373	YES		07/26/2016
ANDERSON, ADAM D	AGENT	2335605	YES		07/27/2016
JOHNSON, HEIDI WENZEL	AGENT	8907893	YES		07/29/2016
JONES, DARRELL THORSTED	AGENT	1008677	YES		07/29/2016
KOSZALKA, LINDA M	AGENT	1437456	YES		07/27/2016
MAHLER, PAUL C	AGENT	520435	YES		07/26/2016
MAYNES, LAURA A	AGENT	3384697	YES		07/29/2016
OSSEWAARDE,STEVEN R	AGENT	984798	YES		07/27/2016
PETERSON, KIMBERLY	AGENT	10212980	YES		07/27/2016
PHILLIPS, JOHN	AGENT	1345804	YES		07/29/2016
QUENNEVILLE, CHAD ERIC	AGENT	2093830		YES	07/28/2016
SANBORN, JONATHAN M	AGENT	8761198	YES		07/27/2016
UTLEY JR.,JOHN FRANCIS	AGENT	635814	YES

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