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:	8448790217
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
KOCH, DANIEL	AGENT	16022471		YES	01/31/2017
ROBINSON, E.	AGENT	384098		YES	03/02/2017
SNYDER, MARVIN	AGENT	3072376		YES	02/27/2017
STOLL, SANDRA	AGENT	6829696		YES	02/27/2017
TROTTA, ANTHONY	AGENT	9749148		YES	03/02/2017
RINGER, CRYSTAL	AGENT	16690637		YES	03/02/2017
NUTT, MICHAEL	AGENT	723092		YES	03/02/2017
POWER, KEVIN	AGENT	2575360		YES	03/02/2017
PETERS, CHRISTOPHER	AGENT	10504092		YES	03/02/2017
PARKE, WILLIAM	AGENT	2854100		YES	03/02/2017
HANCOCK, JONATHAN	AGENT	8617466		YES	03/02/2017
ADAMS, JEFFERY	AGENT	9235994		YES	03/02/2017
SUTHERLAND, STEPHEN	AGENT	512373		YES	03/02/2017
ZYSK, STEPHANIE	AGENT	8448126		YES	03/02/2017
TAYLOR, THOMAS EUGENE	AGENT	16745641	YES		02/27/2017

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)	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