Notification of Changes for Business Entity
General Information
Business Entity Name:	FINANCIAL INSURANCE SERVICES INC
Incorporation / Formation Date:
FEIN:	470791671
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	NE
County:	DOUGLAS
Business Address
Address 1:	5601 NORTH 103RD STREET
Address 2:
City:	OMAHA
State:	NE
Zip:	68134
Phone:	4029632361
Fax:
Business Web Site Address:
Business Email Address:	AGENT@SITEL.COM
Mailing Address
Address 1:	5601 NORTH 103RD STREET
Address 2:
City:	OMAHA
State:	NE
Zip:	68134
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
ASIA ABRAM	PRODUCER	18567394	YES		04/12/2018
KEINIRA ASHFORD	PRODUCER	18665149	YES		04/12/2018
JARROD ATTERBERRY	PRODUCER	18722548	YES		04/12/2018
NATHAN BAILEY	PRODUCER	18724145	YES		04/12/2018
BRYAN BAPTISTE	PRODUCER	18746471	YES		04/12/2018
AMANDA BASTO	PRODUCER	18674335	YES		04/12/2018
KEYAIRA BEAN	PRODUCER	18630429	YES		04/12/2018
JESSICA BIGGERS	PRODUCER	18746328	YES		04/12/2018
KRISTON BISHOP	PRODUCER	18681008	YES		04/12/2018
JIMIA BLAINE	PRODUCER	18683950	YES		04/12/2018
TONY BOONE	PRODUCER	18674341	YES		04/12/2018
TIFFANY BOSARGE	PRODUCER	18674275	YES		04/12/2018
ALISIA BOWEN	PRODUCER	18652636	YES		04/12/2018
KENNETH BOYKIN	PRODUCER	18674350	YES		04/12/2018
HAILEY BRAXTON	PRODUCER	18735513	YES		04/12/2018

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:	KATHERINE VEENSTRA-REYES
Title:	LICENSING SPECIALIST
Phone Number:	4029632361
Email Address:	KATHERINE.REYES@SITEL.COM