Notification of Changes for Business Entity
General Information
Business Entity Name:	THRIVENT INSURANCE AGENCY INC
Incorporation / Formation Date:
FEIN:	411780150
Ohio License Number:
NPN:	662734
DBA / Trade Name:
State of Domicile:	MN
County:	HENNEPIN
Business Address
Address 1:	625 FOURTH AVE S
Address 2:
City:	MINNEAPOLIS
State:	MN
Zip:	55415
Phone:	9206285808
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	625 FOURTH AVE S
Address 2:
City:	MINNEAPOLIS
State:	MN
Zip:	55415
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
CRAIG NENNIG	AGENT	18406485	YES		06/14/2018
KATHRYN CRAGER	AGENT	1194064	YES		6/6/2018
WILLIAM DIEDERICH	AGENT	1193718	YES		6/4/2018
GEORGE BURGIN	AGENT	1193347	YES		6/1/2018
CONNOR DUIS	AGENT	1192594	YES		6/1/2018
DAVID SAMPL	AGENT	1192588	YES		5/24/2018
JACOB RABAS	AGENT	1077787	YES		5/24/2018
JAMIE RIGATTI	AGENT	18622990		YES	6/13/2018
LEE STRAUMANN	AGENT	1000771		YES	5/31/2018
STACEE JACOBS	AGENT	10170293		YES	5/30/2018
MARK RANKIN	AGENT	1854639		YES	5/25/2018
MICHAEL PACAK	AGENT	16195230		YES	5/21/2018

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:	RACHAEL STURM
Title:	SPECIALIST
Phone Number:	9206285808
Email Address:	RACHAEL.STURM@THRIVENT.COM