Notification of Changes for Business Entity
General Information
Business Entity Name:	AAA TEXAS LLC
Incorporation / Formation Date:	12/29/2000
FEIN:	760664740
Ohio License Number:	35294
NPN:	5111111
DBA / Trade Name:
State of Domicile:	TX
County:	TRAVIS
Business Address
Address 1:	3333 FAIRVIEW ROAD A451
Address 2:
City:	COSTA MESA
State:	CA
Zip:	92626
Phone:	714-885-1314
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	3333 FAIRVIEW ROAD A451
Address 2:
City:	COSTA MESA
State:	CA
Zip:	92626
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
ERIC N WOZNIAK	RDA	2649334	YES		01/25/2016

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)
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?
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:	GAIL LOUIS
Title:	SECRETARY
Phone Number:	714-885-1314
Email Address:	LOUIS.GAIL@AAA-CALIF.COM