Notification of Changes for Business Entity
General Information
Business Entity Name:	FINKELMEIER INSURANCE AGENCY, INC.
Incorporation / Formation Date:
FEIN:	34-1508775
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	AUGLAIZE
Business Address
Address 1:	811 REDSKIN TRAIL
Address 2:	PO BOX 210
City:	WAPAKONETA
State:	OH
Zip:	45895
Phone:	419-739-4000
Fax:	419-738-8403
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	PO BOX 210
Address 2:
City:	WAPAKONETA
State:	OH
Zip:	45895
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
JULIE CAROL MIESSE	CUSTOMER SERVICE REP	17677973		YES	04/12/2018
RAINA L MANGER	CUSTOMER SERVICE REP	18753071	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:	THOMAS S FINKELMEIER
Title:	PRESIDENT
Phone Number:	419-739-4000
Email Address:	TSFJR@THEFIA.COM