Notification of Changes for Business Entity
General Information
Business Entity Name:	FIRST ALLIED SECURITIES INC
Incorporation / Formation Date:
FEIN:	113152836
Ohio License Number:	25372
NPN:	766511
DBA / Trade Name:
State of Domicile:	OH
County:	SAN DIEGO
Business Address
Address 1:	655 W BROADWAY 11TH FLOOR
Address 2:
City:	SAN DIEGO
State:	CA
Zip:	92101
Phone:	3102574845
Fax:
Business Web Site Address:
Business Email Address:	LICENSING@FIRSTALLIED.COM
Mailing Address
Address 1:	655 W BROADWAY 11TH FLOOR
Address 2:
City:	SAN DIEGO
State:	CA
Zip:	92101
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:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
JOHN TAYLOR	PROCUDER	726761		YES	01/25/2017

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)
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:	KELSEY STRUZYK
Title:	R&L
Phone Number:	3102574845
Email Address:	LICENSING@FIRSTALLIED.COM