Notification of Changes for Business Entity
General Information
Business Entity Name:	GALLAGHER BENEFIT SERVICES, INC.
Incorporation / Formation Date:
FEIN:	36-4291971
Ohio License Number:	24453
NPN:	3234811
DBA / Trade Name:
State of Domicile:	IL
County:	COOK
Business Address
Address 1:	2850 GOLF ROAD
Address 2:
City:	ROLLING MEADOWS
State:	IL
Zip:	60008-4050
Phone:	614 356 4522
Fax:
Business Web Site Address:
Business Email Address:	JON_REED@AJG.COM
Mailing Address
Address 1:	545 METRO PLACE SOUTH, SUITE 150
Address 2:
City:	DUBLIN
State:	OH
Zip:	43017-5453
Indicate the type of change you are seeking
Address Change:	YES
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

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:	JONATHAN REED
Title:	ASSISTANT CORPORATE COUNSEL
Phone Number:	614 356 4522
Email Address:	JON_REED@AJG.COM