Notification of Changes for Business Entity
General Information
Business Entity Name:	GS ADMINISTRATORS, INC.
Incorporation / Formation Date:	05/25/1988
FEIN:	76-0255277
Ohio License Number:	32854
NPN:	6081510
DBA / Trade Name:
State of Domicile:	TX
County:	HARRIS
Business Address
Address 1:	1345 ENCLAVE PARKWAY
Address 2:
City:	HOUSTON
State:	TX
Zip:	77077
Phone:	713-580-3000
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	1345 ENCLAVE PARKWAY
Address 2:
City:	HOUSTON
State:	TX
Zip:	77077
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

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
STEPHEN H. CLARK	VICE PRESIDENT	451-85-0899	YES		1/30/18

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:	LISA GINTHER
Title:	LICENSING AND COMPLIANCE SPECIALIST
Phone Number:	713-580-3165
Email Address:	LGINTHER@GSFSGROUP.COM