Notification of Changes for Business Entity
General Information
Business Entity Name:	FINANCIAL INSURANCE SERVICES INC
Incorporation / Formation Date:
FEIN:	470791671
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	DOUGLAS
Business Address
Address 1:	5601 NORTH 103RD STREET
Address 2:
City:	OMAHA
State:	NE
Zip:	68134
Phone:	4029632361
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	5601 NORTH 103RD STREET
Address 2:
City:	OMAHA
State:	NE
Zip:	68134
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
ALECIA BRITT	PRODUCER	18701216	YES		04/13/2018
CANDACE BROOKS	PRODUCER	18674319	YES		04/13/2018
KARNESHIA BROWN	PRODUCER	18685418	YES		04/13/2018
SHELIA BROWNLEE	PRODUCER	18736769	YES		04/13/2018
SHAMAYA BROYLES	PRODUCER	18720160	YES		04/13/2018
MICHAEL BRUCE	PRODUCER	18461757	YES		04/13/2018
CARMEN BUTCHER	PRODUCER	18723296	YES		04/13/2018
MELANIE CABRAL	PRODUCER	18746470	YES		04/13/2018
WILLIAM CALLAWAY	PRODUCER	18677193	YES		04/13/2018
CHANDLER CARLTON	PRODUCER	18733378	YES		04/13/2018
NATALIE CARROLL	PRODUCER	18723382	YES		04/13/2018
TALIYAH CASTRON	PRODUCER	18742651	YES		04/13/2018
KENYETTE CHANDLER	PRODUCER	18695778	YES		04/13/2018
RANESHA CHERRY	PRODUCER	18695779	YES		04/13/2018
JULIE CHILDRESS	PRODUCER	18695781	YES		04/13/2018

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
MARIA CHOUINARD	PRODUCER	18725955	YES		04/13/2018
ANNIE CLARK	PRODUCER	18695794	YES		04/13/2018
KRISTEN CLARK	PRODUCER	18721195	YES		04/13/2018
DEUNDRAE COCKRELL	PRODUCER	18629080	YES		04/13/2018
TYRIA COLEMAN	PRODUCER	18665148	YES		04/13/2018
FAYE CONNER	PRODUCER	18698872	YES		04/13/2018
DAVID COOK	PRODUCER	17600021	YES		04/13/2018
ERIKA COTTON	PRODUCER	13888326	YES		04/13/2018
WHITNEY CRAWFORD	PRODUCER	18700037	YES		04/13/2018
AMBER CRENSHAW	PRODUCER	18629088	YES		04/13/2018

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:	KATHERINE VEENSTRA-REYES
Title:	LICENSING SPECIALIST
Phone Number:	4029632361
Email Address:	KATHERINE.REYES@SITEL.COM