Notification of Changes for Business Entity
General Information
Business Entity Name:	AIG AEROSPACE INSURANCE SERVICES, INC.
Incorporation / Formation Date:
FEIN:	58-1354492
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	GA
County:	GWINNETT
Business Address
Address 1:	1200 ABERNATHY RD. NE, BLDG. 600
Address 2:
City:	ATLANTA
State:	GA
Zip:	30328
Phone:	404-249-1800
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	1200 ABERNATHY RD. NE, BLDG. 600
Address 2:
City:	ATLANTA
State:	GA
Zip:	30328
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
TIMOTHY BARTOS	VICE PRESIDENT	768713		YES	07/18/2017

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:	DAVID BAKER
Title:	EMPLOYEE/RDA
Phone Number:	404-249-1800
Email Address:	CHARLOTTE.GREEN@AIG.COM