Notification of Changes for Business Entity
General Information
Business Entity Name:	KEMBA CREDIT UNION, INC
Incorporation / Formation Date:
FEIN:	316034125
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	BUTLER
Business Address
Address 1:	8763 UNION CENTRE BLVD
Address 2:
City:	WEST CHESTER
State:	OH
Zip:	45069
Phone:	513-762-1647
Fax:	513-762-1605
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	8763 UNION CENTRE BLVD
Address 2:
City:	WEST CHESTER
State:	OH
Zip:	45069
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
DANA RENE PAYTON	AGENT	1103842		YES	2/13/2017
JILL WALDRON	AGENT	715463		YES	2/13/2017
NICHOLE GADDIS	AGENT	995836		YES	2/13/2017
PORTIA BELL	AGENT	715818		YES	2/13/2017

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)	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:	DUANE STACKLIN
Title:	VICE PRESIDENT OF LENDING
Phone Number:	513-762-1647
Email Address:	DUANES@KEMBACU.ORG