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:	NE
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
VICTORIA MOORE	PRODUCER	18674286	YES		04/13/2018
RON'ALDNEOMA MYERS	PRODUCER	18724023	YES		04/13/2018
JANEL NOREN	PRODUCER	18723491	YES		04/13/2018
ASHLEY OBRYANT	PRODUCER	18695797	YES		04/13/2018
YARAXI PACHECO-MARTINEZ	PRODUCER	18653712	YES		04/13/2018
TAMMY PIERCE	PRODUCER	18709538	YES		04/13/2018
KADEIJAH PIPPIN	PRODUCER	18676986	YES		04/13/2018
SATIN POOLE	PRODUCER	18689468	YES		04/13/2018
ERICA POPE	PRODUCER	18679881	YES		04/13/2018
NEOSHA PRATT	PRODUCER	18674370	YES		04/13/2018
BRITTANY ROBBINS	PRODUCER	18652440	YES		04/13/2018
CASANDRA ROBERSON	PRODUCER	18674345	YES		04/13/2018
MARTINECE ROBERTSON	PRODUCER	18743912	YES		04/13/2018
JOI ROBINSON	PRODUCER	18722790	YES		04/13/2018
ARIEL SAMMIS	PRODUCER	18728290	YES		04/13/2018

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
S PATRIC SCAVOTTO	PRODUCER	18695401	YES		04/13/2018
DANIELLE SCOTT	PRODUCER	18730544	YES		04/13/2018
DARREN SEIBER	PRODUCER	18723464	YES		04/13/2018
PAIGE SHELTON	PRODUCER	18679874	YES		04/13/2018
JESSICA SIDES	PRODUCER	18674318	YES		04/13/2018
TOVARIS SKINNER	PRODUCER	18725916	YES		04/13/2018
AMY SMITH-HEDGE	PRODUCER	17942049	YES		04/13/2018
CALVIN SMITH	PRODUCER	18735639	YES		04/13/2018
VALENCIA SMITH	PRODUCER	18685400	YES		04/13/2018
TRISTA SOTO	PRODUCER	18662526	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