Notification of Changes for Business Entity
General Information
Business Entity Name:	NORTHWEST TITLE FAMILY OF COMPANIES, INC
Incorporation / Formation Date:	5/18/1967
FEIN:	31-06730671
Ohio License Number:	5491
NPN:	2441377
DBA / Trade Name:
State of Domicile:	OH
County:	OHIO
Business Address
Address 1:	1160 DUBLIN ROAD
Address 2:	SUITE 500
City:	COLUMBUS
State:	OH
Zip:	43215
Phone:	16144516313
Fax:
Business Web Site Address:	HTTPS://WWW.NWTITLE.COM
Business Email Address:	GRANDVIEW@NWTITLE.COM
Mailing Address
Address 1:	1160 DUBLIN ROAD
Address 2:	SUITE 500
City:	COLUMBUS
State:	OH
Zip:	43215
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
CORY DELGUZZO	RESIDENT AGENT	1071429	YES		8/6/2015

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
JAMES S STEVENSON

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:	LIZ DAVIS
Title:	AVP CORPORATE ADMINISTRATION
Phone Number:	16144516313
Email Address:	GRANDVIEW@NWTITLE.COM