Notification of Changes for Business Entity
General Information
Business Entity Name:	WELLS FARGO ADVISORS INSURANCE AGENCY LLC.
Incorporation / Formation Date:
FEIN:	540910269
Ohio License Number:	28429
NPN:
DBA / Trade Name:
State of Domicile:	VA
County:	INDEPENDENT CITY
Business Address
Address 1:	901 E. BYRD ST.
Address 2:
City:	RICHMOND
State:	VA
Zip:	23269
Phone:	6057825112
Fax:	8448790217
Business Web Site Address:	WWW.WELLSFARGO.COM
Business Email Address:	AGENCYLICENSING@WELLSFARGO.COM
Mailing Address
Address 1:	3201 N 4TH AVE
Address 2:
City:	SIOUX FALLS
State:	SD
Zip:	57104
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
BUCHWEITZ, JOHN E	AGENT	542446		YES	04/03/2017
SHIELDS, MICHAEL PAUL	AGENT	1011358		YES	04/03/2017
KOTARSKI, MICHAEL	AGENT	5704501		YES	04/03/2017
DANIEL, BURTON	AGENT	15887538		YES	04/06/2017
CAPAN, AARON BRETT	AGENT	8502361	YES		04/06/2017
DURLESTER, MATTHEW HUNTER	AGENT	17612642	YES		04/03/2017
SCHULTEN, MARK EDWARD	AGENT	1350843	YES		04/03/2017
HUSKINS, ROBERT	AGENT	1003547		YES	04/03/2017
ROSSIN, NICHOLAS	AGENT	17549907	YES		04/03/2017
LUSEBRINK JR, FRANK M	AGENT	17400504	YES		04/03/2017
MCMURTREY, MICHAEL E	AGENT	16791232		YES	04/03/2017
AMYS, CHRISTOPHER	AGENT	14805276	YES		04/05/2017
FRISBEE, TANYA	AGENT	8974009	YES		04/07/2017
JONES, CHARLES	AGENT	2353288		YES	04/05/2017
LEWIS, BEN	AGENT	2384182	YES		04/05/2017

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:	MELISSA L. SHUTT
Title:	SOSS2
Phone Number:	6057825112
Email Address:	MELISSA.L.SHUTT@WELLSFARGO.COM