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 103 ST
Address 2:
City:	OMAHA
State:	NE
Zip:	68134
Phone:	4029632361
Fax:
Business Web Site Address:
Business Email Address:	AGENT@SITEL.COM
Mailing Address
Address 1:	5601 NORTH 103 ST
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
SHEA FOSTER	AGENT	18330888	YES		10-26-2018
RACHEL HOWARD	AGENT	18330912	YES		10-26-2018
GARRETT TEASLEY	AGENT	18925397	YES		10-26-2018
DARIN WORLEY	AGENT	18590906	YES		10-26-2018
CHARLES BRIDGES	AGENT	18944536	YES		10-26-2018
PORSHA KEY	AGENT	18946407	YES		10-26-2018
DELONDA SIMS	AGENT	18946335	YES		10-26-2018
STEPHANIE BACCUS	AGENT	12708840	YES		10-26-2018
PENNY LINEBAUGH	AGENT	5945831	YES		10-26-2018
DAWN WOLL	AGENT	18923967	YES		10-26-2018
LAUREN YEARY	AGENT	17929122	YES		10-26-2018
KIMBERLY BOYD	AGENT	18876698	YES		10-26-2018
JAMEL GANDY	AGENT	18940048	YES		10-26-2018
COURTNEY KEATON	AGENT	18940057	YES		10-26-2018
EBONI OUTLAW	AGENT	18940051	YES		10-26-2018

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:	SHARON WALKER
Title:	LICENSING SPECIALIST
Phone Number:	4029633009
Email Address:	AGENT@SITEL.COM