Notification of Changes for Business Entity
General Information
Business Entity Name:	CREATIVE PLANNING PROPERTY & CASUALTY LLC
Incorporation / Formation Date:
FEIN:	311819007
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	JOHNSON
Business Address
Address 1:	11350 TOMAHAWK CREEK PKWY, STE 200
Address 2:
City:	LEAWOOD
State:	KS
Zip:	66211
Phone:	9133410900
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	11350 TOMAHAWK CREEK PKWY, STE 200
Address 2:
City:	LEAWOOD
State:	KS
Zip:	66211
Indicate the type of change you are seeking
Address Change:	NO
Business Entity Name Change:	YES	Old Business Entity Name:	FIDELITY GROUP INS PROFESSIONA
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:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date

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:	CRAIG SEILER
Title:	MEMBER
Phone Number:	9133410900
Email Address:	DSCHROEGER@CPFIRMS.COM