Notification of Changes for Business Entity
General Information
Business Entity Name:	CAILOR FLEMING & ASSOCAITES, INC.
Incorporation / Formation Date:
FEIN:	341043104
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	MAHONING
Business Address
Address 1:	4610 MARKET STREET
Address 2:
City:	YOUNGSTOWN
State:	OH
Zip:	44512
Phone:	330-782-8068
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	PO BOX 3989
Address 2:
City:	YOUNGSTOWN
State:	OH
Zip:	44513
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
JOHN W FLEMING	EMPLOYEE	519129		YES	08/18/2016
KATHLEEN A HAWKINS	AGENT	2223577		YES	08/18/2016
KIM ANN BLAINE	AGENT	2341755		YES	08/18/2016
MARY ELLEN LINDQUIST	AGENT	2341643		YES	08/18/2016
NANCY J. EPSTEIN	AGENT	1773972		YES	08/18/2016
NANCY J. EPSTEIN	EMPLOYEE	1773972		YES	08/18/2016
NILLA DEMARCO	AGENT	1900405		YES	08/18/2016
THADDEUS WOODMAN, JR.	EMPLOYEE	2761650		YES	08/18/2016
THOMAS L PRICE	EMPLOYEE	2514874		YES	08/18/2016
URBAN A ROTHERMEL	EMPLOYEE	1855624		YES	08/18/2016

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:	TRENT CAILOR
Title:	PRESIDENT
Phone Number:	330-782-8625
Email Address:	TCAILOR@CAILORFLEMING.COM