Notification of Changes for Business Entity
General Information
Business Entity Name:	SES INS BROKERAGE SERVICES INC
Incorporation / Formation Date:	07/22/1988
FEIN:	33-0305416
Ohio License Number:	24792
NPN:	654319
DBA / Trade Name:
State of Domicile:	CA
County:	ORANGE
Business Address
Address 1:	1851 E. FIRST STREET
Address 2:	SUITE 600
City:	SANTA ANA
State:	CA
Zip:	92705
Phone:	714-352-7801
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	701 B STREET - LEGAL DEPT.
Address 2:	6TH FLOOR
City:	SAN DIEGO
State:	CA
Zip:	92101
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
WILLIAM MECKLENBURG	DRLP	17099761	YES		09/29/2017
JANET MARIA WHITE	N/A	3321540		YES	09/29/2017

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)
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:	KENNETH A. ZAK, ESQ.
Title:	SVP & SECRETARY
Phone Number:	619-238-1828
Email Address:	LICENSING@ALLIANT.COM