Notification of Changes for Business Entity
General Information
Business Entity Name:	LUCIA SECURITIES, LLC
Incorporation / Formation Date:	12/16/2002
FEIN:	954481399
Ohio License Number:	931737
NPN:	16206728
DBA / Trade Name:
State of Domicile:	CA
County:	SAN DIEGO
Business Address
Address 1:	13520 EVENING CREEK DR. NORTH
Address 2:	SUITE 300
City:	SAN DIEGO
State:	CA
Zip:	92128
Phone:	8587261095
Fax:
Business Web Site Address:
Business Email Address:	MDOTSON@LUCIACAP.COM
Mailing Address
Address 1:	13520 EVENING CREEK DR. NORTH
Address 2:	SUITE 300
City:	SAN DIEGO
State:	CA
Zip:	92128
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
BRENDA KNUDSEN	AGEMT	16962388	YES		08/23/2017

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:	MELISSA DOTSON
Title:	LICENSING MGR
Phone Number:	8587261095
Email Address:	MDOTSON@LUCIACAP.COM