Notification of Changes for Business Entity
General Information
Business Entity Name:	WELLS FARGO ADVISORS INSURANCE AGENCY LLC.
Incorporation / Formation Date:
FEIN:	540910269
Ohio License Number:	28429
NPN:
DBA / Trade Name:
State of Domicile:	VA
County:	INDEPENDENT CITY
Business Address
Address 1:	901 E BYRD ST.
Address 2:
City:	RICHMOND
State:	VA
Zip:	23219
Phone:	6057825112
Fax:	8663548566
Business Web Site Address:	WWW.WELLSFARGO.COM
Business Email Address:	AGENCYLICENSING@WELLSFARGO.COM
Mailing Address
Address 1:	3201 N 4TH AVE
Address 2:
City:	SIOUX FALLS
State:	SD
Zip:	57104
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
KERR, IAN	AGENT	17610222	YES		04/29/16
POWERS, JODI	AGENT	15725872	YES		04/28/16
BYRNES, DANIEL	AGENT	16349823	YES		04/25/16
CASALE, CHRSITINE	AGENT	16436976	YES		04/25/16
FAWCETT, RANDALL	AGENT	3689538	YES		04/28/2016
MARQUARDT, ROBERT	AGENT	17913274	YES		04/28/2016
PAPOLOS, RICHARD	AGENT	476512	YES		04/28/2016
PELLICCIONI, BRICE	AGENT	1104316	YES		04/28/2016
PRIESS, H.	AGENT	14857439	YES		04/29/2016
TOMBLIN, BROOKS	AGENT	3699014	YES		04/25/2016
ZWICK, ILENE	AGENT	6984057	YES		04/28/2016
ZWICK, BRUCE	AGENT	9396304	YES		04/28/2016
KING, SCOTT	AGENT	516627		YES	04/27/2016
MOSSBARGER, JEFF	AGENT	4797620		YES	04/26/2016

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:	MELISSA L SHUTT
Title:	SOSS2
Phone Number:	6057825112
Email Address:	MELISSA.L.SHUTT@WELLSFARGO.COM