Notification of Changes for Business Entity
General Information
Business Entity Name:	HWG INSURANCE AGENCY LLC
Incorporation / Formation Date:
FEIN:	760420169
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	TX
County:	HARRIS
Business Address
Address 1:	600 TRAVIS STREET, SUITE 5900
Address 2:
City:	HOUSTON
State:	TX
Zip:	77002
Phone:	7139934668
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	600 TRAVIS STREET, SUITE 5900
Address 2:
City:	HOUSTON
State:	TX
Zip:	77002
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

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
GEORGE ARNOLD	VICE PRESIDENT	262799363	YES		07/27/2016
JEFFREY RHAME	VICE PRESIDENT	450513569		YES	07/27/2016

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:	LEANNE MILLS - ILSA
Title:	CLIENT LIAISON SERVICES
Phone Number:	2547296141
Email Address:	LMILLS@ILSAINC.COM