| Notification of Changes for Business Entity |
| General Information | |
| Business Entity Name: | GOLDEN RESERVE, LLC |
| Incorporation / Formation Date: | 12/02/2011 |
| FEIN: | 45-3962110 |
| Ohio License Number: | 954473 |
| NPN: | 1655411 |
| DBA / Trade Name: | |
| State of Domicile: | OH |
| County: | FRANKLIN |
| Business Address | |
| Address 1: | 6037 FRANTZ ROAD, SUITE 105 |
| Address 2: | |
| City: | DUBLIN |
| State: | OH |
| Zip: | 43017 |
| Phone: | 855-456-4777 |
| Fax: | 855-765-4254 |
| Business Web Site Address: | WWW.GOLDENRESERVE.COM |
| Business Email Address: | INFORMATION@GOLDENRESERVE.COM |
| Mailing Address | |
| Address 1: | 6037 FRANTZ ROAD, SUITE 105 |
| Address 2: | |
| City: | DUBLIN |
| State: | OH |
| Zip: | 43017 |
| | |
| Indicate the type of change you are seeking |
| Address Change: | YES |
| 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 |
| | |
| 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) | YES |
| 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 | GREGORY ALER - ALERSTALLINGS LLC
- AN OWNER & PARTNER – LAW FIRM. OWN AND OPERATE LAW FIRM.
GREGORY ALER - SCOUT TITLE LLC
- AN OWNER – TITLE COMPANY. JUST OWNER – NO DAY-TO-DAY INVOLVEMENT.
GREGORY ALER - GOLDEN RESERVE LLC
- AN OWNER – INVESTMENT COMPANY. JUST OWNER – NO DAY-TO-DAY INVOLVEMENT.
GREGORY ALER - BRIGADO INVESTMENTS LLC
- AN OWNER – REAL ESTATE HOLDING COMPANY. OWN AND MANAGE COMMERCIAL REAL ESTATE.
GREGORY ALER - AS ADVISORS LLC
- AN OWNER – EVENT AND MARKETING COMPANY. JUST OWNER – NO DAY-TO-DAY INVOLVEMENT.
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