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
   
Licensed Producers
Name Title NPN Add Delete Eff. Date
PATRICK SCHMIDT NEW RDA - REPLACE TYLER LEWIS 16742864 YES   6/12/2016
           
Members, Owners, Partners, Officers and Directors
Name Title Identifying # Add Delete Eff. Date
TYLER LEWIS FOUNDER 1655411   YES 6/12/2016
GREGORY ALER OWNER 273802995 YES   6/12/2016
PATRICK SCHMIDT OWNER 16742864 YES   6/12/2016
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) 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.
Submitted By  
Submitted By: TYLER N LEWIS
Title: AGENT
Phone Number: 4405915854
Email Address: TYLER@GOLDENRESERVE.COM