Notification of Changes for Business Entity
General Information  
Business Entity Name: STOR ALL CORPORATION FOR REAL ESTATE DEVELOPMENT INC
Incorporation / Formation Date:  
FEIN: 61-1325678
Ohio License Number:
NPN:
DBA / Trade Name:  
State of Domicile: KY
County: CARTER
Business Address  
Address 1: 253 WOMSTEAD DRIVE
Address 2:  
City: GRAYSON
State: KY
Zip: 41143
Phone: 606-474-6601
Fax:  
Business Web Site Address:  
Business Email Address:  
Mailing Address  
Address 1: 253 WOMSTEAD DRIVE
Address 2:  
City: GRAYSON
State: KY
Zip: 41143
   
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
BADER COMPANY RDA 3122916   YES 7/31/2017
XERCOR INSURANCE SERVICES RDA 17687370 YES   7/31/2017
           
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: JAMES S WOMACK
Title: PRESIDENT
Phone Number: 606-474-6601
Email Address: AARONELDRIDGE@STORALL.ONMICROSOFT.COM