Notification of Changes for Business Entity
General Information
Business Entity Name:	MERRILL LYNCH LIFE AGENCY INC
Incorporation / Formation Date:
FEIN:	132808480
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	WA
County:	KING
Business Address
Address 1:	1215 FOURTH AVENUE
Address 2:
City:	SEATTLE
State:	WA
Zip:	98161
Phone:	800-333-4858
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	9000 SOUTHSIDE BLVD, BLDG 200
Address 2:
City:	JACKSONVILLE
State:	FL
Zip:	32256
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
MICHAEL LAYMAN	AGENT	17872556	YES		04/26/2016
TINA MIGGE	AGENT	17204021	YES		04/26/2016
JOSHUA MARKS	AGENT	4058702	YES		04/26/2016
THERESA COOPER	AGENT	17518263	YES		04/26/2016
ADAM OURS	AGENT	7737472	YES		04/26/2016
NED ALTIC	AGENT	17222456	YES		04/26/2016
CHAD EDEL	AGENT	17545130	YES		04/26/2016
JOHN ANDERSON	AGENT	16931790	YES		04/26/2016
ROBERT IDOL	AGENT	7890781	YES		04/26/2016
ERIN TIMMERDING	AGENT	1493205	YES		04/26/2016
THOMAS HURLEY	AGENT	17897676	YES		04/26/2016
JONATHAN RENNER	AGENT	17745129	YES		04/26/2016
DOUGLAS ROSS	AGENT	2058390	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)
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:	BEVERLY FITCH
Title:	REGISTRATION ANALYST
Phone Number:	904-440-1166
Email Address:	BEVERLY.FITCH@BANKOFAMERICA.COM