Notification of Changes for Business Entity
General Information
Business Entity Name:	INSURANCE ANSWER CENTER LLC
Incorporation / Formation Date:
FEIN:	261971917
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	CA
County:	LOS ANGELES
Business Address
Address 1:	15910 VENTURA BLVD FL 6
Address 2:
City:	ENCINO
State:	CA
Zip:	91436
Phone:	865-226-1060
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	PO BOX 261220
Address 2:
City:	ENCINO
State:	CA
Zip:	91426
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
TACKETT, JUSTIN	PRODUCER	1177481	YES		01/16/2018
BROADHEAD, SAMANTHA	PRODUCER	1177595	YES		01/16/2018
BUNDERSON, JULIE	PRODUCER	1177596	YES		01/16/2018
CARTY, JOSEPH	PRODUCER	1177493	YES		01/16/2018
HANSEN, CORTNEY	PRODUCER	1177597	YES		01/16/2018
PEREZ, EVELYN	PRODUCER	937320	YES		01/16/2018
ROSADO, JONATHAN	PRODUCER	1177413	YES		01/16/2018
SEVERSON, KYLE	PRODUCER	1037532	YES		01/16/2018
SHUMAKER, SCOTT	PRODUCER	1177491	YES		01/16/2018
TREJO, HEAVENLY	PRODUCER	1177415	YES		01/16/2018
TRUEBA, ANTHONY	PRODUCER	1177414	YES		01/16/2018
WADE, MICHAEL	PRODUCER	1166383	YES		01/16/2018

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)	NO
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

Submitted By
Submitted By:	BRENDA HARBIN
Title:	LICENSE MANAGER
Phone Number:	865-226-1060
Email Address:	TEAMLICENSING@ANSWERFINANCIAL.COM