Notification of Changes for Business Entity
General Information
Business Entity Name:	THE UNIFIED BANK
Incorporation / Formation Date:
FEIN:	34-0144400
Ohio License Number:	42046
NPN:	16113296
DBA / Trade Name:
State of Domicile:	OH
County:	BELMONT
Business Address
Address 1:	201 S. FOURTH STREET
Address 2:
City:	MARTINS FERRY
State:	OH
Zip:	43935
Phone:	888-275-5566
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	P.O. BOX 10
Address 2:
City:	MARTINS FERRY
State:	OH
Zip:	43935
Indicate the type of change you are seeking
Address Change:	NO
Business Entity Name Change:	YES	Old Business Entity Name:	THE CITIZENS SAVINGS BANK
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:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date

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)	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	THE CITIZENS SAVINGS BANK; FINANCIAL INSTITUTION

Submitted By
Submitted By:	SHERI JOHNSON
Title:	CLIENT RELATIONS, THE MILBY GROUP INSURANCE AGENCY
Phone Number:	740-652-9942
Email Address:	SHERIJOHNSON@MILBYGROUP.COM