Notification of Changes for Business Entity
General Information
Business Entity Name:	JONES-GRIMES-LONG-SNIDER, INC
Incorporation / Formation Date:	10/24/1968
FEIN:	31-0745051
Ohio License Number:	1459
NPN:	2226000
DBA / Trade Name:	INSURANCE ASSOCIATES OF MIDDLETOWN
State of Domicile:	OH
County:	BUTLER
Business Address
Address 1:	1061 N. UNIVERSITY BLVD.
Address 2:
City:	MIDDLETOWN
State:	OH
Zip:	45042
Phone:	513-424-2481
Fax:
Business Web Site Address:	WWW.INSURANCEASSOCIATES.NET
Business Email Address:
Mailing Address
Address 1:	P.O. BOX 911
Address 2:
City:	MIDDLETOWN
State:	OH
Zip:	45044
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
JUDY LEDFORD	AGENT	7202694		YES	7-1-2016

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
DAVID HARRISON	PRESIDENT	967306		YES	7-15-16

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:	GLENNA SETTERS
Title:	ACCOUNTING MGR.
Phone Number:	513-424-2481
Email Address:	GSETTERS@INSURANCEASSOCIATES.NET