Notification of Changes for Business Entity
General Information
Business Entity Name:	METROPCS MICHIGAN, LLC
Incorporation / Formation Date:	2/11/05
FEIN:	20-2509038
Ohio License Number:	996567
NPN:	17011811
DBA / Trade Name:
State of Domicile:	DE
County:	USA
Business Address
Address 1:	6200 OAK TREE BLVD
Address 2:	STE 125
City:	INDEPENDENCE
State:	OH
Zip:	44131
Phone:	214-570-5800
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	11460 TOMAHAWK CREEK PKWY
Address 2:	STE 300
City:	LEAWOOD
State:	KS
Zip:	66211
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

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
MATTHEW STANEFF	SVP, PRODUCT MARKETING	531862147		YES	5/8/18
ROBERT GARY	SVP, PRODUCT MARKETING	545816373	YES		5/8/18

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:	LAURA ASKEW
Title:	SR LICENSING COORDINATOR
Phone Number:	816-237-3139
Email Address:	METROPCS@ASURION.COM