Notification of Changes for Business Entity
General Information
Business Entity Name:	J. C. BATTLE & SONS FUNERAL HOME
Incorporation / Formation Date:
FEIN:	310686702
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	OH
Business Address
Address 1:	543 ROCKDALE AVENUE
Address 2:
City:	CINCINNATI
State:	OH
Zip:	45229
Phone:	5132814330
Fax:
Business Web Site Address:
Business Email Address:	LYNWOODBATTLE@GMAIL.COM
Mailing Address
Address 1:	543 ROCKDALE AVENUE
Address 2:
City:	CINCINNATI
State:	OH
Zip:	45229
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:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
JUDITH E. ANTHONY	FUNERAL DIRECTOR	3417560	YES		4-16-2018

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)
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:	JUDITH ANTHONY
Title:	FUNERAL DIRECTOR
Phone Number:	5132814330
Email Address:	LYNWOODBATTLE@GMAIL.COM