Notification of Changes for Business Entity
General Information
Business Entity Name:	AAA ALLIED INSURANCE SERVICES INC
Incorporation / Formation Date:
FEIN:	311104973
Ohio License Number:
NPN:	686060
DBA / Trade Name:
State of Domicile:	OH
County:	HAMILTON
Business Address
Address 1:	15 W CENTRAL PKWY
Address 2:
City:	CINCINNATI
State:	OH
Zip:	45202
Phone:	5133455687
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	15 W CENTRAL PKWY
Address 2:
City:	CINCINNATI
State:	OH
Zip:	45202
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
EMILY BUNTS	AGENT	7696422	YES		11/17/14
JOHN CRAWFORD	AGENT	16094510	YES		01/16/17
FRANK DIGENNARO	AGENT	1719850	YES		10/01/15
SARAH IACOVONE	AGENT	9833599	YES		07/08/13
DANNY SCROGGINS	AGENT	7223730	YES		01/14/13
ELIZABETH BURCHETT	AGENT	17433957	YES		07/17/15
JOHN GEHA	AGENT	16022964	YES		07/20/15
DANIEL HELVEY	AGENT	968297	YES		05/26/15
STEVEN OSTROTH	AGENT	17587365	YES		04/03/17
ADRIAN RAWSON-PIERCE	AGENT	13351985	YES		11/03/14
GRETCHEN SETTLES	AGENT	1842170	YES		10/01/15
CAREY SPEER	AGENT	17239565	YES		04/17/17
FRANCISCA TORRES	AGENT	7883620	YES		10/01/15

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:	LISA KLEBART
Title:	DIRECTOR INSURANCE OPERATIONS / SECRETARY
Phone Number:	(860) 570-4212
Email Address:	LKLEBART@AAA-ALLIEDGROUP.COM