Notification of Changes for Business Entity
General Information
Business Entity Name:	WELLS FARGO ADVISORS INSURANCE AGENCY, LLC
Incorporation / Formation Date:
FEIN:	54-0910269
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	VA
County:	INDEPENDENT CITY
Business Address
Address 1:	901 E. BYRD ST.
Address 2:
City:	RICHMOND
State:	VT
Zip:	23219
Phone:	605-782-5116
Fax:
Business Web Site Address:
Business Email Address:	JENNIFER.L.BECHT@WELLSFARGO.COM
Mailing Address
Address 1:	3201 N 4TH AVE
Address 2:
City:	SIOUX FALLS
State:	SD
Zip:	57104
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
ANDREW R STROMWALL	AGENT	15699481		YES	01/16/2018
FRANK MICHAEL CACCAVALLO	AGENT	1597517	YES		01/16/2018
FRANSHELL DUMIES CARRIER	AGENT	16099521	YES		01/16/2018
JOEL ANDERSON	AGENT	18621468	YES		01/16/2018
JONATHAN B KULICK	AGENT	536662	YES		01/16/2018
JAMES CHA	AGENT	5736199	YES		01/16/2018
MARY E FULTON CAMPBELL	AGENT	5773878	YES		01/16/2018
THOMAS GARCIA	AGENT	6763140	YES		01/16/2018
PAULETTE A DOUGLAS	AGENT	6907739	YES		01/16/2018
JOSEPH SINNOTT MOYNIHAN	AGENT	7531688	YES		01/16/2018
LINDSAY MONICA NAVIN	AGENT	789345		YES	01/16/2018
CYNTHIA ANN BERRY	AGENT	9146452	YES		01/16/2018

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:	JENNIFER BECHT
Title:	SECURITIES SPECIALIST
Phone Number:	605-782-5116
Email Address:	JENNIFER.L.BECHT@WELLSFARGO.COM