Notification of Changes for Business Entity
General Information  
Business Entity Name: MERRILL LYNCH LIFE AGENCY, INC
Incorporation / Formation Date:  
FEIN: 13-2808480
Ohio License Number:
NPN:
DBA / Trade Name:  
State of Domicile: WA
County: KING
Business Address  
Address 1: 1215 4TH AVENUE, 26TH FL
Address 2:  
City: SEATTLE
State: WA
Zip: 98161
Phone: 800-333-4858
Fax:  
Business Web Site Address:  
Business Email Address:  
Mailing Address  
Address 1: 9000 SOUTHSIDE BLVD
Address 2: BLDG 200, 4TH FL
City: JACKSONVILLE
State: FL
Zip: 32256
   
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
TRACY MCGUIRE AGENT 2088754   YES 07/31/2018
MICHAEL HENLEY AGENT 15919006   YES 07/31/2018
STEVE MACONI AGENT 610968   YES 07/31/2018
MARK JACKSON AGENT 8511182   YES 07/31/201/
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: TANDREA MATTHEWS
Title: EAC COMPLIANCE
Phone Number: 904-440-1212
Email Address: TANDREA.MATTHEWS@BANKOFAMERICA.COM