Notification of Changes for Business Entity
General Information
Business Entity Name:	PARK AVENUE SECURITIES LLC
Incorporation / Formation Date:
FEIN:	134023176
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	MANHATTAN
Business Address
Address 1:	7 HANOVER SQ
Address 2:
City:	NEW YORK
State:	NY
Zip:	10004
Phone:	6108077291
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	6255 STERNER'S WAY
Address 2:
City:	BETHLEHEM
State:	PA
Zip:	18017
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
ADAM GREENSTEIN	AGENT	9113590	YES		08/29/2016
HOWARD ELIAS	AGENT	422855	YES		09/01/2016
ANANDO MUKHERJEE	AGENT	16148311	YES		07/21/2016
AURTHUR MUTH	AGENT	17572832	YES		09/01/2016
BARTOSZ WARZYCHA	AGENT	16962501	YES		05/04/2016
BRANDON CAPPS	AGENT	8595448	YES		09/1/2016
CHARLES DUGGER	AGENT	16730932	YES		04/21/2016
JAMES HAILEY	AGENT	2345921	YES		05/02/2016
CHRISTOPHER LONG	AGENT	8055108	YES		09/1/2016
JAMES DRISCOLL	AGENT	5408307	YES		02/26/2016
DANIEL PRICE	AGENT	8638844	YES		05/27/2016
JOHN SPOLETI	AGENT	6408975	YES		09/01/2016
KEVIN KOVACH	AGENT	3925991	YES		09/01/2016
LINDA MILLER	AGENT	6733822	YES		07/12/2016
DAVID FISHER	AGENT	17180480	YES		06/10/2016

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
DENNIS MILLER	AGENT	17639040	YES		06/13/2016
DONALD MARSEE	AGENT	7085897	YES		05/01/2016
DOUGLAS TIMMERMAN	AGENT	17139196	YES		04/29/2016
MARC MILLER	AGENT	407914	YES		05/23/2016
FRANK MOORE	AGENT	3574994	YES		04/11/2016
GAGANDEEP SAHNI	AGENT	2678623	YES		02/22/2016
GERARD TAVELLA	AGENT	8317329	YES		7/26/2016
THOMAS CATES	AGENT	2204782	YES		09/01/2016
STEPHEN KILEY	AGENT	1481193	YES		09/01/2016
ROBERT ANGEL	AGENT	13128774	YES		8/29/2016

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:	MARY SINKIEWICZ
Title:	SUPERVISOR
Phone Number:	6108077291
Email Address:	MARY_SINKIEWICZ@GLIC.COM