Notification of Changes for Business Entity
General Information  
Business Entity Name: BROWNYARD PROGRAMS LTD
Incorporation / Formation Date:  
FEIN: 11 3179789
Ohio License Number: 34065
NPN: 662024
DBA / Trade Name:  
State of Domicile: OH
County: SUFFOLK
Business Address  
Address 1: 91 E MAIN ST
Address 2:  
City: BAY SHORE
State: NY
Zip: 11706
Phone: 6315819300
Fax: 6315819385
Business Web Site Address:  
Business Email Address: MMCMILLEN@BROWNYARDPROGRAMS.COM
Mailing Address  
Address 1: 91 E MAIN ST
Address 2:  
City: BAY SHORE
State: NY
Zip: 11706
   
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
ARLEEN PALADINO DIRECTOR 147583146 YES   11/14/2017
ANDREW SMITH ASSISTANT VP 464454989 YES   11/14/2017
GEORGE FRENCH VICE PRESIDENT 139483013 YES   11/14/2017
GEORGE FRENCH TREASURER 139483013 YES   11/14/2017
ANTHONY SLIMOWICZ DIRECTOR 139701220 YES   11/14/2017
MAUREEN TORTORICI VICE PRESIDENT 067560234 YES   11/14/2017
JOSEPH MUCCIA VICE PRESIDENT 148703099   YES 11/14/2017
JOSEPH MUCCIA TREASURER 148703099   YES 11/14/2017
PAMELA J VAN COTT VICE PRESIDENT 108388374   YES 11/14/2017
PAUL WILLIAM BASSALINE DIRECTOR 044541107   YES 11/14/2017
           
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: CHRISTY KRICK
Title: LICENSING ADMINISTRATOR
Phone Number: 8124942472
Email Address: CKRICK@SUPPORTIVEIS.COM