Notification of Changes for Business Entity
General Information
Business Entity Name:	UNIVERSAL 1 CREDIT UNION
Incorporation / Formation Date:
FEIN:	31-0387145
Ohio License Number:	34264
NPN:	8733873
DBA / Trade Name:
State of Domicile:	OH
County:	MONTGOMERY
Business Address
Address 1:	1 RIVER PARK DR
Address 2:
City:	DAYTON
State:	OH
Zip:	45409
Phone:	937-225-6800
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	1 RIVER PARK DR
Address 2:
City:	DAYTON
State:	OH
Zip:	45409
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
MICHELLE L SCARBERRY	MSR	17861561	YES		2/25/2016
RACHELLE DM MARBURY	MSR	17863301	YES		2/25/2016
STACY M WORLEY	MSR	17863067	YES		2/25/2016
MOLLY WALLS	MSR	17863248	YES		2/25/2016
SOPHIA S TRAVIS	MSR	17861502	YES		2/25/2016
TAMMY M LYME	MSR	17861543	YES		2/25/2016
AMANDA K GRUMP	MSR	17861431	YES		2/25/2016
PEGGY E STOFF	MSR	17861527	YES		2/25/2016
ROBERT S ROCKWELL	MSR	17861430	YES		2/25/2016
LINDSEY R KURTZ	MSR	17861524	YES		2/25/2016
AUDREY E YOUNG	MSR	17861481	YES		2/25/2016
SHERRIE L PERKINS	MSR	6624712	YES		2/25/2016
AMBER N MYERS	MSR	17861607	YES		2/25/2016

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)	YES
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?	YES
3. If the answer to questions #1 or #2 is yes, identify the business or profession and the nature of person's involvement	ALL OUR EMPLOYEES OF UNIVERSAL 1 CREDIT UNION

Submitted By
Submitted By:	LESA A GARWOOD
Title:	RDA
Phone Number:	937-225-9290
Email Address:	L.GARWOOD@U1CU.ORG