Notification of Changes for Business Entity
General Information  
Business Entity Name: PROEQUITIES, INC
Incorporation / Formation Date:  
FEIN: 63-0879387
Ohio License Number: 28281
NPN: 1046690
DBA / Trade Name:  
State of Domicile: AL
County: JEFFERSON
Business Address  
Address 1: 2801 HIGHWAY 280 SOUTH
Address 2:  
City: BIRMINGHAM`
State: AL
Zip: 35223
Phone: 205-268-5899
Fax: 205-268-5006
Business Web Site Address: WWW.PROEQUITIES.COM
Business Email Address: MELISSA.SANDERS@PROEQUITIES.COM
Mailing Address  
Address 1: 2801 HIGHWAY 280 SOUTH
Address 2:  
City: BIRMINGHAM
State: AL
Zip: 35223
   
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
JAMES ANDERSON PRODUCER 937547   YES 5/26/2016
JOHN BAMBERGER PRODUCER 719031   YES 5/26/2016
BRYON BAYLOG PRODUCER 707187   YES 5/26/2016
JAMES BEERBOWER PRODUCER 940122   YES 5/26/2016
WAYNE CREEDEN PRODUCER 1022941   YES 5/26/2016
ROBERT DONATI PRODUCER 83409   YES 5/26/2016
JOEY FENDERSON PRODUCER 1053727   YES 5/26/2016
BRUCE GOEPFERT PRODUCER 554388   YES 5/26/2016
TAHSIEN HAMIDEH PRODUCER 1014854   YES 5/26/2016
THERESA KUNKELI PRODUCER 1016443   YES 5/26/2016
JOHN KWASNIK PRODUCER 615541   YES 5/26/2016
CHRISTOPHER MALONE PRODUCER 939761   YES 5/26/2016
ADAM MCHENRY PRODUCER 705314   YES 5/26/2016
ANDREA OLIVERIO PRODUCER 1008613   YES 5/26/2016
RYAN TARJANYI PRODUCER 805710   YES 5/26/2016
           
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)
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: MELISSA SANDERS
Title: SR. LICENSING ADMIN.
Phone Number: 205-268-5899
Email Address: MELISSA.SANDERS@PROEQUITIES.COM