Notification of Changes for Business Entity
General Information
Business Entity Name:	ON CALL INTERNATIONAL, LLC
Incorporation / Formation Date:	05/07/1997
FEIN:	04-3373226
Ohio License Number:	34258
NPN:	8020181
DBA / Trade Name:
State of Domicile:	DE
County:	US
Business Address
Address 1:	11 MANOR PARKWAY
Address 2:
City:	SALEM
State:	NH
Zip:	03079
Phone:	6033281793
Fax:	6038985264
Business Web Site Address:
Business Email Address:	JENNIFER.BRUNELLE@ONCALLINTERNATIONAL.COM
Mailing Address
Address 1:	11 MANOR PARKWAY
Address 2:
City:	SALEM
State:	NH
Zip:	03079
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
MICHAEL KELLY	MEMBER	158487890		YES	05/15/17

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:	HAILEY OVERBY
Title:	TREAS OF KLS
Phone Number:	2148550737
Email Address:	HOVERBY@KENNEDYLICENSING.COM