Notification of Changes for Business Entity
General Information
Business Entity Name:	RICHWOOD FINANCIAL SERVICES, LLC
Incorporation / Formation Date:
FEIN:	010970025
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	UNION
Business Address
Address 1:	28 N FRANKLIN STREET
Address 2:
City:	RICHWOOD
State:	OH
Zip:	43344
Phone:	7409432317
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	28 N FRANKLIN STREET
Address 2:
City:	RICHWOOD
State:	OH
Zip:	43344
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
CHAD HOFFMAN	MANAGER/PRESIDENT	292829688	YES		9/26/16
SETH TAYLOR	MANAGER/TREASURER	298586728	YES		9/26/16
JENNY WOLF	SECRETARY	274887054	YES		9/26/16

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:	JAMES SAROSY
Title:	RDA
Phone Number:	614.846.2170
Email Address:	JJSAROSY@CBAO.COM