Notification of Changes for Business Entity
General Information
Business Entity Name:	TITLE FIRST AGENCY INC
Incorporation / Formation Date:
FEIN:	31-0984096
Ohio License Number:	2991
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	FRANKLIN
Business Address
Address 1:	3650 OLENTANGY RIVER ROAD
Address 2:	SUITE 400
City:	COLUMBUS
State:	OH
Zip:	43214
Phone:	614-493-2107
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	3650 OLENTANGY RIVER ROAD
Address 2:	SUITE 400
City:	COLUMBUS
State:	OH
Zip:	43214
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
DIRK CANTRELL	TREASURER	273-50-4258		YES	11/18/2015
KATHLEEN MARIE NOVAK	TIMR	279-80-7930		YES	11/18/2015
LIBBY GREGG CUTLER	TIMR	298-66-6747		YES	11/18/2015
SCOTT ROBERT BECK	TIMR	288-66-5137		YES	11/1/2015

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
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