Notification of Changes for Business Entity
General Information  
Business Entity Name: CAREZONE FINANCIAL SERVICES LLC
Incorporation / Formation Date:  
FEIN: 300882838
Ohio License Number:
NPN:
DBA / Trade Name:  
State of Domicile: DE
County: NEWCASTLE
Business Address  
Address 1: 3175 17TH STREET
Address 2:  
City: SAN FRANCISCO
State: CA
Zip: 94110
Phone: 9162370162
Fax:  
Business Web Site Address:  
Business Email Address:  
Mailing Address  
Address 1: 3175 17TH STREET
Address 2:  
City: SAN FRANCISCO
State: CA
Zip: 94110
   
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
ANA FE ALVAREZ BALSIZER AGENT 8173203 YES   03/07/2017
PATRICIANNE TINGLE-KEY AGENT 17528052 YES   03/07/2017
GARY JONES AGENT 10944529 YES   03/07/2017
ROGER THOMAS AGENT 2628889 YES   03/07/2017
CHARLES DEVER AGENT 15870766 YES   03/07/2017
OSAMA SAFA AGENT 16304923 YES   03/07/2017
NATASHA POOLE AGENT 8736916 YES   03/07/2017
           
Members, Owners, Partners, Officers and Directors
Name Title Identifying # Add Delete Eff. Date
CARRIE MCLEAN    
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) NO
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? NO
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: CARRIE MCLEAN
Title: DIRECTOR, OPERATIONS
Phone Number: 9162370162
Email Address: CHELSIE.LYNCH@CAREZONEINSURANCE.COM