Notification of Changes for Business Entity
General Information
Business Entity Name:	ESTATE PLANNING OF DELAWARE VALLEY, INC.
Incorporation / Formation Date:	01/14/1997
FEIN:	52-2012755
Ohio License Number:	575200
NPN:	2036855
DBA / Trade Name:
State of Domicile:	DE
County:	NEW CASTLE
Business Address
Address 1:	14715 FOULK ROAD
Address 2:	SUITE 103
City:	WILMINGTON
State:	DE
Zip:	19803
Phone:	302 477 9700
Fax:	302 477 9710
Business Web Site Address:
Business Email Address:	LLOCKE@EPDV.COM
Mailing Address
Address 1:	1414 FOULK ROAD
Address 2:	SUITE 103
City:	WILMINGTON
State:	DE
Zip:	19803
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
FRANK KESSELMAN	PRESIDENT	52-2012755	YES		09/01/2016

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)	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:	LINDA LOCKE
Title:	OFFICE MANAGER
Phone Number:	302 477 9700
Email Address:	LLOCKE@EPDV.COM