Notification of Changes for Business Entity
General Information
Business Entity Name:	RED VENTURES INSURANCE, LLC
Incorporation / Formation Date:
FEIN:	46-0976984
Ohio License Number:	974972
NPN:	16793012
DBA / Trade Name:
State of Domicile:	SC
County:	LANCASTER
Business Address
Address 1:	1101 RED VENTURES DRIVE
Address 2:
City:	FORT MILL
State:	SC
Zip:	29707
Phone:	844-828-5995
Fax:
Business Web Site Address:
Business Email Address:	HICOMLICENSING@REDVENTURES.COM
Mailing Address
Address 1:	1101 RED VENTURES DRIVE
Address 2:
City:	FORT MILL
State:	SC
Zip:	29707
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:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
ADAM BENFER	AGENT	16932119		YES	5/31/2017
ALEXANDRA JONES	AGENT	17297357		YES	5/31/2017
ALYSSA HAMLIN	AGENT	17846425		YES	5/31/2017
AMANDA HUGHES	AGENT	17816906		YES	5/31/2017
AMANDA PIERSON	AGENT	17758573		YES	5/31/2017
AMY BENDER	AGENT	17560738		YES	5/31/2017
AMY TIRPAK	AGENT	17844111		YES	5/31/2017
ANA PLASENCIA	AGENT	17035143		YES	5/31/2017
APRIL BAILEY	AGENT	17715936		YES	5/31/2017
ARCHIE LEE WALKER	AGENT	17533542		YES	5/31/2017
ASHLEY D MATHEWS	AGENT	17701600		YES	5/31/2017
ASHLEY HOLCOMB	AGENT	17728395		YES	5/31/2017
AUSTEN DITZHAZY	AGENT	17382687		YES	5/31/2017
BRENDEN KELLEY	AGENT	17206646		YES	5/31/2017
BRIAN WEAR	AGENT	6583107		YES	5/31/2017

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)	YES
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	MARKETING

Submitted By
Submitted By:	MELISSA PATTERSON
Title:	LICENSING COORDINATOR
Phone Number:	844-828-5995
Email Address:	MEPATTERSON@REDVENTURES.COM