Notification of Changes for Business Entity
General Information
Business Entity Name:	THRIVENT INSURANCE AGENCY
Incorporation / Formation Date:
FEIN:	411780150
Ohio License Number:	26090
NPN:	662734
DBA / Trade Name:
State of Domicile:	MN
County:	HENNEPIN
Business Address
Address 1:	625 FOURTH AVE S
Address 2:
City:	MINNEAPOLIS
State:	MN
Zip:	55415
Phone:	9206285808
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	625 FOURTH AVE S
Address 2:
City:	MINNEAPOLIS
State:	MN
Zip:	55415
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
CYNTHIA STEINER	AGENT	247607		YES	4/25/2018
THOMAS KUYKENDALL	AGENT	6981967		YES	4/25/2018
DOUGLAS BALVANZ	AGENT	1896946		YES	4/25/2018
MARK HOWLETT	AGENT	7817391		YES	4/25/2018
CHRISTOPHER HARRIS	AGENT	8750841		YES	4/25/2018
BRANDON GRECO	AGENT	1957858		YES	4/25/2018
TIMOTHY GRECO	AGENT	8317188		YES	4/25/2018
WILLIAM BARGHOLTZ	AGENT	6499382		YES	4/25/2018
JANELLE FUHRMANN	AGENT	322649		YES	5/1/2018
WAYNE SMITH	AGENT	8519545		YES	5/1/2018
GREG LOVETTE	AGENT	10911313		YES	5/1/2018
JACE JUNGEMANN	AGENT	18396775		YES	5/1/2018
MICHAEL GOLLENBERG	AGENT	12123103		YES	5/1/2018
DANIEL DORSCH	AGENT	16966701		YES	5/4/2018
CYNTHIA CRANE	AGENT	16811544		YES	5/4/2018

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:	RACHAEL STURM
Title:	SPECIALIST
Phone Number:	9206285808
Email Address:	RACHAEL.STURM@THRIVENT.COM