Notification of Changes for Business Entity
General Information
Business Entity Name:	FX INSURANCE AGENCY, LLC
Incorporation / Formation Date:
FEIN:	35-2281892
Ohio License Number:	1152464
NPN:	8963028
DBA / Trade Name:
State of Domicile:	DE
County:	NEW CASTLE
Business Address
Address 1:	3 BEAVER VALLEY RD
Address 2:
City:	WILMINGTON
State:	DE
Zip:	19803
Phone:	302-252-2165
Fax:	302-252-2455
Business Web Site Address:
Business Email Address:	JEANNIE.MCLARNON@FARMERSINSURANCE.COM
Mailing Address
Address 1:	3 BEAVER VALLEY RD
Address 2:
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
JOSEPH ABRIL	AGENT	18426417	YES		12/19/2018
BRITTANY ALTAMIRANO	AGENT	18086118	YES		12/19/2018
TRACIE ANDERSON	AGENT	17096232	YES		12/19/2018
DAMIEN BALDWIN	AGENT	17319409	YES		12/19/2018
DENISE BENAVIDES	AGENT	18872689	YES		12/19/2018
KAYLEE BETZ	AGENT	18881601	YES		12/19/2018
FRANK BIENEMAN	AGENT	9794805	YES		12/19/2018
CHRISTINE BLESSIE	AGENT	6734351	YES		12/19/2018
TAMMY BLOOMFIELD	AGENT	8309127	YES		12/19/2018
RODOLFO BOGOJEVICH	AGENT	18456656	YES		12/19/2018
GENTA BOTKA	AGENT	2442606	YES		12/19/2018
VICTOR CASTANEDA	AGENT	18976033	YES		12/19/2018
ADAM COHEN	AGENT	9972607	YES		12/19/2018
KENNETH COLANDER	AGENT	3235789	YES		12/19/2018
KATHLEEN CONLEY	AGENT	18976087	YES		12/19/2018

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:	REGINA M. MCLARNON
Title:	ASSISTANT SECRETARY
Phone Number:	302-252-2165
Email Address:	JEANNIE.MCLARNON@FARMERSINSURANCE.COM