Notification of Changes for Business Entity
General Information
Business Entity Name:	THE GENERAL AUTOMOBILE INS SVCS INC
Incorporation / Formation Date:
FEIN:	62-1684225
Ohio License Number:	36214
NPN:	6539339
DBA / Trade Name:
State of Domicile:	CA
County:	SAN BERNARDINO
Business Address
Address 1:	4141 E INLAND EMPIRE BLVD #290
Address 2:
City:	ONTARIO
State:	OH
Zip:	91764
Phone:	800-280-1466
Fax:
Business Web Site Address:	WWW.THEGENERAL.COM
Business Email Address:	MBARNETT@THEGENERAL.COM
Mailing Address
Address 1:	2636 ELM HILL PIKE
Address 2:
City:	NASHVILLE
State:	TN
Zip:	37214
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
SANFORD, KIM	PRODUCER	16378993	YES		12/27/2016
SATING, LAURA ANN	PRODUCER	3363033	YES		12/27/2016
SCHROCK, ALLEN	PRODUCER	1890047	YES		12/27/2016
SCOTCH, STEVE MICHAEL	PRODUCER	7364763	YES		12/27/2016
SCOTT, JENNIFER RUTH	PRODUCER	8267661	YES		12/27/2016
SCOTT, MONTE A	PRODUCER	1855067	YES		12/27/2016
SECKINGER, DAVID N	PRODUCER	2772439	YES		12/27/2016
SHUBROWSKY, JAY R	PRODUCER	1393627	YES		12/27/2016
SILVESTRO, KRISTIE L	PRODUCER	9120829	YES		12/27/2016
SMEAL, ANGELA MARIA	PRODUCER	7379613	YES		12/27/2016
SMITH, CYNTHIA ELAINE	PRODUCER	3979497	YES		12/27/2016
SMITH, KATHLEEN B	PRODUCER	13227760	YES		12/27/2016
STACK, STEPHEN J	PRODUCER	2444080	YES		12/27/2016
STRZALA, JENNIFER CLAIRE	PRODUCER	9705862	YES		12/27/2016
THOMAS, JOHN LOVELL	PRODUCER	17572405	YES		12/27/2016

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)
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?
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:	MEGAN BARNETT
Title:	LICENSING ADMIN
Phone Number:	800-257-0263 #3248
Email Address:	MBARNETT@THEGENERAL.COM