Notification of Changes for Business Entity
General Information
Business Entity Name:	MCSHERRY & HUDSON
Incorporation / Formation Date:	01/31/1913
FEIN:	941240338
Ohio License Number:	27602
NPN:
DBA / Trade Name:
State of Domicile:	CA
County:	SANTA CRUZ
Business Address
Address 1:	35 PENNY LANE, SUITE #6
Address 2:
City:	WATSONVILLE
State:	CA
Zip:	95076
Phone:	831-724-3841
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	PO BOX 2690
Address 2:
City:	WATSONVILLE
State:	CA
Zip:	95077
Indicate the type of change you are seeking
Address Change:	YES
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
FREDERICK R. HUDSON	PARTNER	2810		YES	9/17/17

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:	MARTHA GARCIA
Title:	LICENSE COORDINATOR
Phone Number:	831-724-3841
Email Address:	MGARCIA@MCSHERRYANDHUDSON.COM