Notification of Changes for Business Entity
General Information
Business Entity Name:	MYLO, LLC
Incorporation / Formation Date:
FEIN:	822576713
Ohio License Number:	1171106
NPN:	18590034
DBA / Trade Name:
State of Domicile:	KS
County:	JOHNSON
Business Address
Address 1:	14425 COLLEGE BLVD SUITE 180
Address 2:
City:	LENEXA
State:	KS
Zip:	66215
Phone:	9139045300
Fax:
Business Web Site Address:
Business Email Address:	KCLICENSING@LOCKTON.COM
Mailing Address
Address 1:	14425 COLLEGE BLVD STE 180
Address 2:
City:	LENEXA
State:	KS
Zip:	66215
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
MAURICE A ELSTON	AGENT	16592895	YES		04/11/2018
DAVID W EMBRY	AGENT	16490016	YES		04/11/2018
SASHA E ESPARZA	AGENT	17040283	YES		04/11/2018
CHRISTOPHER S FIELDS	AGENT	16888160	YES		04/11/2018
MATTHEW W FISHER	AGENT	14419333	YES		04/11/2018
JASON L GIBSON	AGENT	17064654	YES		04/11/2018
JESS P GOLDEN	AGENT	8147040	YES		04/11/2018
ROGER L HACKETT	AGENT	4885228	YES		04/11/2018
EMILY R HOLSCHER	AGENT	18614246	YES		04/11/2018
CARLTON K LOGAN	AGENT	17199770	YES		04/11/2018
KASEY D LOOMIS	AGENT	18612617	YES		04/11/2018
ALEX C LUBECK	AGENT	18539964	YES		04/11/2018
HANNA C MALONE	AGENT	10734618	YES		04/11/2018
DARREN P MALONEY	AGENT	16196978	YES		04/11/2018
AIMEE D MELIN	AGENT	18654572	YES		04/11/2018

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)
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:	JASON GIBSON
Title:	AUTHORIZED PERSON / MANAGER OF CALL CENTER
Phone Number:	9139045300
Email Address:	KCLICENSING@LOCKTON.COM