Notification of Changes for Business Entity
General Information
Business Entity Name:	TELETECH FINANCIAL SERVICES MANAGEMENT, LLC
Incorporation / Formation Date:
FEIN:	912089159
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	CO
County:	ARAPAHOE
Business Address
Address 1:	1209 ORANGE ST
Address 2:
City:	WILMINGTON
State:	DE
Zip:	19801
Phone:	4175201775
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	9197 S PEORIA
Address 2:
City:	ENGLEWOOD
State:	CO
Zip:	80112
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
JACOB BROUS	MSR	1140127	YES		03/27/2017
SAMANTHA BROWN	MSR	1139907	YES		03/27/2017
ETHAN BROWNING-PARCELL	MSR	1140506	YES
JONAH BUTTERBAUGH	MSR	1141866	YES
CORY CLEMENSEN	MSR	1140131	YES
TRUMAN CLOVEN	MSR	1129140	YES
LESLIE COPELAND	MSR	1139918	YES
GABRIELLE DALTON	MSR	1140138	YES
KASIE KIRKLAND	MSR	1126947	YES
LARRY LAFORGE	MSR	1141898	YES
ERIC LIEBERT	MSR	1140839	YES
JULIA MERICA	MSR	1139924	YES
LUCAS PREWITT	MSR	1139926	YES
SIERRA PRINCE	MSR	1140140	YES
EDWARD ROPER	MSR	1140505	YES

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

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