Notification of Changes for Business Entity
General Information
Business Entity Name:	RED VENTURES INSURANCE
Incorporation / Formation Date:
FEIN:	460976984
Ohio License Number:	974972
NPN:	16793012
DBA / Trade Name:
State of Domicile:	SC
County:	LANCASTER
Business Address
Address 1:	1101 RED VENTURES DRIVE
Address 2:
City:	FORT MILL
State:	SC
Zip:	29707
Phone:	844-828-5995
Fax:
Business Web Site Address:
Business Email Address:	HICOMLICENSING@REDVENTURES.COM
Mailing Address
Address 1:	1101 RED VENTURES DRIVE
Address 2:
City:	FORT MILL
State:	SC
Zip:	29707
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:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
RASULLAH HARRIS	PRODUCER	1086952	YES		4/13/2016
LINDSEY MIDDLETON	PRODUCER	1091098	YES		4/13/2016
MADELINE GIRARD	PRODUCER	1088201	YES		4/13/2016
MARGARET FREEMAN	PRODUCER	1094004	YES		4/13/2016
MARVIN FERRUFINO	PRODUCER	1093833	YES		4/13/2016
MICHAEL RAPLEY	PRODUCER	1084644	YES		4/13/2016
MICHAEL CAMERON	PRODUCER	1091127	YES		4/13/2016
PAUL BRADLEY	PRODUCER	1088098	YES		4/13/2016
ROBERT HUANG	PRODUCER	1091102	YES		4/13/2016
RYAN QUERY	PRODUCER	1088112	YES		4/13/2016
SAVANNAH FOREST	PRODUCER	1088196	YES		4/13/2016
SNEHA SARAVANAN	PRODUCER	1091104	YES		4/13/2016
YUSSRA MANSOUR	PRODUCER	1081455	YES		4/13/2016
AMY SCHELL	PRODUCER	1041611	YES		4/13/2016
ARCHIE WALKER	PRODUCER	1060940	YES		4/13/2016

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)	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:	MELISSA PATTERSON
Title:	LICENSING COORDINATOR
Phone Number:	8448285995
Email Address:	MEPATTERSON@REDVENTURES.COM