Notification of Changes for Business Entity
General Information
Business Entity Name:	RICHWOOD TITLE AGENCY LLC
Incorporation / Formation Date:
FEIN:	31-1563650
Ohio License Number:
NPN:	1876732
DBA / Trade Name:
State of Domicile:	OH
County:	UNION
Business Address
Address 1:	15 WEST OTTAWA STREET
Address 2:
City:	RICHWOOD
State:	OH
Zip:	43344
Phone:	7409432325
Fax:	7409432326
Business Web Site Address:
Business Email Address:	IEVANS@EVANSANDHOFFMAN.COM
Mailing Address
Address 1:	15 WEST OTTAWA STREET
Address 2:
City:	RICHWOOD
State:	OH
Zip:	43344
Indicate the type of change you are seeking
Address Change:	NO
Business Entity Name Change:	YES	Old Business Entity Name:	RICHWOOD TITLE AGENCY LLP
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

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)	YES
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?	YES
3. If the answer to questions #1 or #2 is yes, identify the business or profession and the nature of person's involvement	ALL OWNERS ARE ALSO ENGAGED IN THE PRACTICE OF LAW IN THE STATE OF OHIO.

Submitted By
Submitted By:	SCOTT L HOFFMAN
Title:	MANAGING MEMBER
Phone Number:	7409432325
Email Address:	SLHOFFMAN@EVANSANDHOFFMAN.COM