Notification of Changes for Business Entity
General Information
Business Entity Name:	FNB SYCAMORE FINANCIAL SERVICES, LLC
Incorporation / Formation Date:
FEIN:	450592619
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	WYANDOT
Business Address
Address 1:	141 SOUTH SYCAMORE AVENUE
Address 2:
City:	SYCAMORE
State:	OH
Zip:	44882
Phone:	419 927 6392
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	141 SOUTH SYCAMORE AVENUE
Address 2:
City:	SYCAMORE
State:	OH
Zip:	44882
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

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
FIRST NATIONAL BANKOF SYCAMORE	OWNER	34-4370555	YES		9/1/2017

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:	JAMES SAROSY
Title:	RDA
Phone Number:	6148462170
Email Address:	JJSAROSY@CBAO.COM