Notification of Changes for Business Entity
General Information
Business Entity Name:	CAREFREE INSURANCE SERVICES INC.
Incorporation / Formation Date:
FEIN:	59-3750548
Ohio License Number:	1024981
NPN:	15079778
DBA / Trade Name:
State of Domicile:	FL
County:	BROWARD
Business Address
Address 1:	1600 SW 80TH TERRACE, 1ST FLOOR
Address 2:
City:	PLANTATION
State:	FL
Zip:	33324
Phone:	954-693-2885
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	151 FARMINGTON AVE, RW61 ROUX-HALLORAN
Address 2:
City:	HARTFORD
State:	CT
Zip:	06156
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
ELAINE ROSE COFRANCESCO	VICE PRESIDENT & TREASURER	040-62-4637	YES		01/01/2017
JOHN PATRICK MARONEY	VICE PRESIDENT & TREASURER	046-80-7004		YES	01/01/2017

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:	EDWARD C. LEE
Title:	VICE PRESIDENT & SECRETARY
Phone Number:	860-273-8329
Email Address:	LEEE1@AETNA.COM