Notification of Changes for Business Entity
General Information
Business Entity Name:	CAREFREE DIRECT AGENCY LLC
Incorporation / Formation Date:	02/12/2013
FEIN:	38-4013094
Ohio License Number:	1124696
NPN:	18121498
DBA / Trade Name:
State of Domicile:	UT
County:	UT
Business Address
Address 1:	9980 SOUTH 300 WEST
Address 2:	SUITE 258
City:	SANDY
State:	UT
Zip:	84070
Phone:	8015984307
Fax:
Business Web Site Address:
Business Email Address:	DONEAL@MYCAREFREE.COM
Mailing Address
Address 1:	9980 SOUTH 300 WEST
Address 2:	SUITE 258
City:	SANDY
State:	UT
Zip:	84070
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
CONNEXION POINT	OWNER	16893510		YES	07/30/2018

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:	DENISE ONEAL
Title:	LICENSE AND CONTRACT SPECIALIST
Phone Number:	8015984307
Email Address:	DONEAL@MYCAREFREE.COM