Notification of Changes for Business Entity
General Information
Business Entity Name:	WELLS FARGO ADVISORS INSURANCE AGENCY LLC.
Incorporation / Formation Date:
FEIN:	540910269
Ohio License Number:	28429
NPN:
DBA / Trade Name:
State of Domicile:	VA
County:	INDEPENDENT CITY
Business Address
Address 1:	901 E BYRD ST.
Address 2:
City:	RICHMOND
State:	VA
Zip:	23219
Phone:	6057825112
Fax:	8778490217
Business Web Site Address:	HTTP://WWW.WELLSFARGOADVISORS.COM
Business Email Address:	AGENCYLICENSING@WELLSFARGO.COM
Mailing Address
Address 1:	3201 N 4TH AVE
Address 2:
City:	SIOUX FALLS
State:	SD
Zip:	57104
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
DEVORE, BRENDA KAY	AGENT	7341146	YES		08/28/2017
ANTONY, LANCE	AGENT	11197957	YES		08/30/2017
CALDWELL JR, JOHN RAYMOND	AGENT	768349	YES		08/28/2017
CRAWFORD, JOAN	AGENT	1522646	YES		08/31/2017
DINALLO, ANTHONY	AGENT	2676692	YES		08/28/2017
HEVNER, RICHARD	AGENT	376335	YES		09/01/2017
DINALLO JR., ANTHONY	AGENT	2676692	YES		08/28/2017
HEVNER, RICHARD	AGENT	376335	YES		09/01/2017
KELLEHER, CORNELIUS W	AGENT	2341080	YES		08/28/2017
MELECO, STEVEN JUDE	AGENT	17074298	YES		08/28/2017
MOORE, JAMES C	AGENT	710088	YES		08/31/2017
MUNCY, ANDREW SCOTT	AGENT	16900107		YES	08/29/2017
SZALKIEWICZ, MICHAEL E	AGENT	8140646	YES		08/28/2017

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 L. SHUTT
Title:	SOSS2
Phone Number:	6057825112
Email Address:	MELISSA.L.SHUTT@WELLSFARGO.COM