Notification of Changes for Business Entity
General Information
Business Entity Name:	COVERDELL & COMPANY, INC.
Incorporation / Formation Date:
FEIN:	58-1604660
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	IL
County:	USA
Business Address
Address 1:	8770 W BRYN MAWR
Address 2:	STE 1000
City:	CHICAGO
State:	IL
Zip:	60631
Phone:	(404) 881-8641
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	8770 W BRYN MAWR
Address 2:	STE 1000
City:	CHICAGO
State:	IL
Zip:	60631
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
RICHARD C CARY	CONTROLLER	052422926	YES		08/01/18
KEVIN P GARVIN	PRESIDENT, DIRECTOR	331605525	YES		08/01/18
APRIL J HANES-DOWD	SECRETARY	332564405	YES		08/01/18
JEROME S HANNER	VICE PRESIDENT	330561798	YES		08/01/18
LAURA D SKALE	SECRETARY	282841800		YES	08/01/18
LAURA D SKALE	ASSISTANT SECRETARY	282841800	YES		08/01/18
JACK H LAZZARO	TREASURER	319-48-3514	YES		08/01/18
VINCENT E DIBENEDETTO	PRESIDENT, CEO, DIRECTOR	354522000		YES	08/01/18
VINCENT E DIBENEDETTO	AREA PRESIDENT	354522000	YES		08/01/18
PAUL WASIKOWSKI	VICE PRESIDENT OF TAX	268526643	YES		08/01/18

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:	LAURA SKALE
Title:	ASSISTANT SECRETARY
Phone Number:	(404) 881-8641
Email Address:	KAITLIN@PATTONCOMPLIANCE.COM