Notification of Changes for Business Entity
General Information
Business Entity Name:	THE GENERAL AUTOMOBILE INS SVCS INC
Incorporation / Formation Date:
FEIN:	62-1684225
Ohio License Number:	36214
NPN:	6539339
DBA / Trade Name:
State of Domicile:	CA
County:	SAN BERNARDINO
Business Address
Address 1:	4141 E INLAND EMPIRE BLVD #290
Address 2:
City:	ONTARIO
State:	OH
Zip:	91764
Phone:	800-280-1466
Fax:
Business Web Site Address:	WWW.THEGENERAL.COM
Business Email Address:	MBARNETT@THEGENERAL.COM
Mailing Address
Address 1:	2636 ELM HILL PIKE
Address 2:
City:	NASHVILLE
State:	OH
Zip:	37214
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:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
GARCIA, BRIDGETTE PILAR	PRODUCER	17585969	YES		12/28/2016
GARCIA, MIRIAM A	PRODUCER	17356488	YES		12/28/2016
GILLEY, KARIN JANAE	PRODUCER	8195034	YES		12/28/2016
GONZALES, LOURDES	PRODUCER	2773284	YES		12/28/2016
GUZMAN, ARLENE	PRODUCER	3615186	YES		12/28/2016
HERNANDEZ, PAUL ANTHONY	PRODUCER	15725756	YES		12/28/2016
LAWHORNE DOHERTY, BRONDOLYNN B	PRODUCER	16380719	YES		12/28/2016
LESSAR, SHANE	PRODUCER	16915173	YES		12/28/2016
LOCKHART, ANGELICA D	PRODUCER	10778386	YES		12/28/2016
MARTIN, YAHNTAYE LA JOYE	PRODUCER	14639913	YES		12/28/2016
MERRIWEATHER, ANGELA RENEE	PRODUCER	17422875	YES		12/28/2016
MILLER, BRIDGETTE LEE	PRODUCER	4585565	YES		12/28/2016
MOJICA, MABEL	PRODUCER	7042556	YES		12/28/2016
PAUSTIAN, KATIE	PRODUCER	17811829	YES		12/28/2016
PINCKNEY, CHRIS VINCENT	PRODUCER	451074	YES		12/28/2016

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)
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:	MEGAN BARNETT
Title:	LICENSING ADMIN
Phone Number:	800-257-0263 #3248
Email Address:	MBARNETT@THEGENERAL.COM