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Appendix G

ARKANSAS INSURANCE DEPARTMENT

APPENDIX G

CORRESPONDENCE COURSE

CERTIFICATION OF COMPLETION AND PROCTOR AFFIDAVIT

FOR USE WITH RULE 50

All Correspondence Courses must have a proctored exam to be valid. Form must be typed or printed.

LICENSEE’S INFORMATION

Appendix G

ARKANSAS INSURANCE DEPARTMENT

APPENDIX G

CORRESPONDENCE COURSE

CERTIFICATION OF COMPLETION AND PROCTOR AFFIDAVIT

FOR USE WITH RULE 50

All Correspondence Courses must have a proctored exam to be valid. Form must be typed or printed.

LICENSEE’S INFORMATION

Appendix G

ARKANSAS INSURANCE DEPARTMENT

APPENDIX G

CORRESPONDENCE COURSE

CERTIFICATION OF COMPLETION AND PROCTOR AFFIDAVIT

FOR USE WITH RULE 50

All Correspondence Courses must have a proctored exam to be valid. Form must be typed or printed.

LICENSEE’S INFORMATION

Appendix G

ARKANSAS INSURANCE DEPARTMENT

APPENDIX G

CORRESPONDENCE COURSE

CERTIFICATION OF COMPLETION AND PROCTOR AFFIDAVIT

FOR USE WITH RULE 50

All Correspondence Courses must have a proctored exam to be valid. Form must be typed or printed.

LICENSEE’S INFORMATION

Appendix G

ARKANSAS INSURANCE DEPARTMENT

APPENDIX G

CORRESPONDENCE COURSE

CERTIFICATION OF COMPLETION AND PROCTOR AFFIDAVIT

FOR USE WITH RULE 50

All Correspondence Courses must have a proctored exam to be valid. Form must be typed or printed.

LICENSEE’S INFORMATION

Appendix G

ARKANSAS INSURANCE DEPARTMENT

APPENDIX G

CORRESPONDENCE COURSE

CERTIFICATION OF COMPLETION AND PROCTOR AFFIDAVIT

FOR USE WITH RULE 50

All Correspondence Courses must have a proctored exam to be valid. Form must be typed or printed.

LICENSEE’S INFORMATION

Appendix G

ARKANSAS INSURANCE DEPARTMENT

APPENDIX G

CORRESPONDENCE COURSE

CERTIFICATION OF COMPLETION AND PROCTOR AFFIDAVIT

FOR USE WITH RULE 50

All Correspondence Courses must have a proctored exam to be valid. Form must be typed or printed.

LICENSEE’S INFORMATION

Appendix G

ARKANSAS INSURANCE DEPARTMENT

APPENDIX G

CORRESPONDENCE COURSE

CERTIFICATION OF COMPLETION AND PROCTOR AFFIDAVIT

FOR USE WITH RULE 50

All Correspondence Courses must have a proctored exam to be valid. Form must be typed or printed.

LICENSEE’S INFORMATION

Appendix G

ARKANSAS INSURANCE DEPARTMENT

APPENDIX G

CORRESPONDENCE COURSE

CERTIFICATION OF COMPLETION AND PROCTOR AFFIDAVIT

FOR USE WITH RULE 50

All Correspondence Courses must have a proctored exam to be valid. Form must be typed or printed.

LICENSEE’S INFORMATION