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054.00.50 Appendix E. Individual Certificate of Completion for Use with Rule 50

AR ADC 054.00.50 Appendix EArkansas Administrative CodeEffective: February 7, 2016

West's Arkansas Administrative Code
Title 054. Insurance Department
Division 00.
Rule 50. Continuing Education for Producers and Adjusters
Effective: February 7, 2016
Ark. Admin. Code 054.00.50 Appendix E
054.00.50 Appendix E. Individual Certificate of Completion for Use with Rule 50
Currentness
___________________________________
______________________________
Producer Name (Type or Print)
Arkansas License Number(s)
____________________________________________________________
Street Address
City
State
Zip Code
I, Authorized Representative (Type or Print) ________________________________________, of Course Provider ____________________________________________________________, do hereby certify that the person named herein has successfully completed the following approved courses:
Course Title ____________________________________________________________
Number of Credit Hours Earned _______________ Course Number _______________
Date of Course Completion _____________________________________________
This course has been approved by the Arkansas Department of Insurance pursuant to Rule 50.
_______________
_____________________________________________
Date
Signature of Authorized Representative
_______________
_____________________________________________
Date
Signature of Producer
THIS FORM MAY BE PROVIDED TO THE PRODUCER UPON COMPLETION OF THE COURSE IF REQUESTED BY THE PRODUCER.

Credits

Amended Sept. 30, 2010; Feb. 7, 2016.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 054.00.50 Appendix E, AR ADC 054.00.50 Appendix E
End of Document