Get Retired Insurance Agents Exemption From The ... - State Of Indiana

This guide will help you understand the Retired Insurance Agents Exemption From The Continuing Education Requirement form and provide you with step-by-step instructions on how to fill it out online.

Follow the steps to complete the exemption form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. In the first blank field, input your full name to attest your retirement status as a licensed insurance agent.
3. Confirm that you retired in 2014 and that you are currently not actively soliciting or servicing any insurance businesses for which you receive commissions. This may involve carefully reviewing your previous activities as an insurance agent.
4. State that you have no future intentions of engaging in soliciting or servicing insurance businesses. This is an important affirmation for your exemption request.
5. Include a statement indicating that if your status changes, you will notify the Indiana Department of Insurance immediately.
6. Provide your signature and date on the designated lines, ensuring the date reflects the day you are completing the document.
7. Fill in your license number(s) and their expiration dates in the appropriate section.
8. Complete your contact information, including your street address, city, state, zip code, email, and phone number.
9. In the notary section, indicate the date when the document is being sworn and provide the county and state as required.
10. Ensure that the document is notarized and that the notary public fills in their information, including their commission expiration date.
11. Once all fields are completed, save your changes, and you may then download, print, or share the completed form as needed.

Complete your Retired Insurance Agents Exemption form online today.