Get Course Assignment Form - Texas Department Of Insurance - Tdi Texas

Filling out the Course Assignment Form for the Texas Department of Insurance is an important step for those involved in continuing education. This guide will provide you with clear and detailed instructions on how to complete this form online, ensuring compliance with all necessary requirements.

Follow the steps to effectively complete the Course Assignment Form online:

1. Click ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. In section A, provide the assignee’s current provider registration number and registered name in the designated fields.
3. Answer the yes or no questions in section A(2) by checking the appropriate box. Ensure to refer to the provided instructions if you select 'Yes' for questions (a) to (d).
4. Complete the assignor’s current provider registration number and registered name in section A(3).
5. Insert the effective date of the assignment in section A(4) using the MM/DD/YYYY format. Ensure this date is at least ten days after mailing the form.
6. Provide the termination date in section A(5), which must not exceed two years from the effective date.
7. In section A(6), complete the course assignment details, including the name of the certified course, the original course certification number, and the expiration date of the original certification.
8. In section B, both the assignor and assignee need to sign and date the form to certify the information provided is accurate.
9. Save changes, download, print, or share the completed form as needed for your records.

Complete your Course Assignment Form online today for efficient processing.