DIRECTOR'S REPORT OF EXAMINATION NO. _____________
STATE OF MISSOURI DEPARTMENT OF INSURANCE APPROVAL OF LICENSE AS A
VARIABLE CONTRACT INSURANCE PRODUCER
____________________________________
Name of Applicant
____________________________________
Address
Enter name and address of broker-dealer and of the company to which approval of application for Variable Contract Insurance Producer's License should be directed.
____________________________________
Broker-Dealer
____________________________________
Address
____________________________________
Company
____________________________________
Address
When validated by the Department of Insurance, this will be your notice of approval of your qualification for a Variable Contract Insurance Producer's License.
LICENSE APPROVED
____________________________________
Date
____________________________________
Director
TEST SCORE: NAIC EXAMINATION
SECURITIES Part I _____________
Variable Contracts Part II ____________
(If test waived, indicate variable contract regulation section conferring exemption)
____________________________________
If NAIC examination not taken, then name of general securities examination acceptable to the SEC.
____________________________________
TEST SCORE: _______________________
Tit. 20, div. 400, ch. 1, exh. A CSR
*Original authority: 374.045, RSMo 1967 amended 1993, 1995; 375.936, RSMo 1959, amended 1967, 1969, 1971, 1976, 1978, 1983, 1991; 376.309, RSMo 1963, amended 1969, 1983, 1992, 1993; 376.590, RSMo 1939; 376.670, RSMo 1943, amended 1959, 1961, 1965, 1975, 1979, 1982; and 376.675, RSMo 1963, amended 1984.