Authority: IC 27-1-15.7-7

Affected: IC 27-1-15.6-3; IC 27-1-15.7-2

Sec. 13.5. The form referenced in section 13 of this rule is as follows: CONTINUING EDUCATION EXEMPTION FORM FOR RETIRED INSURANCE PRODUCERS AND SOLICITORS

I, _____________________, do hereby attest that effective __________ I am retired and am no longer an active insurance producer. I will not solicit or service any insurance policy or policyholder. I respectfully request that I be exempt from fulfilling the continuing education requirements as prescribed by IC 27-1-15.7-2.

If my current situation changes and I plan to solicit or service insurance policies or policyholders, I will immediately notify the Indiana Department of Insurance of my change in status. I understand that the Department will rescind any continuing education exemption, and I will thereafter be responsible for all continuing education requirements as prescribed in IC 27-1-15.7-2.

I further understand that if I fail to notify the Department of Insurance of any change in my retirement status and I engage in the business of insurance, including soliciting or servicing an insurance policy, I will be subject to administrative sanctions. Subscribed and sworn to before me this _________ day of ___________, ____ ____________________________________ Notary Public My commission expires: _______________ County of residence: __________________

(Department of Insurance; 760 IAC 1-50-13.5; filed Nov 4, 1999, 10:12 a.m.: 23 IR 576; filed Dec 12, 2003, 10:30 a.m.: 27 IR 1571; readopted filed Nov 24, 2010, 9:17 a.m.: 20101222-IR-760100633RFA; readopted filed Nov 23, 2016, 9:47 a.m.: 20161221-IR-760160436RFA; readopted filed Nov 30, 2022, 11:39 a.m.: 20221228-IR-760220302RFA)