Missouri Code of State Regulations
Title 20 - DEPARTMENT OF COMMERCE AND INSURANCE
Division 400 - Life, Annuities and Health
Chapter 1 - Life Insurance and Annuity Standards
Exhibit A

Current through Register Vol. 48, No. 18, September 15, 2023

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.

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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

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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.

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TEST SCORE: _______________________

AUTHORITY: sections 374.045, 375.936, 376.309, 376.590, 376.670 and 376.675, RSMo 2000.* This rule was previously filed as 4 CSR 190-13.080. Original rule filed Dec. 5, 1969, effective Dec. 15, 1969. Amended: Filed Aug. 5, 1974, effective Aug. 15, 1974. Amended: Filed Dec. 23, 1975, effective Jan. 2, 1976. Amended: Filed Sept. 12, 1984, effective March 11 , 1985. Amended: Filed July 12, 2002, effective Jan. 30, 2003.

*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.