FIN 517 | 0720
Apply for a continuing education exemption or extension
Licensee name License Number
Email Last 4 digits of SSN
► I want to apply for a Permanent Exemption from continuing education:
(Excluding Title or Escrow Officer licensees)
I hereby certify that I have been licensed by the Texas Department of Insurance for
at least 20 continuous years with no gaps in licensure greater than 90 days, while
maintaining CE compliance for all CE terms.
*Please confirm your CE compliance by reviewing your Online CE Transcript found online at
► I want to apply for a CE Extension or waiver:
Check one box.
Illness or medical disability
Active military duty in a combat theater
Circumstance beyond the licensee’s control
Send all information that applies:
Medical illness or disability:
• Medical evidence on a Physician and/or Hospital System letterhead regarding exact nature of illness
or disability that has prevented the licensee from completing the required hours within the two-year
• A statement listing the activities of an agent or adjuster that the licensee can’t/couldn’t do as a
result of the condition or circumstances.
• Estimated date the licensee will be able to perform activities of an agent or adjuster in accordance
with the medical reports or other documents.
Active military duty in a combat theater:
• Copy of an order to active duty, expected duration of assignment, and any other information about
active military duty.