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2. First Name*
3. Last Name*
5. License Number (NPN)*
6. Email Address*
8. Statement

   I am requesting a Continuing Education exemption because I fall within one of the scenerios below. Please select the reason below that exempts you from the Continuing Education requirements.

10. Exemption Reasons:*

    You only need to submit one application.

    1. 1: SC resident producer licensed for 25 or more continuous years in South Carolina and is 65 years of age or older.
    2. 2: SC resident producer who is 65 years of age or older and has 25 total years of licensure, but with some of those years being licensed in another state. Must provide proof from the other state.
    3. 3: SC resident producer who is 65 years of age or older with a total of 25-years non-continuous licensure in SC.
12. Please upload documentation proving licensure in other state.*
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14. 1. Receive an email copy of this form.
15. Email address

    This field is not part of the form submission.

16. Submit

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