(Please Print)

Name:
Title
Company:
Address:
Address 2:
City: / State: / Zip Code:
Phone:
email:
Time / Class Time (Minutes) / Indicate Session Attended (√) / Session Title
8:20-9:10 am / 50 / Millennials and Workforce Integration
9:15-10:05 am / 50 / Investment Update and Fixed Income
10:20-11:10 am / 50 / Discussion on Model Valuation
11:15-12:05 pm / 50 / Investments Reporting Update
12:05-1:20 pm / 75 / Key Note Speaker
1:30-2:45 pm / 75 / NAIC Update
3:00-3:50 pm / 50 / “IRS’ Kryptonite or Goldmine?”
3:55-4:45 pm / 50 / Making Conflict an Asset in the Workplace
8:00-8:50 am / 50 / NAIC Reporting and RBC Updates
8:55-9:45 am / 50 / Equity Investments Update
10:00-10:50 am / 50 / Cyber Security
10:55-11:45 am / 50 / Common Planning Opportunities for Tax Credits in NC and SC
CPE Credits

Note: Education Credits for Accounting Professionals is calculated as 50 minutes of class time.

I certify that I attended the sessions described above.

Signature of Attendee


According to records maintained in the IASA International Office in Durham, NC, the foregoing information represents attendance of the above named person at the sessions described.

Authorized IASA Representative

Attendance is verified from event records maintained in the IASA International Office and are subject to audit by your state agency. A copy of this form will be certified and returned to you for your records. Mail a copy of this form to:
IASA, Inc. PO Box 51340 Durham, NC 27717

IT IS YOUR RESPONSIBILITY TO INITIATE A FILING FOR CONTINUING EDUCATION CREDITS. IASA does not initiate your filing; IASA only verifies your attendance based on event records.

Insurance Accounting and Systems Association, Inc. is registered with the National Association of State Boards of Accountancy (NASBA), as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville, TN, 37219-2417. NASBA phone number: 615.880.4200 Website: www.nasba.org.