Affidavit of Webinar Attendance

This form is for Wisconin Life Insurace Credit ONLY. There is no need to complete this form if you are not seeking credit for WI Life Insurance.

Please complete the Affidavit of Webinar Attendance Form for each registered student that is requesting Wisconsin credit. A single form may not be used to acknowledge the attendance of more than one registered student.

This form must be COMPLETED IN FULL by the attendee. Failure to complete this form and return within the allotted amount of time may result in loss of credit.

Attendee's full name:*

National Producer Number:*

If you do not have a Wisconsin Life Insurance Producer Number, you needn't fill out this form.

State Requesting Credit:

Which event did you attend?*

2025 Business Issues Update and Review - Webinar2025 Part 1 Update and Review - Webinar2025 Part 2 Update and Review - WebinarOther

Which event did you attend?

2025 Business Issues Update and Review - Webinar2025 Part I Update and Review - Webinar2025 Part II Update and Review - Webinar

Date of the Event:*

Acknowledgement of Personal Responsibility (By signing, I certify that I personally participated in and attended all sessions of the Webinar course referenced above.) *

To ensure CE credit for the Webinar course referenced above, submit this form either (1) by filling it out here and hitting "submit" or (2) by printing it out, completing it, scanning it, and emailing it to livestream@btb.tax within 48 hours of the course taking place or before completion of course.