This application must be completed by a licensed Funeral Director or an operator of a Funeral Establishment in order for the applicant to be a registered Agent to sell or solicit the sale of burial agreements funded with the proceeds of a life insurance policy. If the Agent is already registered and wishes to sell or solicit on behalf of a different or additional Funeral Director or operator of a Funeral Establishment, complete Form #2345.
Pre-Credential Education Information
Successful completion of at least 20 hours of approved educational training. An agent who is a WI licensed Funeral Director and a WI licensed insurance intermediary is exempt from completing the 20 hours of approved educational training as provided in Wis. Admin. Code § FD 6.05.
Application for Licensure
2343||Application for Registration as an Agent for Burial Agreements|
2252||Convictions and Pending Charges|
3071||Fax Payment Form|
2344||Notice of Conversion of a Burial Trust to a Burial Agreements|
2345||Notice Concerning Contract Between a Funeral Establishment and an Agent for Burial Agreements|