THIS AFFIDAVIT MUST BE FILLED OUT, SIGNED AND SENT BY EMAIL (olta@cox.net), FAX (405-562-1321) OR MAILED TO: 811 S. Littler, Edmond, OK 73034, within FIVE business days of viewing to allow prompt reporting.

1)     I have viewed the following approved continuing education course in its entirety:

2)     Said course was presented by DVD under the supervision of the below named Approved Instructor, who is an Approved Instructor of the provider: Oklahoma Land Title Association.

3)     I viewed such Course on the ____ day of _____________, 2008

PLEASE NOTE: IF REPORTING IS NOT TIMELY TO THE OKLAHOMA INSURANCE DEPARTMENT, FILING WILL NOT BE POSSIBLE pursuant to Oklahoma Administrative Code 365:25-3(f)(8):

AFFIDAVIT PURSUANT TO ADMINISTRATIVE RULE 365:25-3 (f)(8)

     (8) List of producers completing course to Commissioner; producer license numbers. Within (10) business days after completion of each course, the provider shall provide the commissioner a list of all insurance producers who completed the course on the Course Completion Form. This list shall contain the course number, date of completion and license numbers of all insurance producers completing the course. If the list is not reported within ten (10) business days, a late report fee of $50.00 shall be paid to the Insurance Department. Failure to pay the late report fee may result in revocation of provider approval. Continued late filing may also result in loss of approval.