Ins 6.43(6)(6)Transactions and holdings to be reported. Every transaction shall be reported even though purchases and sales during the month are equal or the change involves only the nature of ownership; for example, from direct to indirect ownership. Beneficial ownership at the end of the month of all classes of securities required to be reported shall be shown even though there has been no change during the month in the ownership of securities of one or more classes.
Ins 6.43(7)(7)Title of security. The statement of the title of the security shall be such as clearly to identify the security even though there may be only one class; for example, “Class A Common Stock”.
Ins 6.43(8)(8)Date of transaction. The exact date (month, day and year) of each transaction shall be stated opposite the amount involved in the transaction.
Ins 6.43(9)(9)Statement of amounts of securities. In stating the amount of the securities acquired, disposed of, or beneficially owned, give the face amount of debt securities or the number of shares or other units of other securities. In the case of securities owned indirectly, i.e., through a partnership, corporation, trust or other entity, the entire amount of securities involved in the transaction or owned by the partnership, corporation, trust or other entity shall be stated. The person whose ownership is reported may, if he or she so desires, also indicate in a footnote, or other appropriate manner, the extent of his or her interest in the transaction or holdings of the partnership, corporation, trust or other entity.
Ins 6.43(10)(10)Nature of ownership. Under “Nature of ownership”, state whether ownership of the securities is “direct” or “indirect”. If the ownership is indirect, i.e., through a partnership, corporation, trust or other entity, indicate in a footnote, or other appropriate manner, the name or identity of the medium through which the securities are indirectly owned. The fact that securities are held in the name of a broker or other nominee does not, of itself, constitute indirect ownership. Securities owned indirectly shall be reported on separate lines from those owned directly and from those owned through a different type of indirect ownership.
Ins 6.43(11)(11)Character of transaction. If the transaction was with the issuer of the securities, so state. If it involved the purchase of securities through the exercise of options, so state and give the exercise price per share. If any other purchase or sale was effected otherwise than in the open market, that fact shall be indicated. If the transaction was not a purchase or sale, indicate its character; for example, gift, 5% stock dividend, etc., as the case may be. The foregoing information may be appropriately set forth in the table or under “Remarks” at the end of the table.
Ins 6.43(12)(12)Inclusion of additional information. A statement may include any additional information or explanation deemed relevant by the person filing the statement.
Ins 6.43(13)(13)Signature. If the statement is filed for a corporation, partnership, trust, etc., the name of the organization shall appear over the signature of the officer or other person authorized to sign the statement. If the statement is filed for an individual, it shall be signed by him or her or specifically on his or her behalf by a person authorized to sign for him or her.
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State of Wisconsin
Commissioner of Insurance
Form 4
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
(Filed pursuant to Wisconsin Administrative Code section Ins 6.43)

(Name of insurance company)

(Name of person whose ownership is reported)

(Business address of such person; street, city, state, zip code)

Relationship of such person to company named above. (See s. Ins 6.43 (5))

Statement of Calendar Month of
, 2
Changes During Month and Month-End Ownership (See s. Ins 6.43 (6))
Remarks: (See s. Ins 6.43 (11))
  I affirm under penalty of perjury that the       foregoing is full, true, and correct.
Date of statement
Signature
Ins 6.43 HistoryHistory: Cr. Register, August, 1966, No. 128, eff. 9-1-66; am. Register, September, 1976, No. 249, eff. 10-1-76.
Ins 6.50Ins 6.50Kinds of individual intermediary or agent licenses.
Ins 6.50(1)(1)Purpose. This rule sets forth the kinds of individual intermediary-agents, reinsurance intermediary and managing general agent licenses which may be issued.
Ins 6.50(2)(2)Lines of licenses. The following individual licenses may be issued, each authorizing the solicitation of the line of insurance or the function indicated:
Ins 6.50(2)(a)(a) Major lines are all of the following:
Ins 6.50(2)(a)1.1. Life insurance — insurance coverage on human lives including benefits of endowment and annuities, and may include benefits in the event of death or dismemberment by accident and benefits for disability income.
Ins 6.50(2)(a)2.2. Accident and health insurance — insurance coverage for sickness, bodily injury or accidental death and may include benefits for disability income.
Ins 6.50(2)(a)3.3. Property insurance — insurance coverage for the direct or consequential loss or damage to property of every kind.
Ins 6.50(2)(a)4.4. Casualty insurance — insurance coverage against legal liability, including that for death, injury or disability or damage to real or personal property.
Ins 6.50(2)(a)5.5. Personal lines insurance — property and casualty insurance coverage sold to individuals and families for primarily noncommercial purposes.
Ins 6.50(2)(a)6.6. Variable life and variable annuity products — insurance coverage provided under variable life insurance contracts and variable annuities.
Ins 6.50(2)(b)(b) Limited lines are all of the following:
Ins 6.50(2)(b)1.1. Credit insurance — credit life, credit disability, credit property, credit unemployment, involuntary unemployment, mortgage life, mortgage guaranty, mortgage disability, guaranteed automobile protection (gap) insurance, and any other form of insurance offered in connection with an extension of credit that is limited to partially or wholly extinguishing that credit obligation that the insurance commissioner determines should be designated a form of limited line credit insurance.
Ins 6.50(2)(b)2.2. Title insurance — as described in s. Ins 6.75 (2) (h);
Ins 6.50(2)(b)3.3. Legal expense insurance — insurance that covers only legal expenses incurred by or provided to an individual or business