1.	Are you currently life licensed?
		Yes   No
	A. If yes, please fill in name of Agency, Sponsor, or Life License #:
2.	Are you currently securities licensed?
		Yes   No
	A. If yes, what licenses do you currently have:
		Series 6/63 Series 7/24 Series 26 Series 51 Series 53 Series 65 Series 66 Other
		Please fax or mail copies of all current licenses to World Financial Group. Please include the New Agent Information page (Step 10).
	By Fax: By Mail: Attn: Licensing WFG Licensing Telephone Number: (678) 966-6161 11315 Johns Creek Parkway Johns Creek, GA 30097