University of Miami School of Law Heckerling Institute on Estate Planning
    
CONTINUING EDUCATION PROOF OF ATTENDANCE FORM

51st Annual Heckerling Institute on Estate Planning
 

Many accrediting agencies have imposed mandatory cut-off dates for reporting credits. Attendees who return forms after January 20, 2017 may be subject to additional fees or may be denied credits by the accrediting agency.

All registrants must complete this form as proof of attendance. All credit, including ethics credit, will be awarded based on sessions actually attended. LIST ALL JURISDICTIONS AND PROFESSIONS IN WHICH YOU WISH TO RECEIVE CREDIT AND INCLUDE YOUR LICENSE OR IDENTIFICATION NUMBER. PLEASE NOTE THAT IT IS YOUR RESPONSIBILITY TO ASCERTAIN THE CONTINUING EDUCATION GUIDELINES FOR YOUR JURISDICTION AND PROFESSION.
Forms MUST be received by January 20, 2017.


Contact Information:
First Name *
Last Name *
E-Mail Address*  Find
Firm Name  
Address *
City *
State*
Province
Zip Code*
Country *
Phone*
Credit applying for:


 
Bar # State
Bar # State
Bar # State
Bar # State
Bar # State
Bar # State


 
CPA # State
CPA # State
CPA # State
CPA # State
CPA # State
CPA # State


 
License #/NPN State
License #/NPN State
License #/NPN State
License #/NPN State
License #/NPN State
License #/NPN State


Last 4 digits of Social Security #  
License #


 
PTIN # P

 (Enter license number if applicable)






 
Please indicate sessions attended:

Monday Morning, January 9, 2017 (9:00 12:00)

Monday Afternoon, January 9, 2017 (1:30 5:30)

Tuesday Morning, January 10, 2017 (9:00 12:35)




Tuesday Afternoon, January 10, 2017 (2:00 5:35)




Wednesday Morning, January 11, 2017 (9:00 12:35)



Wednesday Afternoon, January 11, 2017 (concurrent sessions) (2:00 - 3:30) (3:50 5:20)













Thursday Morning, January 12, 2017 (9:00 12:35)




Thursday Afternoon, January 12, 2017 (concurrent sessions) (2:00 - 3:30) (3:50 5:20)












Friday Morning, January 13, 2017 (9:00 12:00)


*Ethics credit may be available for this session. Please refer to the ethics accreditation information for your specific jurisdiction and profession.


Attendance Notes (less than 200 characters only)

 
Acknowledgement

*


SIGNATURE: *                   Date: 06/22/2017

You may wish to print this form for your records.  Print