Life Settlements

Thank you for your interest in life settlements

In order to provide you with specific fee and program information we will need the following form completed.

It is not necessary to complete the entire form at this time – providing basic information about you and your policy are sufficient in most cases for us to provide you an initial quote.

Proposals are offered free of charge and at no obligation to you. All inquiries are confidential.



Client Information
First Name:
Last Name:
Address:
City:
State:
Zip:
Email:
Phone Number:

Policy Information
How old is the policy?
What is the amount of the death benefit?
What is the individual’s life expectancy?
What life insurance company is the carrier on the policy?

Client's Needs
What is your motivation?
How much cash do you need?