Forms

These forms must be filled out before a life settlement can be made.
Please insure accuracy in filling out all the forms as this will speed the process to obtain the best settlement for your policy. Regarding medical information, please provide the most detail possible as this will also help expedite the application process.


PERSONAL INFORMATION


LIFE INSURANCE POLICY INFORMATION - MEDICAL -
  DISCLOSURE STATEMENT (SIGN)

 

HIPAA – SENT TO DOCTORS TO GET MEDICAL   RECORDS (SIGN)

 

Fax forms to us at:

1- 866-202-9258

 

Or mail to our processing office at:

 

PoliciesUSA
PO Box 1561
Deerfield Beach, FL 33443
Attention: Peter Partos