Life Settlement Pre-Qualification Request The first step to the Life Settlement Policy is determining if the policy will price on the secondary market.To start this process, please complete the form below: Please Complete the Form Below - Responses made in 24 Hours.Policy Face Amount:*Reason for selling policy:*Applying for Medicaid (or similar program)High Premium Payment - Needs ChangedPolicy is underperformingA Key Person is no longer neededBankruptcy (personal or corporate)Term Policy about to lapse or conversion period about to expireDeath or Divorce of BeneficiaryOtherClient Age and Gender:* Male age 74 or less / Female age 77 or less Male age 75-78 / Female age 78-81 Male age 79-83 / Female age 82-86 Male age 84+ / Female age 87+ *If Survivorship Policy - please select younger age.Medical Condition:* Healthy Has minor health problems Health has changed considerably since policy issue Client has developed serious medical issues Policy Type:* Whole Life Term Life (must be convertible) Universal Life Survivorship Life Cash Value as a Face Amount:* 31% or greater 21% - 30% 16% - 20% 11% - 15% 6% - 10% 0% - 5% Current Premium as a Percentage of Death Benefit:* 4% + 3% - 3.9% 2% - 2.9% 1% - 1.9% < 1% Outstanding Loan as a Percentage of Death Benefit:* 31% 21% - 30% 11% - 20% 0% - 10% Name:* First Last Email: Phone:Comments / Special Considerations:Policy Information Upload Drop files here or Select files Max. file size: 512 MB. If you have any policy information, please upload here.Advisor InformationIf you are a Professional Advisor, please add your contact information below.Name: First Last Email: Phone:
