Annuity

All fields are required. Please provide exact, accurate responses from your documentation to each question. The offer we make will be based upon the information you provide; HELP US HELP YOU!

CONTACT INFORMATION
TCF Locator ID Number (if applicable)
TCF Locator Name (if applicable)
TCF Locator Email Address (if applicable)
The person completing this form is
Annuitant's first & last name
Annuitant's address including city, state and ZIP
Annuitant's email address
Annuitant's home phone
Annuitant's work phone
Annuitant's cell phone
Best time to contact you (if you have a preference)
Are you personally receiving payments on this note?
BUSINESS INFORMATION
Exact name & address of insurance company making payment(s)
Payment amount
Payments are made
# of Payments remaining
Annuity resulted from what
Current age of Annuitant
PAYMENT DATES
List all of the EXACT payment dates (mm/dd/yy) and amounts for the payments you wish to sell (EXACT DATES ONLY - no estimates please)
MOTIVATION OF THE NOTE SELLER
Why are you selling this
How much cash do you need
When do you need the cash by
Do you prefer to sell your entire settlement (a full purchase), just sell a portion of the payments (a partial purchase), or do you have no preference
Comments or other pertinent information

The "We Simply Pay You More" Guarantee:
If you get a better offer for your structured settlement ... WE'LL BEAT IT, PERIOD!