Comprehensive General Structures Checklist

To ensure a smooth application process and secure your annuity policy or contract, please review the checklist below. This list outlines the information and documents that may be required as part of your structured settlement planning.

Traditional Settlement Structures

  • Full Name of Claimant(s) (the person who will receive the annuity payments)

  • Proof of Date of Birth of Claimant(s)

  • Social Security Number of Claimant(s)

  • Current Mailing Address of Claimant’s Parent or Court Appointed Guardian

  • Current Phone Number of Claimant’s Parent or Court Appointed Guardian

  • Current Email Address of Claimant’s Parent or Court Appointed Guardian

  • Name of Claimant(s) Parent(s) or Court Appointed Guardian/Representative

  • Brief Description of Claimant(s) Injury (Ex. Broken leg, spinal fractures from automobile accident)

  • Name of Attorney Handling Personal Injury Claim

  • Name of the Personal Representative of the Estate (if applicable)

  • Name of the Defendant and or Insurer

  • Copy of the Demand or Complaint

  • Copy of the Draft Release

  • Copy of the Draft Petition and Order Approving Settlement

  • Copy of Mediation Agreement

  • Copy of Trust (if applicable)

  • Copy of the Release with Terms of Settlement or Settlement Agreement

  • Copy of the Qualified Assignment

  • Copy of the Beneficiary Designation

  • Medicare Set-Aside Allocation Report (if applicable)

  • Centers for Medicare and Medicaid Services (CMS) Decision (if applicable)

Attorney Fee Structure

  • Completed W9

  • Completed W4-P

  • Hold Harmless Agreement