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Life Settlement Provider Renewal Application

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Form Instructions

INSTRUCTIONS: CONNECTICUT LIFE SETTLEMENT PROVIDER RENEWAL APPLICATION

To renew your license to act as a Connecticut life settlement provider, use the form discussed in this article. This document can be obtained from the website of the government of Connecticut.

Connecticut Life Settlement Provider Renewal Application Step 1: Enter the name of the life settlement provider on the first blank line.

Connecticut Life Settlement Provider Renewal Application Step 2: Enter the date on which you are sending the form on the second blank line.

Connecticut Life Settlement Provider Renewal Application Step 3: Enter the name of a contact person for further questions or correspondence on the third blank line.

Connecticut Life Settlement Provider Renewal Application Step 4: Enter a contact address on the next two blank lines.

Connecticut Life Settlement Provider Renewal Application Step 5: Enter a contact phone number on the sixth blank line.

Connecticut Life Settlement Provider Renewal Application Step 6: Enter a contact fax number on the seventh blank line.

Connecticut Life Settlement Provider Renewal Application Step 7: Enter a contact email address on the eighth blank line.

Connecticut Life Settlement Provider Renewal Application Step 8: Enter the expiration date of your current license on the ninth blank line.

Connecticut Life Settlement Provider Renewal Application Step 9: The remainder of the first page and the entirety of the second page contains a checklist of documentation that must be attached to your application.

Connecticut Life Settlement Provider Renewal Application Step 10: Enter your signature on the first blank line on the third page.

Connecticut Life Settlement Provider Renewal Application Step 11: Print your name on the second blank line.

Connecticut Life Settlement Provider Renewal Application Step 12: Enter your title on the third blank line.

Connecticut Life Settlement Provider Renewal Application Step 13: The form should then be presented to a notary public, who will sign the document and affix their seal.

Connecticut Life Settlement Provider Renewal Application Step 14: Cut a check for $40. This is the fee for processing of your form. This check should be made out to "Treasurer, State of Connecticut."

Connecticut Life Settlement Provider Renewal Application Step 15: Mail the form to the address given at the top of the first page along with all required supporting documentation and your check. Allow a minimum of 30 days for processing to ensure your license is renewed in a timely fashion.

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