Fast, Free Life Settlement Quotes from SaviCare

Please enter your information below. All information provided will be kept safe and secure and will be used to determine your eligibility for a Life Settlement.

First Name*
Last Name*
Initial
Address*
City*
Email*
Zip Code*
Home Phone*
Work Phone
Sex*
Male
Female
Marital Status*
Married
Single
Date of Birth (MM/DD/YYYY)*
Second Insured Name
Date of Birth (MM/DD/YYYY)
Dependent Children?
Yes
No
Have you been a party to a bankruptcy since policy issue date?
Yes
No
Is the policy subject to liens?
Yes
No
Are you a U.S. citizen or permanent resident of the U.S.?
Yes
No
Life Insurance Policy Information
Name of Insurance Company? *
Face Value $*
Insuring*
Policy Type*
Policy Issue Date (MM/DD/YYYY)*
What is the conversion date? (MM/DD/YYYY)
Annual Premium*
Next Premium Due (MM/DD/YYYY)*
State of Issue
Health History
List health conditions here:*
Please give us some detail about your health history. Please list any health conditions.
In the past 12 months, have you used tobacco in any form? *
Yes
No
Have you ever smoked?*
Yes
No
Have you ever consumed alcoholic beverages?*
Yes
No
Frequency of Use
Amount consumed on each occasion?
Have you ever had treatment for alcohol abuse (including AA).
Yes
No
Family History
Father Deceased?
Fathers Current Age
Fathers Deceased Date
Fathers Deceased Cause
Mothers Deceased Cause
Mother Deceased?
Mothers Current Age
Mothers Deceased Date
Brother Deceased?
Brothers Current Age
Brothers Deceased Date
Brothers Deceased Cause
Sister Deceased?
Sisters Current Age
Sisters Deceased Date
Sisters Deceased Cause

At SaviCare Financial, LLC we help you convert your existing life insurance policies directly into cash – at an amount that exceeds the cash surrender value.

We are dedicated to ensuring the best purchase price for each policy – quickly, discreetly and with a smooth transaction.

SaviCare Financial, LLC is a life settlement broker. Many states regulate license life settlement transactions. Invitations for application for life settlements are made through SaviCare Financial Services, LLC, Oak Star Partners, LLC or one of its principals and only where duly licensed.

It is understood and agreed that:

All statements and answers made in all parts of this application are true and complete to the best of my knowledge and belief. I will notify SaviCare of any changes to the statements and answers given in any part of the application.

I understand the information obtained by use of this Authorization will be used by SaviCare to determine my eligibility for Life Settlement. To facilitate rapid submission of such information, I authorize all said sources to give such information to any agency employed by Savicare to collect and transmit it.

A photographic copy of this authorization shall be as valid as the original. I agree this Authorization shall be valid for 24 months from the date shown below, and that upon my request I have a right to receive a copy of this Authorization.

Fast, Free Life Settlement Quotes from SaviCare

Life Insurance Policy Information

Health History

Family History

It is understood and agreed that: