1-Download and Print forms package. Please fill forms out as completely as possible for a timely evaluation. 2-To begin the evaluation timeline, fax forms directly to (305) 675-2964 3-Call Case Management to confirm your fax was received: (800) 481-3481 Affidavits Only necessary if policy is less than three years old from the date it was issued by the insurance company. Policy Owner Affidavit Agent Affidavit Adobe Acrobat Reader software is required to view these forms. Download Acrobat Now

Forms Approval in this state is still pending. (WE ARE LICENSED THERE)

Please call Life Asset toll-free for assistance 1-800-481-3481

*IN TEXAS, D/B/A LAG SETTLEMENTS, LLC (See also Important Limitations in Texas)

Life Asset Group, LLC and/or Gary E. Brecka, as an individual, are licensed as a life settlement broker or viatical settlement broker in the following regulated states.

Gary E. Brecka, individually, can broker a life insurance policy owned by a resident of the following states: AR, CO, FL, GA, HI, IN, KS, KY, LA, MD, ME, MS, MT, NV, NC, NJ, OK, PA, TN, TX, UT, VA.

Life Asset Group, LLC, as a licensed entity, can broker a life insurance policy owned by a resident of the following states: AR, CT, FL, HI, LA, MD, ME, NV, NJ, OH, OK, PA, TX*, VA.

Depending on the medical condition of the insured, Life Asset Group, LLC and/or Gary E. Brecka, as an individual, may or may not be able to broker a life insurance policy owned by a resident of the following states: CA, DE, IL, MA, MI, MN, NM, NY, OR, VT, WA, WI.

Life Asset Group, LLC and/or Gary E. Brecka, as an individual, may broker a life insurance policy owned by a resident of the following states that are not regulated and do not require licensure: AL, AZ, DC, ID, MO, NH, RI, SC, SD, WY.

Life Asset Group, LLC is in the process of becoming licensed in the following states: AK, IA, NE, ND, WV, PR.

*IN TEXAS, D/B/A LAG SETTLEMENTS, LLC

This Compliance Notice is current as of August 26, 2008 and is subject to change.