Dear Client,

Please fully complete this application to the best of your ability. Answer all appropriate questions on this application even if it is a negative issue. You will want to let your new Funding Source know as much as possible. Our job is to help you get the cash you need. Any negative issues are not intended to disqualify you, but to allow us to confront these issues head on. So be accurate and truthful to the best of your knowledge. This is very important. You don't want to waste time, slow down your application, or not receive a quote at all!

Upon completion and submission of this form, you will receive an immediate email with your confirmation and funding source information. Please add “globalquickcapital.com” to your allowed email to ensure delivery.

Please note that these Applications are for conducting cash flow business or applying for loans only! These are not job applications!

Thank you,
GlobalQuick CAPITAL

Request For Life Settlement Application

Requirements

No Minimum
No Maximum
Accepted Locations: USA
Adults 18 and Over

Notice: This form is a request for a Life Settlement Application. There are over 35 different applications used for Life Settlements depending on the state specified. To make sure that you will have the right application form, fill out this request and submit it. The Funding Source will respond and email you the appropriate application for your state. This request is free with no obligation.

Client/Note Seller

•First Name:

•Last Name:

•Address 1:

Address 2:

•City:

•State:

•ZIP Code:

•Email Address:

•Phone Number:

Fax Number:

Cell Number:

•Date of birth:

•Marital Status:

Name of Attorney
(if applicable):

Policy Information

•Is contact the Policy Owner?

Yes No

If no, Who is the Policy Owner?

•Policy Type:

•Policy Amount:

Client Information

•What is your motivation?

•How much cash do you need or want?

Date Needed:

Comments

Additional Comments:

•How did you hear about GlobalQuick CAPITAL?

Who Referred You?

No one referred me:

Referred Name:

Referred Phone:

Referred Email:

Application Id:

20240428-123606-843

Please note:

The Funding Source may require copy of additional documents
to make your quote. They will let you know by Email.

Upon submission of this form, you will receive an immediate email with your confirmation and funding source information. Please add “globalquickcapital.com” to your allowed email to ensure delivery.