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PA License Number: SSN COMMONWEALTH OF PENNSYLVANIA INSURANCE DEPARTMENT VERTICAL SETTLEMENT BROKER INDIVIDUAL LICENSE RENEWAL FORM Process your renewal online in minutes on or before your license
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How to Fill out Viatical Individual Addendum PDF:

01
Open the viatical individual addendum PDF on your computer or device.
02
Start by entering your personal information, such as your name, address, and contact details, in the designated fields.
03
Provide the necessary details of the viatical settlement provider or company, including their name, address, and contact information.
04
Specify the policy number or identification number associated with the viatical settlement.
05
Indicate the effective date of the viatical individual addendum by selecting or typing the appropriate date.
06
Review the terms and conditions of the viatical individual addendum carefully, and if any changes or amendments are required, make sure to document them accurately.
07
If there are additional policy beneficiaries or payees involved, provide their relevant information, including their names, addresses, and contact details.
08
Ensure that you understand and acknowledge the consequences and implications of the viatical individual addendum by reading and signing the appropriate sections.
09
Proofread the completed viatical individual addendum thoroughly to avoid any mistakes or omissions before submitting it.

Who Needs Viatical Individual Addendum PDF:

01
Individuals who have entered into a viatical settlement agreement may need a viatical individual addendum PDF. This additional document allows for amendments or changes to the original viatical settlement agreement, ensuring that all parties involved are aware of the modifications made.
02
Viatical settlement providers or companies may require viators (the individuals selling their life insurance policies) to fill out the viatical individual addendum PDF as part of the settlement process. This document helps formalize any adjustments or alterations made to the original agreement and ensures that all parties have a clear understanding of the changes.
03
Policy beneficiaries or payees who are involved in the viatical settlement may also need to complete the viatical individual addendum PDF, especially if there are modifications to be made regarding the distribution of the settlement proceeds or changes in beneficiaries. This document helps update and clarify the terms of the viatical settlement for all parties concerned.

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