Life Settlement Providers

Application - $600.00 plus $5.00 processing fee

Renewals - $500.00 plus $5.00 processing fee

The processing staff requests that all documents and forms be uploaded as one pdf. Scrolling through one document is preferred over downloading one document at a time. 

Be prepared to enter all entity information such as name, EIN, responsible parties, business and mailing addresses along with phone numbers and email addresses

Documents and Forms required to be uploaded with application:

• Documents and Forms to prepare and gather prior to submitting the online application:
  • Corporate Formation Documents and Certificate of Existence from Georgia Secretary of State
  • Copies of certified By-laws, Organization Chart including job descriptions
  • Bond in the amount of $100,000 in favor of the Commissioner executed by a corporate surety insurer authorized to transact business in Georgia (OCI provides a bond form if needed. Link is below in Forms)
    • Language must be included that the insurer may cancel the insurance upon 30 days advance notice filed with the Commissioner
    • Must be retained for at least one year if license is inactivated for any reason
  • Audited Financial statement or other such information that demonstrates the applicant possesses a minimum net worth of $300,000 (OCI provides a Financial Statement (GID-056-NT) template if needed. Link is below in Forms)
  • Copy of Anti-fraud plan pursuant to but not limited to the information required under O.C.G.A. 33-59-14
  • Copy of all life settlement contracts and disclosure statements, containing the provisions stipulated under O.C.G.A. 33-59-9 for review and approval
  • Citizenship Affidavit and ID, also known as Illegal Immigration Reform and Enforcement Act Form with copies of acceptable identification (Link to form and instructions below)
  • Background Statement and Affidavit Form (GID-052-NT) and Release of Information Form (GID-053-NT). An Investigation background report from an approved NAIC vendor must be submitted to OCI.
  • Statement stipulating that the entity's advertisements shall not be misleading, in fact or by implication, shall not suggest that the purchase of a policy is for the sole purpose of life settling the policy, and shall not use the words "free:, "no cost", or words of similar meaning in order to entice purchase for subsequent life settlement.

Renewals are to be filed by May 1 of every year. A late fee of $15 will be imposed. If not renewed or the renewal filing is not completed by June 30th, the license will be inactivated for reason of failure to renew. The company will be required to reapply.

Following are the required items to filed in www.Sircon.com/georgia

• Renewal fee of $500 plus $5 processing fee
• Proof of Continuation of Bond in the amount of $100,000 in favor of the Commissioner executed by a corporate surety insurer authorized to transact business in Georgia
  • Language must be included that the insurer may cancel the insurance upon 30 days advance notice filed with the Commissioner
  • Must be retained for at least one year if license is inactivated for any reason
• Audited Financial statement or other such information that demonstrates the applicant possesses a minimum net worth of $300,000
• If any changes in formation of the entity or by-laws, upload with renewal
• If any changes in ownership or principals, upload Biographical Statement and Release of Information forms for each individual. Background Reports from an authorized NAIC company must be sent to OCI also.
• IF any changes in any agreements, upload a red-lined version to the renewal.
• Notarized statement from the President or CEO stating if any events have happened since the last renewal or license issuance that has impacted either the solvency of the company, forces any regulatory actions in any jurisdiction where the entity operates or any other issues that have materially impacted any of the principals. 
• List of all transactions involving Georgia residents/consumers:
  • Total number, aggregate face amount, and life settlement proceeds of policies settled during the preceding calendar year, together with a breakdown of the information by policy issue year for Georgia business. 
  • The names of the insurance companies whose policies have been settled.
  • The life settlement brokers receiving compensation related to those policies; and
  • The names of any and all employees, who solicit, market and/or sell life insurance products.
• Signed and notarized advertising statement in accordance with O.C.G.A. § 33-59-8
• Citizenship Affidavit and ID is only required for a renewal if the previously filed individual is a non-citizen or if the officer, owner, partner or director is new to the organization

• After submission, an email will be sent confirming submittal.
• The application will be reviewed within ten (10) business days of submittal
• Any deficiencies will be sent via an email to the applicant email address
• All deficiencies must be resolved within 60 days of the email notice
  • If not completed, the application will be closed incomplete
  • Another application submittal including payment of all fees will be required. No refunds for closed incomplete applications.
• If the application is approved, the license will be sent via email as an attachment. Please save the license. Any future copies will require a fee for printing.

Financial Statement (GID)056-NT) or provide audited financials

Biographical Affidavit (GID-052-NT)

Authority for Release of Information (GID-053-NT)

Citizenship Affidavit and Instructions (GID-276-EN)

Verification of Coverage (GID-257-NT)

These changes can be filed with the annual renewal if during that time period.

• Name Changes after Licensed - Name Change form along with Corporation Filing Documents, By-laws and organization changes - Email to [email protected]
• Address Changes After Licensed - addresses can be updated at www.sircon.com/georgia
• Surrender of License - Form and proof of bond to be held at least 12 months from the inactivation of the license
• Changes of Officers, Owners, Partners or Directors - email to [email protected]. Please provide license number and describe update and provide all necessary documents required.
• Changes in By-laws or Organization Structure - email to [email protected]. Please provide license number and describe update along with all documents. 

O.C.G.A. § 33-59 - Life Settlements

Georgia Rules and Regulations - Ga. Comp. R. & Regs. r. 120-2-93-.02-09