Licensing

Viatical Settlement Representative, Broker, or Provider

Resident/Nonresident

  • Electronic Applications

  • Paper Applications:

    (must include a $50 paper processing fee in addition to the $100 application fee)

    • Representative or Broker:

      • Initial Application:
      • Renewal: Please contact the Division to obtain a duplicate copy of your renewal form.
    • Provider: (must include a $50 paper processing fee in addition to the $300 application fee)

      • Initial Application:
      • Renewal: Please contact the Division to obtain a duplicate copy of your renewal form.
    • Appointment/Termination Form

    • Bond Form

    • Viatical Settlement Provider Annual Filing Form