One-Step Life Settlement Qualification InstructionsPlease complete the fields below to the best of your ability. * Denotes required fields Agent Name (Optional) First Last Your Name* First Last Email* Phone Number*Abacus Settlements Account Executive (If Applicable)Case InformationGender*MaleFemaleAge*--Select--45464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100Health Status*--Select--ExceptionalOrdinaryPoorLife-threateningPolicy Type*TermWhole LifeUniversal LifeJoint SurvivorshipJoint Survivorship/One DeceasedDeath BenefitPremiums (Yearly)Cash Surrender ValuePolicy Loan AmountDisclaimer: The Abacus Qualify a Life Settlement Tool is intended to determine the validity of a Life Settlement. It is not intended to represent a bid or actual offer to purchase a policy. In order to get a valid offer for a life settlement, a full application, medical & financial underwriting process must be completed and documented. A favorable or non-favorable result does not guarantee that Abacus Settlements will or will not offer or purchase a policy.Untitled This iframe contains the logic required to handle AJAX powered Gravity Forms.