2023 Life Settlement Provider Annual Statement Filing Instructions

Two complete copies of the 2023 Annual Statement must be filed  with DFS by March 1, 2024. It is the responsibility of each licensed provider to comply with applicable statutes and regulations at all times.


You will need to submit one copy of the Statement in MS Word format and one signed, scanned and notarized copy in PDF format.

For the MS Word document, do not use any format other than Microsoft Word.

Statements will need to be printed single-sided on 8.5" by 14" paper.

Include the name of the life settlement provider at the top of all pages.

Preparing the PDF Document

The PDF copy of the Statement must contain a Jurat, signed by at least two principal officers. All signatures must be original. The signatures must be in the spaces indicated at the bottom right, below the sworn statement, next to the officer’s title.

The original signed Jurat must be properly notarized. To be properly notarized, the “State” where the Jurat is signed and the “State” of the Notary stamp must be the same. Statements received without a properly executed Jurat will not be accepted as filed.

Submitting the Statement

Once the final Statement is signed and notarized, scan it and save it as a PDF. The 2023 Statement in MS Word format does not need to be notarized.

To file the 2023 Statement via email, attach the MS Word and PDF documents to an an email addressed to [email protected] and copy [email protected] and [email protected].

Do not send, mail, or deliver a hard copy of the Statement to the Department.

Completing the Statement

Respond fully to each item. Statements filed containing blank lines or unanswered questions may be deemed incomplete. Reply with “None”, “Not Applicable”, “N/A”, or “0”, as applicable. If no entries are to be made in a Schedule, write “N/A” somewhere in the Schedule and include an explanation as to why the requested information is not applicable.

Report all amounts in whole dollars only. You may elect to report the amounts to  the nearest dollar or through truncation of digits below a dollar. (Example: $583,683.52 may be reported as $583,684 by rounding or as $583,683 by truncation). It is expected that the failure of items to add to the summary of totals may reflect this treatment.

Do not change the designated page numbers in the Statement. If extra pages are needed, use decimals after the page number, for example: 2.1, 2.2, etc.

All amounts on the Schedules are to be reported according to designations within the Schedules. (Example: “Life Settlement Transactions Involving New York Residents” should not include transactions for other than New York).

For Annual Statement lines labeled “Aggregate Write-ins”, enter the total of the write-ins listed in the Section “DETAILS OF WRITE-INS AGGREGATED AT  LINE...” (Example: In Page 2, “ASSETS”, copy the number in line 1199 to line 11. The Provider should list separately each category of miscellaneous assets for which there is no pre-printed line on Page 2). An overflow page has been provided on the last page of the Annual Statement in the event that the Provider has more write-ins than were provided for in the write-in section. Use an aggregate write-in only if the item being reported is completely incompatible with  any of the pre-printed lines on Pages 2, 3, and 4.

Individual policyowners or insureds should not be identified by name in the Annual Statement.


If you have questions about regarding the Annual Statement, contact Edgardo Sison by email at [email protected] or by phone at 212-709-7710.