Assignment Documents - Sales & Service Forms Structured Settlements

Assignment Documents | Writable Forms

Please use our version of the assignment documents or NSSTA versions below. If changes are requested to any Assignment Document format please submit them to our group email address for review by our compliance area.

Email us if other variations are needed.

Qualified Assignment Agreement

Qualified Assignment & Release Agreement

1 Claimant, 1 Assignor (with Addendum)

RPD957 (PDF)

1 Claimant, 1 Assignor

RPD1832 (PDF)

1 Claimant, 2 Assignor

RPD987 (PDF)

2 Claimants, 1 Assignor (with Addendum)

RPD984 (PDF)

2 Claimants, 1 Assignor

RPD1834 (PDF)

2 Claimants, 2 Assignors

RPD990 (PDF)

1 Claimant (with reversion to Claimant), 1 Assignor (For use with QSF cases)

RPD1066 (PDF)

Qualified Assignment, Release and Pledge Agreement

Not for use on Attorney Fee Structures

* Please note — An individual QARP form needs to be completed for each Annuitant in order to put it into the Annuitant's possession to perfect the interest.

1 Claimant, 1 Assignor

RPD958 (PDF)

1 Claimant, 2 Assignors

RPD988 (PDF)

2 Claimants, 2 Assignors

RPD991 (PDF)

1 Claimant (with reversion to Claimant), 1 Assignor (For use with QSF cases)

RPD1065 (PDF)

Special Needs Trust Modified Qualified Assignment Release and Pledge

Please note, if your case involves a QARP with a Special Needs Trust, we have developed a format which includes an additional definition of Releasor – the party(s) releasing the claim. The Claimant-Secured Party definition should be defined as the Trustee of the John Doe Special Needs Trust, who will execute the document and receive an original annuity contract to perfect the interest. Ownership will not go back to the Claimant but to the Trust if anything would happen in the future with receiving the periodic payments.

It is also recommended to utilize the commutation benefit rider on Special Needs Trust cases. The commutation provision can only be included at contract issuance. Please do not complete the Effective Date; it will be populated during contract issuance.