Life Settlement Document Ii Form - Arkansas Securities Department Page 4

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You will be obligated to pay additional money to fund premium payments after
(date) ___________. Payments of $ ________ will be due to be paid:
Monthly
Quarterly
Semi-annually
Annually
Before these additional payments are due, you will be notified of when and to whom to make
your premium payments.
Use of your investment funds
Of the amount you are investing:
$ ________ will be used to purchase the policy from the insured.
$ ________ will be set aside to pay premiums on the policy.
$ ________ will be used to pay a commission to the person who sold you the policy.
$ ________ will be used to pay administrative expenses and other transaction costs.
The Arkansas Securities Department is the agency of state government responsible for the
licensing of brokerage firms, investment advisers and their employees, the registration of
securities and the enforcement of the Arkansas Securities Act. Anyone with questions or
concerns about life settlements contracts may contact the Arkansas Securities Department at the
address and telephone numbers listed below.
Arkansas Securities Department
Heritage West Building, Suite 300
201 East Markham
Little Rock, Arkansas 72201
501-324-9260 or 1-800-981-4429
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