Membership Application 2023

Individual Applicant (Producer or Business Associate)

Corporate Membership (Provider or User)

Is your mailing address different from the physical address?
Please provide your mailing address

Membership Category

Producer Firm dues are paid in July of each year and covers the balance of the current year and the first 6 months of the new year. Associate & Provider dues are paid annually on January and cover dues through December.

Membership Selection
Structured settlement consulting firms, insurance agencies, brokerage firms, or other organizations that are in the business of settling or funding personal injury damage actions or other claims utilizing periodic payments.
Life insurance companies, bond brokerage firms, and other financial institutions or financial services companies that are in the business of providing financial vehicles to settlement companies to fund settlements or judgments through periodic payments.
Any individual or organization that is not eligible to be a Producer or Provider Member of NSSTA but has a legitimate interest in the structured settlement business. An Associate Member (including its employees, in the case of an organization) shall have no vote and shall not be eligible to serve as a Director or Officer of NSSTA.
An employee of a Producer who is a Member of NSSTA who serves in a business support capacity in connection with the structured settlement business, and who does not serve in a producer, principal, or executive role for such NSSTA Member.
Casualty companies, self-insured firms, or other organizations that purchase financial products to settle personal injury damage actions or other claims utilizing periodic payments. A User Member shall have no vote and its employees shall not be eligible to vote or to serve as a Director or Officer of NSSTA.

Background Questions

1. Do you know any current individuals NSSTA members, if so, who, what company and how do you know them?
2. How did you hear about NSSTA?
3. Do you currently have any structured settlement life insurance carrier affiliations?
If so, name them:
4. Are you currently providing structured settlement services to the industry, if so, what services?
5. Why do you want to join NSSTA?
6. Are you currently a member of any related trade associations? If so, name association and for how long have you been a member?
7. Are you, or any affiliated entity, and/or any of their respective officers and directors engaged in any of the following activities:

(i) soliciting or promoting structured settlement factoring transactions.
(ii) sharing information and documentation about existing structured settlements with any entity engaged in structured settlement factoring transactions, or using such information to solicit structured  settlement factoring transactions.
(iii) selling structured settlement payee names/addresses or other
identifying information to any entity engaged in structured settlement factoring transactions; or
(iv) engaging in or promoting the marketing or distribution of previously acquired structured settlement payment rights?
8. If the answer to any of questions 7 (i)-(iv) is yes, please identify the entity, officer, or director and describe the activity in which such entity, officer or director is engaged

Applicant's Certification and Attestation

The applicant must read the following and sign below:

I grant permission to the NSSTA Membership Committee to conduct an interview to verify the information provided herein and/or request additional information as it pertains to membership requirements. I also accept any decision made by the NSSTA Board of Directors as final regarding my membership.
Sign above