CSSC Application

Contact Information
Agreement: I understand that the NSSTA CSSC/MSSC Committee must favorably consider this application prior to acceptance. By submitting this form, I declare that the facts herein are true and complete to the best of my knowledge. I also state that my organization, voting and professional members are actively involved in, associated with, or have an interest in the furtherance of periodic payment of compensation on account of personal physical injuries as set forth in Article II of the NSSTA Bylaws.

Please use the space below to fill out your personal information for the CSSC Program
NSSTA Membership
Please indicate below if you are a current NSSTA Member
NSSTA Membership
Structured Settlement Industry Experience
Please describe your Structured Settlement Industry experience with the following questions listed below:
Have you sold structured settlement products for two consecutive years?
Have you sold structured settlement products through a life insurance company for two consecutive years or appointed by a brokerage company to handle structured settlement products?