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Texas Department of Insurance
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Life Settlement Provider Entity license application documents

Attach the following documents to your online Sircon application. (View application instructions.)

Documents that must be attached to the electronic application submission:

  • Certificate of Status from State of Domicile - (Non Residents)
    • A certificate of status is a document issued by the applicant’s state of domicile public records custodian for corporate records, generally the Secretary of State. The certificate documents that the company is duly organized and that all state taxes and fees have been paid. The certificate must show good standing, be sealed by the state, and be an original document dated within 30 days of application date.
  • Business Authority in Texas: Most entities are required to register to do business in this state prior to obtaining an insurance license.
    • All resident and non-resident corporations, limited liability companies, limited partnerships, limited liability partnerships, and agricultural cooperatives must provide a copy of their Charter, Certificate of Formation, Certificate of Status, or registration that was obtained from the Texas Secretary of State's office. You may contact the Texas Secretary of State's office at or call 512-463-5701.
    • All banks and farm credit administration entities must provide a copy of the document issued by a federal or Texas state agency authorizing the entity to do business in Texas.
  • Control means the power to direct or cause the direction of the management and policies of a license holder, whether directly or indirectly. A person is considered to control:
    • a corporate license holder if the person, individually or acting with others, directly or indirectly, holds with the power to vote, owns, or controls, or holds proxies representing, at least 10 percent of the voting stock or voting rights of the corporate license-holder; or
    • a partnership if the person through a right to vote or through any other right or power exercises rights in the management, direction, or conduct of the business of the partnership. At least one officer or one active partner of the applicant entity must be individually licensed by the Texas Department of Insurance.
  • Fingerprinting is only required for those individuals who have not previously been fingerprinted for TDI.
  • Additional attachments required:
      • Plan of Operation (to be submitted by Providers Only)
        • If the applicant is a subsidiary of a parent or holding company, provide an organizational chart showing the relationship of all related persons
        • Other information
      • Marketing Plan
        • A detailed description of the applicant’s marketing plan
        • Three-year volume projection Texas and nationwide
        • Other information
      • Financial Information
        • Amount and type of funds to meet planned projections identified
        • Special purpose entity or financing entity identified
      • Name, address, and contact person identified
      • Copy of agreement between applicant and entity
        • Third-party escrow agent(s)/trustee(s) information
        • Copy of agreement between applicant and entity
        • Third-party escrow agent(s)/trustee(s) information
      • Related provider trust identified
        • Identify any related provider trust, if applicable, and include a copy of the organizational documents for the trust as well as copies of all forms the trust will utilize in transacting business for which the applicant seeks licensure.
      • Any bankruptcy proceeding
        • Submit a statement summarizing the details of the indebtedness and arrangements for payment
        • Type and location of bankruptcy
      • Proof of Financial Responsibility
        • Errors and Omissions, Directors, and Officer, Liability, etc.

  • Additional Information (to be submitted by both, Providers and Brokers)
    • Location of Books and Records and
      • Provide the address of the applicant’s home office where all records are maintained
      • All branches operating in and out of Texas
      • The location of any single storage facility where books or records pertaining to the business of the captioned company applicant are, or will be stored
    • Anti-Fraud Plan

For more information, contact:

Last updated: 9/30/2022