COMPANY SUPERVISION DIVISION
2016 Annual Statement for
Life Settlement Providers – General Instructions
For the year ending December 31, 2016
Washington State requires all licensed Life Settlement Providers (LSP or Provider) to file anAnnualStatement and required supplements and exhibits on or before March 1 for the previous calendar year in compliance with RCW 48.102.046(1). Failure to complete this Annual Statement as prescribed will subject the Provider to possible disciplinary action. Please contact the Company Supervision division at (360) 725-7200 or if you have any questions regarding the Annual Statement or its Instructions.
The way you will file the 2016 Annual Statement is the same as last year:
The Annual Statement is an on-line form and you must upload required attachments as PDF files with the filing of your Annual Statement.
The questions on the Annual Statement remain the same as last year.
The online filing system will not allow you to file your Annual Statement until all required documents have been uploaded. To help you get ready, here is a list of documents that you may need to have ready to upload. (Note—some of these documents may not be applicable to your company.)
1. Internal Financial Statement specific to the Life Settlement Provider as a separate legal entity.
2. The Annual Statement Attestation.
3. The List of Washington Life Insurance policies Purchased During 2016.
4. The Washington Life Insurance Policies for Which the Life Settlement Provider Received Payment During 2016 form.
5. Biographical Affidavit form for any new officers, directors, investors, partners, or members.
6. Antifraud Plan if changed since it was last filed with our office.
7. Report of Examination from any state department of insurance or any other regulatory body issued since the last Annual Statement filing.
8. Service of Process form if the designee has changed.
The Annual Statement Attestation, List of Washington Life Insurance Policies Purchased, and Washington Life Insurance Policies for Which the Life Settlement Provider Received Payment forms can all be found at the following link.
The Biographical Affidavit and Service of Process forms can be found at:
Online Filing Instructions
You will find Washington’s Annual Statement for Life Settlement Providers (Annual Statement) on our internet site. To access this form, go to
Choose the “For Insurers” tab at the top of the page. Under “Financial filings” at the bottom of the first column, click on “Annual financial filing statements”. Not far from the bottom of the page you will find the link: “File annual statement” under the “Life settlement providers” header.
Using this link, you can login and fill out the Annual Statement. Also on the page you can find out who your company’s contact person is by using the “Find your Entity Contact” tool, and your contact person can use the “Forgot Password?” tool if they have forgotten their password. Your User ID consists of the letters FIN followed by your WAOIC number.
If you do not fill out the Annual Statement completely and need to save your work to return to it later, click on the “Save” button at the bottom of the page. You may then Logout and return to your partially completed Annual Statement at a later time. Detailed instructions for each page of the Annual Statement can be found on our website at:
In order to meet the attestation requirement, the Provider must upload a scanned image of an original, handwritten, and notarized Annual Statement Attestation page to the online filing system.
The Annual Statement will not be filed with this Office until all required documents are attached to the Annual Statement. Please confirm the required documents are attached in the Supporting Documents section of the Annual Statement.
Renewal Fee Payments
Please note: See RCW 48.102.011 for registration renewal fee requirements. Starting January 1, 2015, we merged the payment and Annual Statement filing systems into a single Company Filing and Payment Center, so your Annual Statement filing User ID (FIN followed by your WAOIC number) will also allow you to log into the payment system under your login or by an additional user assigned by you. The E-Tax contact and separate “TAX” (payment) login no longer works. Your Annual Statement filing contact will receive an e-mail in January when your fee is available to be paid. You may now pay by credit card, electronic funds transfer, or by check. A contact person will be listed in the payment center should you have difficulty processing your payment.
Subsequent Filings after filing the Annual Statement
All licensed Life Settlement Providers must file an Audited Financial Report on or before June 1. The Audited Financial Report must be in PDF format and uploaded to the online filing system under the Add Document to Submitted Filing tab. Failure to file the Audited Financial Report by the due date will subject the Provider to possible disciplinary action.
Please note that this information replaces and supersedes all previous filing instructions and exemptions that you may have received from this office. If you have questions regarding the filing information, instructions, or requirements, please contact us at (360) 725-7200 or email prior to any deadline.
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