INTRODUCTION - REFERRAL - CONTACT US - GET A QUOTE CONTACT US NOW We purchase Structured Settlements Form Your Name:* Phone:* Fax: E-Mail Address:* Settlement Information Worksheet Name of Insurer Paying you: Type of Payment being received Pre-Settlement Balloon Balance Investment Annuity Current Payment Amount The Payment is being received Monthly Quarterly Annually Total Award Amount Date of your 1st Payment Is this a "Life" Payment? Yes No If not a "Life" Payment, what is the Final Payment Date? Type of Accident (Why are you receiving payments?) Are You Seeking Total Cash Out Partial Cash Out Why are you seeking these funds? What are your current needs? Please answer the math question. The sum of 8 + 5 =* ="top" bgcolor="#ffffff"> ImmediateCash.com Creative Investment Group, Inc dba ImmediateCash.com 2400 W. Magnolia Blvd Burbank, CA 91506