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Information on Structured Settlements
I am a Plantiff Attorney
I am an Injured Person
I am a Claims Professional
I am a Structured Settlement Holder
I am a Settlement Fiduciary
 



Summit Structured Settlements
755 S.E. Frontier Suite 101
Waukee, Iowa 50263

Voice: 515.987.6888
Fax: 515.987.6999
Toll Free: 866.267.1177
info@summitsettlements.com
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I AM AN INJURED PERSON

Name:  
Phone Number:  
Date of Birth: Date of Loss:  
Email:  
Description of Incident:
Attorney Name:
Phone Number: Fax:  
Email:
Defendants Insurance Company:
Amount of Total Settlement:
Has Case Been Settled:    Has Mediation Occured:
If Mediation has not occured, is it scheduled:
Comments:

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