Genex Capital -- Contact Us -- 800-348-3098

Contact Genex Capital

Mailing Address: 73 Green Tree Drive, #99
Dover, DE 19904
Phone: (302)356-1522
Fax: (302)351-3396
Email: info@genexcapital.com

Complete the form below so that a Customer Service Expert can contact you.

First and Last Name

Email Address

Phone number

Payment Stream Structured Settlement
Investment Annuity
Lottery Payments
Worker's Compensation
Other

Insurance Company

Do you receive periodic payments? Yes
No

How often do you receive periodic payments? Monthly
Quarterly
Biannually
Annual

What date is your next payment?

What is the date of your final guaranteed payment?

How much money will you receive in your next payment? $

Do your payments increase annually? Yes
No

What is the date your next increase occurs on?

What is the percentage your next increase will incur? %

Please enter any lump sum payments you would like to sell below.

Dates:	Amounts:
	$
	$
	$
	$

Thank you! We are in the process of calculating your quote. A Customer Service Representative will be contacting you within the next 24 hours to review your options. In the meantime, please feel free to call us at 1-800-348-3098.