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Structured Settlement Agreement
Free structured settlement agreement template — outlines periodic payments made to settle a legal claim, instead of a single lump sum.
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This free structured settlement agreement covers 1. Settlement of Claim, 2. Payment Schedule, 3. Funding, 4. Release, 5. No Assignment Without Consent with 5 clearly marked [placeholder] fields to fill in — built for small businesses and individuals documenting a loan or expense putting financial terms in writing so both sides have a clear, shared record. Copy it into your own word processor, fill in the placeholders, and review it — or adapt it — before use. It's part of docstoc's free document template library, alongside business, legal, real estate, finance, and HR templates. Every template here is free to copy with no signup required, and each one carries a plain disclaimer: this is a starting point for informational purposes, not a substitute for advice from a licensed professional in your jurisdiction.
Structured Settlement Agreement
Claimant: [Name] · Defendant/Insurer: [Name] · Date: [Date]
1. Settlement of Claim
In full and final settlement of the claim described as [Brief description of the underlying claim], the parties agree to the structured payment terms below.
2. Payment Schedule
| Payment | Amount | Due Date |
|---|---|---|
| Initial lump sum (if any) | [Amount] | [Date] |
| Periodic payment 1 | [Amount] | [Date] |
| Periodic payment 2 | [Amount] | [Date/Frequency] |
3. Funding
This settlement will be funded through [an annuity purchased by Defendant's insurer / another funding mechanism], naming Claimant as the payee.
4. Release
Upon execution of this Agreement, Claimant releases Defendant from any further liability related to the underlying claim, except for the payment obligations described above.
5. No Assignment Without Consent
Claimant may not sell, assign, or transfer rights to future payments without complying with applicable state structured settlement protection laws, which typically require court approval.
6. Tax Treatment
[Note that structured settlement payments for personal physical injury claims are generally tax-free under IRC Section 104(a)(2), but this should be confirmed for the specific claim type.]
Claimant: ______________________ Date: ____________ Defendant/Insurer: ______________________ Date: ____________
*This document is provided for informational and educational purposes only and does not constitute legal or tax advice. Nearly every US state has a Structured Settlement Protection Act requiring court approval before a claimant can sell their future payments to a factoring company — a claimant considering that later should know upfront that it's not a simple private transaction.*
Edit directly in the box above. Download PDF anytime — the docstoc.io footer is always included and cannot be removed.
What's included
- Edit online — click the document, fill in placeholders, download a PDF
- 6 standard sections: 1. Settlement of Claim, 2. Payment Schedule, 3. Funding, 4. Release, 5. No Assignment Without Consent, 6. Tax Treatment
- 5 clearly marked [placeholder] fields for quick personalizing
- Free to use — no account or signup required
- Fully editable — adjust any clause to match your actual situation
- Includes a signature block, ready to print or sign digitally
- Fixed docstoc.io footer on every PDF (not removable)
Who this template is for
Freelancers & solo founders
Handling routine business paperwork without commissioning custom legal drafting for every document.
Small businesses
Standardizing recurring documents — leases, agreements, notices — across a growing operation.
Anyone reviewing before signing
Using a clear starting structure to understand what a document should cover, even if a lawyer finalizes it.
Informal lending & reimbursements
Money changing hands between people or a business and its team, without a bank's paperwork.
FAQ
Is this structured settlement agreement template really free?
Yes — this Structured Settlement Agreement template on docstoc is free to view, edit online, and download as a PDF with no account or signup required.
What does this structured settlement agreement cover?
This finance template includes 1. Settlement of Claim, 2. Payment Schedule, 3. Funding, 4. Release. Fill in the [bracketed] placeholders, edit any clause online, then download a PDF — the docstoc.io footer stays on every export.
Is this legal advice?
No. This covers the standard structure, not the interest-rate limits, disclosure requirements, or tax implications that can apply depending on your state and the amount involved. Check those specifics with an accountant or financial attorney before you rely on it.
Can I edit the wording?
Yes. All 5 placeholder fields and every clause are editable right on the page — change what doesn't fit, then download an updated PDF anytime.
Where can I find more free templates like this?
Browse more free finance and related document templates in the docstoc library at /document-templates/.
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