Indiana Code Title 34. Civil Law and Procedure § 34-50-2-6

(1) The amounts and due dates of the structured settlement payments to be transferred under the transfer agreement.

(2) The aggregate amount of the payments disclosed under subdivision (1).

(3) An estimate of the present fair market value of the future periodic payments under the structured settlement agreement.

(4) The gross amount payable to the payee as consideration for the transfer of the structured settlement payments disclosed under subdivision (1).

(5) An itemized list of all:

payable by the payee or deductible from the gross amount payable to the payee, as disclosed under subdivision (4).

(6) The net amount payable to the payee after any deduction is made from the gross amount payable to the payee, as described in subdivision (5).

(7) The quotient, expressed as a percentage, obtained by dividing the net amount payable to the payee, as disclosed under subdivision (6), by the estimate of the present fair market value of the future periodic payments, as disclosed under subdivision (3).

(8) The amount of any penalty and the aggregate amount of any liquidated damages, including penalties, payable by the payee in the event of a breach of the transfer agreement by the payee.