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HomeMy WebLinkAbout07-0880 IN THE MATTER OF JENNIFER CLAY : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, PENNSYLVANIA ; NO. 07- <;('%"0 CIVIL PETITION FOR APPROVAL OF TRANSFER OF STRUCTURED SETTLEMENT PAYMENT PURSUANT TO THE STRUCTURED SETTLEMENT PROTECTION ACT AND NOW, comes Jennifer Clay, by and through her attorney Michael D. Rentschler, Esquire, who files the within Petition, as follows: 1. The Petitioner is Jennifer Clay, an adult individual who is currently residing at 4 Center Drive, Camp Hill, Cumberland County, Pennsylvania 17011 (hereinafter referred to as "Petitioner/Payee"), Petitioner is married and has one child. 2. This Petition is being filed pursuant to the Structured Settlement Protection Act, 40 P.S. 4000, et sea. (The "Act"). The Act requires Court approval of transactions such as the one contemplated herein, 3. Following a personal injury accident, a claim was asserted against the tortfeasor. The matter was settled through her attorney. The settlement amount, or a portion thereof, was placed in an annuity. The current owner of the annuity is Allstate Settlement Corporation, The issuer of the annuity is Allstate Life Insurance Company, 4. Petitioner/Payee now desires to transfer two structured settlement payments comprising an aggregate amount of $45,000,00, as follows: one (1) payment of $20,000,00 on June 14,2011 and one (1) payment of $25,000.00 on June 14, 2016, The discounted present value of the aggregate payments at 5.60% is $30,763.43. The discounted present value is the calculation of the current value of the transferred structured settlement payments under federal standards for valuing annuities. The gross amount due to the Seller is $20,500,00. There is a $500.00 compliance or administrative fee, Consequently, the net payment to the Seller is $20,000,00. The net amount that Petitioner will receive from the transferee in exchange for her future structured settlement represents 65% of the estimated current value of the payments based upon the discounted value using the applicable federal rate of 5.60%. Petitioner/Payee intends to use the proceeds of this transaction to pay bills. 5. Prior to the enactment of the Act, Court approval was not necessary in order to effect a transaction sale such as the one contemplated herein. 6. On February 2, 2007, Petitioner/Payee executed a Purchase Agreement with 321 Henderson Receivables Origination, LLC, whereby 321 Henderson Receivables Origination, LLC agrees to purchase those structured settlement payments and give Petitioner/Payee a lump sum payment. A true and correct copy of the Purchase Agreement is incorporated herein, made a part hereof, and attached as Exhibit "A", 7. Schedule 1, entitled "Disclosure Statement", advises Petitioner/Payee of certain disclosures and statements concerning the transaction, Said Disclosure Statement is incorporated herein, made a part hereof, and attached as Exhibit "8", 8. According to Exhibit "8", the Petitioner/Payee will be entitled to a lump sum payment of $20,000,00 which amount is the lump sum payment from 321 Henderson Receivables as described in Exhibit "8". 9. The transaction contemplated by this Petition and the contractual documents is limited to the transfer of the June 14, 2011 and the June 14, 2016 payments. The contemplated transaction does not involve the transfer of other future payments, namely; the $50,000.00 guaranteed lump sum payment payable on June 14, 2021, the $50,000.00 guaranteed lump sum payment payable on June 14, 2026, the $75,000.00 guaranteed lump sum payment on June 14,2031, the $100,000.00 guaranteed lump sum payment payable on June 14, 2036, and the $200,000.00 guaranteed lump sum payment payable on July 15, 2040. 10. This transfer is in Petitioner/Payee's best interest and represents the settlement of personal injury claim. Allstate Life Insurance Company, the issuer of the annuity, and Allstate Settlement Corporation, the owner of the annuity, will receive a copy of this Petition, 11. Allstate Life Insurance Company and Allstate Settlement Corporation may file comments indicating its respective agreement or disagreement with this Petition by filing said comments in the Prothonotary's Office in the Cumberland County Courthouse, Carlisle, Pennsylvania 17013. WHEREFORE, it is respectfully requested that this Honorable Court grant the within Petition and, therefore, approve the lump sum payment from the Petitioner/Payee's structured settlement, pursuant to the Act, consistent with the statements contained herein. Respectfully submitted, ~~ MICHAEL D. RENTSCHLER, ESQUIRE 28 North 32nd Street Camp Hill, PA 17011 (717) 975-9129 Attorney for PetitionerlPayee ~ VERIFICATION I, Michael D. Rentschler, privately retained counsel for Petitioner, do hereby swear and/or affirm that the information contained in the forgoing Petition is true and correct based upon the statements made to attorney by Petitioner, Consequently, the statements contained in the Petition are true and correct to the best of my information and belief. I ooderstand that any false statements may be punishable pursuant to 18 PaCS Section 4904, relating to oosworn falsification to authorities. It is further acknowledged that attorney is authorized by Petitioner to sign this verification on her behalf, ~~ Michael D. Rentschler, Esquire Account ID: 311881 PURCHASE AGREEMENT This is a Purchase Agreement. The date of this Agreement is ,200_. Jennifer Clay is the Seller. 321 Henderson Receivables Origination LLC, a Nevada Limited Liability Company, its successors and/or assigns is the Buyer. In this Agreement, Jennifer Clay is referred to as "You" or "Your" and 321 Henderson Receivables Origination LLC or its nominee, is referred to as "We", "Us" or "Our". BACKGROUND OF THIS AGREEMENT 1. Your or someone on your behalf signed a Settlement Agreement (the "Release" or the "Settlement Agreement"). in connection with the resolution of a personal injury claim, 2. The insurer funded the Payments by buying an annuity contract (the "Annuity") issued by Allstate Life Insurance Company (the "Annuity Company"), 3. A list of the Payments being sold under this Agreement is attached to this Agreement as Exhibit "A". 4, You desire to sell and assign to Us all of Your rights to receive all or a portion of the Payments under the Release, as described on Exhibit "A", all of the other rights You have under the Release and the other rights as described in Section 1 (a) below. We desire to purchase all of Your rights and benefits, on the terms and under the conditions described in this Agreement. You and We agree as follows: 1. Purchase and Sale. a. You now sell, transfer and assign to Us all of Your rights in the "Assigned Assets" as listed in Exhibit "A". By Our signing this Agreement, We are hereby purchasing and accepting the sale and assignment of all of the Assigned Assets described above. b. The Gross Purchase Price is Twenty Thousand Five Hundred Dollars and 00/100 Cents ($20,500.00). The Net Purchase Price payable to You is $20,000.00 (the "Purchase Price"). The Net Purchase Price will be paid to You when both You and We sign this Agreement and We have completed Our internal process. 2. Acknowledl!ment. a. You will agree after Your signing of this Agreement to deliver to Us, addressed as We may require, other notices, instructions or documents, and copies of them, as We think are necessary or proper to carry out this Agreement. b. When You and We sign this Agreement, You will also deliver to Us: (1) a letter addressed to the Annuity Company directing that all payments of the Assigned Assets after Your death shall be sent directly to Us, and (2) a Change of Beneficiary Form changing the beneficiary of the Assigned Assets, after Your death, to "321 Henderson Receivables Origination LLC", as sole beneficiary [(1) and (2) above are referred to as the Change of Beneficiary Form]. The Change of Beneficiary Form will state that the instructions may never be revoked and that no change may be made in the instructions or mi.. ~ .. @2006 321 Henderson Receivables Limited Partnership Account ID: 311881 in the payments (including as to the payee or the manner or place of making such payments) without Our prior written consent. You will also, when this Agreement is signed by You and Us, deliver to Us, addressed as We may require, such other notices, instructions or documents, and copies of them, as We think are necessary or proper to carry out this Agreement. c. Before You and We sign this Agreement, You will deliver to Us an acknowledgment of The Estate of Jennifer Clay, as primary beneficiary of the Assigned Assets, of the terms of this Agreement. The Estate of Jennifer Clay will agree that they are not entitled to any rights to any ofthe Assigned Assets, d. You agree to sign all other documents which We may request forever naming Us as the only beneficiary of the Assigned Assets, including but not limited to an agreement to provide in Your Last Will and Testament that all of Your rights to the Assigned Assets were sold to Us (a "Testamentary Agreement"). e, You acknowledge that We advised You to obtain independent professional tax advice to determine whether this transaction will result in any adverse federal and/or state tax consequences, f. You acknowledge that We advised You must obtain independent legal representation prior to executing this Agreement and that We have advised you that We may not refer You to any specific attorney for such purpose. 3. Your Reoresentations and Warranties. You now represent and warrant to Us that: a. You own (and are selling and assigning to Us under this Agreement) all of the Assigned Assets, free and clear of all claims, liens, charges, security interests, encumbrances, and agreements of any nature (other than this Agreement), and when You and We sign this Agreement, no one other than Us shall have any present or future right to the Assigned Assets. b. This Agreement and all of the other documents signed in connection with this Agreement have been properly signed by You, and they represent Your legal, valid and binding obligation, enforceable against You in accordance with their terms. c. The signing and performance of this Agreement by You and the transactions described in this Agreement: i. do not conflict with any other obligations of Yours; ii. will not cause a violation under (or create any right of termination, cancellation or acceleration or similar right under) any contract or agreement by which You or Your assets, including the Release, are bound or may be affected; iii. will not create, or give any party (other than Us) the right to create, any lien, charge, security interest or encumbrance in, to or on any of the Assigned Assets; and iv. will not create a present or future right in any other party to make any claim against You or Your assets, or any of the Assigned Assets, W~+ -. 2 @2006 321 Henderson Receivables Limited Partnership Initial: Account ID: 311881 d. You understand the terms and provisions of this Agreement and You have been represented by tax and accounting advisors and a lawyer in the signing of this Agreement. e. Neither You nor anyone else have to do anything else for (I) the proper signing and performance by You of this Agreement and any transactions intended to be done in this Agreement, or (2) the carrying out by Us of any of Our rights and remedies under this Agreement. No other person has made a claim in any rights in or to the Assigned Assets. f. You have valid reasons for selling Your interest in the Assigned Assets rather than obtaining a loan with the Assigned Assets as collateral, and You agree that the transaction set forth in this Agreement is not a loan or other fmancing transaction, g. This Agreement is a valid sale, transfer and assignment to Us of the Assigned Assets. h. Your residence and legal ad'S is as described in Paragraph II of this Agreement. During the last years, You have lived at such address. i. No representation or warranty of Yours in this Agreement or in any of the documents delivered in connection with this Agreement or in any agreement required by this Agreement, is inaccurate or contains any untrue or misleading statement. j. The signing by You of this Agreement will not violate any other promise or agreement you have made with anyone else. You understand that any and all restrictions on the assignability of the Scheduled Payments were included in the Release and/or Annuity at Your request, for Your benefit and not for the benefit of any other person. These restrictions, if any, were included by You as a precautionary measure to make sure You were allowed favorable tax treatment under the Internal Revenue Code. You understand that by entering into this Agreement, you may be giving up this favorable tax treatment. You understand that any income earned by You on any investment or use of the Purchase Price may be taxable to You. You may have to pay more in taxes as a result of this Agreement. For Our benefit and the benefit of Our assigns or successors, You agree to WAIVE AND RELEASE all of Your rights in, to, or under, such restrictions on assignability, if any, k. You have not before the date of this Agreement, sold or assigned Your right to the Assigned Assets or any part of the Assigned Assets. You do not owe any money to Your present or former spouse for support maintenance or similar obligations, nor do You owe any money to any of Your children or guardians of Your children. The Assigned Assets are not subject to any community property or similar marital rights of any person. .. 3 @2006 321 Henderson Receivables Limited Pannership Account ID: 311881 1. Your right to the Assigned Assets is not affected by any mortgage, pledge, lien, charge, security interest, encumbrance, restriction or adverse claim of any nature. You understand that any violation of any of Your representations in this agreement will result in an act of fraud by You which could result in You being held responsible for damages in favor of Us, with money to be paid by You to Us. m. You are not in violation of any obligations concerning child-care, alimony or support. n. You now give up forever all Your rights in any agreement that says that You cannot assign or sell Your rights in the Assigned Assets to Us, You have not requested and You do not expect to receive from Us, a Form 1099 or any other documentation which could make the transaction described by this Agreement taxable to You in any way. You further understand that We have not given to You any advice about any of Your taxes in this transaction. You have relied on Your own professional advisors concerning taxes, o. As of the date of this Agreement, You are of legal age in the state noted as Your address in Section II of this Agreement, mentally sane, and of a sound mind. You have never been convicted of a felony or any other crime involving dishonesty. p. You are very familiar with Your fmancial affairs and condition. With that full understanding, You certify that (I) on the date We pay You the Purchase Price and You sell to Us the Assigned Assets, the fair value of Your assets are and will be greater than all of Your debts; (2) You presently intend to pay all of Your creditors when such payments are due; and (3) You have not intentionally hidden the fact from any creditor of Yours that You have entered into this Agreement and the other documents referred to in this Agreement. q. You do not intend to file for bankruptcy and there are no lawsuits or other efforts by any of Your creditors to put You into bankruptcy or to take the Assigned Assets. r. The Purchase Price is not Your only or most important source of income and You do not have any mental or physical problems that would prevent You from having a paying job. s. You promise to us that no broker, fmder, or other person other than those persons named in the broker statement signed by you in connection with this Agreement was involved in or important in arranging the purchase transaction in this Agreement. No other person has a right to any fee, payment, commission, or other compensation because of this Agreement. t. You agree that We have not forced You to give to Us copies of any confidential documents. You agree that We told You that We only needed to see those documents which described the Assigned Assets so we could buy from You the Assigned Assets. You agree that We do not intend to tell any other party about what is included in those documents. You understand that if We do so, it will only be for the sole purpose of buying the Assigned Assets. miti.~ -. 4 @2006 321 Henderson Receivables Limited Partnership Account ID: 311881 U. You understand that it usually takes six to eight weeks to complete this process, but that it could take longer. You understand that we have to obtain court approval of this transfer. YOU UNDERSTAND THAT, DUE TO OCCASIONAL DELAYS, WE WILL ESCROW THE AMOUNT EQUAL TO THE NEXT TWO MONTHLY PAYMENTS DUE TO YOU FROM THE ANNUITY COMPANY TO INSURE THAT WE RECEIVE ALL OF THE PAYMENTS THAT WE PURCHASE. YOU UNDERSTAND THAT WE MAY EITHER PAY OR ESCROW FUNDS TO SATISFY ANY JUDGMENTS, TAX LIENS OR CHILD SUPPORT AGAINST YOU OR THE ASSIGNED ASSETS AND DEDUCT THOSE AMOUNTS FROM THE PURCHASE PRICE. YOU UNDERSTAND THAT WE WILL DEDUCT FROM THE PURCHASE PRICE ANY AMOUNTS OF PAYMENTS RECEIVED BY YOU PRIOR TO FUNDING, IF SUCH AMOUNTS ARE NOT COVERED BY THE ESCROWED FUNDS. 4, You promise Us that: a. You will not, and will not allow any other party (except Us or Our assignee, if applicable) to take funds away from the Assigned Assets, You will not do anything else to affect the Assigned Assets. You will not say You still own the Assigned Assets. You will not do anything or allow anyone else to do anything that could in any way interfere with or lessen Our rights in the Assigned Assets, b. You will not do anything that will, or could in the future, violate the Release, or any of the agreements required to be executed by this Agreement. You also agree to cooperate with Us to help Us to obtain all of the rights that Weare buying from You in this Agreement and in the Release, c. You will give to Us at least thirty (30) days written notice of Your intention to move Your residence or change Your legal address from the address in Paragraph 11 of this Agreement. d. You will not make any change in Your instructions to the Annuity Company regarding payments to be made to You. Wti_+ -. 5 @2006321 Henderson Receivables Limited Partnership Account ID: 311881 e. You understand that the Annuity and the Release may say that You agree not to sell Your rights to the Assigned Assets. f. You agree to continue to cooperate with Us. This includes Your obligation to immediately deliver to Us any checks, funds or other form of Payment received after the date of this Agreement by You or anyone other than Us. If any Payment is ever denied, delayed, or withheld from Us, as determined by Us in our reasonable discretion, directly or indirectly on account of any act or omission by You or any person acting for You, then You shall be in default under this Agreement (and an Event of Default under ~8 shall be deemed to have occurred). Immediately upon such default, and without any further notice to You, You will pay to Us the following amounts: (i) the full, dollar value of all remaining Assigned Assets as they become due after the date of the default; All of the remedies specified under this section shall be cumulative with all of the remedies for default pursuant to ~ 8 . g. If You learn before or after the signing of this Agreement of the threat or actual beginning of any lawsuit or proceeding that has anything to do with Our rights under this Agreement or the Assigned Assets, then You will immediately notify Us of that and You will give Us copies of all notices and other writings relating to it promptly after You receive them. h. If You receive any notice relating to any supposedly unpaid claim affecting the Annuity or the Assigned Assets or to any other claim against the Annuity or the Assigned Assets, then You will promptly notify Us and will promptly give Us copies of all notices and other writings relating to it received by You promptly after You receive them. 5. RIGHT TO CANCELLATION. YOU MAY CANCEL THIS CONTRACT WITHOUT PENALTY OR FURTHER OBLIGATION WITHIN TWENTY-ONE DAYS FROM THE DATE YOU RECEIVE PAYMENT FROM 321 HENDERSON. In order for the cancellation to be effective, You must mail a notice of cancellation by registered or certified U.S. mail, postmarked within twenty-one (21) days of receipt of the Purchase Price to Us, c/o Vice President of Operations at 3993 Howard Hughes Parkway, Suite 250, Las Vegas, NV 89169-6754. Furthermore, in order for Your notice of cancellation to be effective, Your registered or certified U.S. mail package to us must include a bank or certified check for the full Purchase Price that We paid You under this Purchase Agreement. Any failure to comply with the above procedure shall be a waiver of Your right to cancel this transaction, 6. Your Further Promises. You agree that, from time to time, at Your expense, You will promptly sign and give to Us any and all documents to help Us realize our rights and benefits under this Agreement. This promise includes signing, filing or allowing Us to file financing or continuation statements, or amendments or assignments of those documents. You permit Us or others acting for Us to sign our name and/or your name and file without Your signature such financing statements, if that is permitted in Your state of residence. When You sign this Agreement, You will also sign and deliver to Us a "Special Irrevocable Power of Attorney" You must retain the services of an attorney and deliver an opinion of Your attorney about the sale of Assigned Assets to Us, in a form acceptable to Us. mrti. r- .. 6 @2006321 Henderson Receivables Limited Partnership Account In: 311881 7. Continuation of ReDresentations. Warranties and Covenants. All of Your representations, warranties and promises made in this Agreement will continue to be relied on by Us after this Agreement is signed. 8. Event of Default. Your failure to comply with any term ofthis Agreement or Your . breach of any of Your representations in this Agreement will mean that You will be in default. We refer to this as an "Event of Default." If there is an Event of Default, We have the right to sue You in court to make You perform Your promises or to get money from You. Your failure to comply with any material terms of this Agreement will be a default. In Paragraph 4 (c) You agree to give US at least thirty (30) days written notice after Your move to a new residence or change of Your legal address from the address in Paragraph II of this Agreement. If we are purchasing from You certain lump sum payments, We will contact you at least 3 months before the scheduled payment is due to determine if the address change We have effected with the annuity company is in place and to determine if Your legal address has remained the same. If We cannot contact you because You have changed Your legal address or moved Your residence and failed to notify Us, We will consider such failure to notify Us to be an EVENT OF DEF AUL T and We will exercise all of our legal rights under this Agreement. OUR RIGHT TO PROCEED AGAINST YOU UNDER THIS AGREEMENT SHALL BE SOLELY LIMITED TO WHEN YOU HAVE COMMITTED AN EVENT OF DEFAULT. WE SHALL NOT HAVE THE RIGHT TO SUE YOU IF OR BECAUSE THE ANNUITY COMPANY IS NOT ABLE TO MAKE PAYMENTS BECAUSE IT IS NOT FINANCIALLY ABLE TO DO SO. 9. Controlling Law. This Agreement shall be governed, construed and enforced in accordance with the internal laws of the State of your domicile without regard for the conflicts of law rules thereof or elsewhere, (For Court Orders or Notice Transfers obtained in the following jurisdictions: AK, AR, AL, AZ, CA, CO, CT, DE, FL, GA, HI, lA, In, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, NE, NJ, NM, NV, OH OK, OR, RI, SC, SD, TN, TX, UT, VA, WA, WV and WY the laws of those jurisdictions shall be applied in the event of a dispute regarding the transfer,) Your domicile is the proper place of venue to bring any action arising out of a breach of this Agreement. 10. Responsibility for this Agreement. This Agreement will hold responsible Your heirs, executors, successors and assigns and will benefit Our representatives, successors, beneficiaries and permitted assigns, Nothing in this Agreement is intended to give anyone other than You or Us or each of Our successors or assigns any benefits, 11. Notices. All notices and other communications under this Agreement will be in writing and will be made by delivery by means by which the sender obtains a receipt of delivery from the carrier (including without limitation, certified mail return receipt requested or overnight courier services), addressed to the party to whom a request or demand is to be made. Such demand or notice or request shall be deemed given on the date which is one business day after the date sent by overnight mail or three days after the date sent by certified mail. The addresses of the parties are as follows: If to You: Jennifer Clay 4 Center Drive Camp Hill, PA 17011 mili. t- .. 7 @2006 321 Henderson Receivables Limited Partnership Account 10: 311881 Ifto Us: 321 Henderson Receivables Origination LLC 3993 Howard Hughes Parkway Suite 250 Las Vegas, NY 89169-6754 Attention: Vice President - Operations 12. Past Actions. Anything either You or We did or said before this Agreement was signed will not affect Your or Our rights under this Agreement in any way. 13. Exoenses. Except as otherwise affIrmatively set forth in this Agreement, You and We agree that we will each pay our respective costs and expenses in connection with the carrying out of this Agreement. 14, Headine:s. The section and subsection headings contained in this Agreement are for reference purposes only and will not affect in any way the meaning or interpretation ofthis Agreement. 15. Counteroarts. One or more originals of this Agreement may be signed with Your or Our signature. When put together they will make one agreement and the Agreement will be considered signed by all parties that need to sign. A facsimile signature will be considered an original. 16. Assie:nment. We and anyone to whom We assign this Agreement may assign Our right, title and interest in and to this Agreement, the Annuity and the Assigned Assets without Your approval. You and We agree that if there is an assignment by Us to someone else, We shall not be responsible to You. You must look only to the person or company that We assign this Agreement to for any payment (for example, of the Purchase Price) and performance of this Agreement. When asked by Us or any assignee, You will sign and deliver any such documents as We may require to perform this transaction, as assigned, mi._ t- .. 8 @2006321 Henderson Receivables Limited Partnership Account 10: 311881 17. Your spouse. You and Your spouse are fully aware of Your rights in the Assigned Assets, You and Your spouse fully give up those rights. You and Your spouse understand that by selling the Assigned Assets to Us, You and Your spouse are not receiving the same amount of money as You would if You waited for all of the scheduled Payments of the Assigned Assets but, rather, are receiving a discounted value in return for receipt of the Purchase Price immediately. You and Your spouse have valid reasons for selling the Assigned Assets. You and Your spouse fully understand the terms of the Purchase Agreement and understand that the sale of the Assigned Assets is final. You also understand that Your spouse gives up any property right he or she may have ill the Assigned Assets that Your spouse could claim because of Your marriage. 18. Entire A2reement. This Agreement and the Exhibits and other documents You signed make up the entire understanding and agreement between You and Us about this Agreement. This Agreement replaces all prior agreements, whether written or oral, about this Agreement. This Agreement may not be changed unless in a writing signed by You and Us. 19, Limitation of Liabilitv of Buver. You understand that Our liability to You under this Agreement is strictly limited to the requirement to pay the Purchase Price and under no circumstances will We be responsible for consequential damages. 20. Court Approval. You understand that court approval is required for this transfer. You agree to cooperate with us to obtain such court approval. 21. Exhibits. Attached to this Purchase Agreement are the following Exhibits: Exhibit" A" List of What Payments We are Buying. Intending to be iegally bound, You and We have signed this Agreement as of the date at the top of the first page of this Agreement. 321 HENDERSON RECEIVABLES ORIGINA nON LLC Sworn to and sub~ribed before me this J2!::. day of h6rutli'oo2 ~-Az/'L~ 4Jg;~ Notary NO'NW. SIAl. MNmI PIRICN Notary PubIc CNllHlLIOIOUGIf, OIl-ilL fH)COUNIY - eomn....,.... "'" 22. 2D09 9 @200S 321 Henderson Receivables Limited Partnership Account ID: 311881 Exhibit A We are hereby purchasing from You under the Annuity: A) 1 payment of $20,000.00 on June 14,2011 B) 1 payment of $25,000.00 on June 14,2016 <3IGN HERE I STATE OF : COUNTY OF Cumb.er(ti.4l;: On this d-- day of 1.(. bn<a~ 200!1, before me, the above signed personally appeared before me, personally known to me to be the person whose name s subscribed to the within instrument and acknowledged to me that he executed it. ~/~ /lIj/Zf~~ Notary NOTARIAL SEAL ANNE11E PERICINS Notary PublIc CNIf1HUIIOIIOUGiMf. CUlIB\lNC)COUN1\' Mv Commlulm bpIMI .Iul22. 2009 Account ID: 311881 SCHEDULE 1 DISCLOSURE STATEMENT PLEASE BE ADVISED THAT THE PROPOSED TRANSACTION IS A SALE, NOT A LOAN, AND THAT YOU WILL BE SELLING ALL RIGHTS AND TITLE TO THE ASSIGNED ASSETS ONCE THIS TRANSACTION IS CONSUMMATED. PLEASE BE ADVISED THAT YOU MAY BE SUBJECT TO ADVERSE FEDERAL AND STATE INCOME TAX CONSEQUENCES AS A RESULT OF THE PROPOSED TRANSACTION. YOU SHOULD CONSULT YOUR OWN COUNSEL, ACCOUNTANT, OR FINANCIAL ADVISOR REGARDING ANY FEDERAL OR STATE INCOME TAX CONSEQUENCES ARISING FROM THE PROPOSED TRANSFER. YOUR PURCHASE PRICE WAS DERIVED ASSUMING A DISCOUNT RATE SIGNIFICANTLY HIGHER THAN THE PRIME INTEREST RATES CHARGED BY COMMERCIAL BANKS, THEREFORE, WE URGE YOU TO EXPLORE ALL FINANCIAL OPTIONS. WE WILL PURCHASE FROM YOU A) 1 payment of $20,000.00 on June 14, 2011 B) 1 payment of $25,000.00 on June 14,2016 [THE REMAINDER OF THIS PAGE LEFT BLANK INTENTIONALLY] Account ID: 311881 SCHEDULE 1. PAGE 2 THE AGGREGATE AMOUNT OF THE PURCHASED PAYMENTS IS $45,000.00. THE DISCOUNTED PRESENT VALUE OF THE AGGREGATE PAYMENTS AT 5.60% IS $30,763.43. THE DISCOUNTED PRESENT VALUE IS THE CALCULATION OF THE CURRENT VALUE OF THE TRANSFERRED STRUCTURED SETTLEMENT PAYMENTS UNDER FEDERAL STANDARDS FOR VALUING ANNUITIES. THE GROSS AMOUNT PAYABLE TO SELLER IS $20,500.00. THE FOLLOWING EXPENSES ARE INCURRED BY THE SELLER (YOU) AND WILL BE DEDUCTED FROM THE PURCHASE PRICE: COMPLIANCE AND ADMINISTRATIVE FEE: $500.00 FILING AND RELATED EXPENSES FEE: $0.00 THE NET AMOUNT PAYABLE TO THE SELLER(YOU) IS $20,000.00. NO OTHER EXPENSES ARE INCURRED BY YOU. THE DISCOUNTED PRESENT VALUE OF PAYMENTS SHALL BE CALCULATED AS FOLLOWS: THE APPLICABLE FEDERAL RATE USED IN CALCULATING THE DISCOUNTED PRESENT VALUE IS 5.60%. THE EFFECTIVE ANNUAL DISCOUNT RATE FOR THIS TRANSACTION IS 12.71 %. THE CASH PAYMENT YOU RECEIVE IN THIS TRANSACTION FROM US WAS DETERMINED BY APPLYING THE SPECIFIED EFFECTIVE ANNUAL DISCOUNT RATE, COMPOUNDED MONTHLY, TO THE TOTAL AMOUNT OF FUTURE PAYMENTS TO BE RECEIVED BY US, LESS THE TOTAL AMOUNT OF COMMISSIONS, FEES, COSTS, EXPENSES AND CHARGES PAYABLE BY YOU. THE NET AMOUNT THAT YOU WILL RECEIVE FROM US IN EXCHANGE FOR YOUR FUTURE STRUCTURED SETTLEMENT PAYMENTS REPRESENTS 65.00% OF THE ESTIMATED CURRENT VALUE OF THE PAYMENTS BASED UPON Account ID: 311881 SCHEDULE 1. PAGE 3 THE DISCOUNTED VALUE USING THE APPLICABLE FEDERAL RATE. THE QUOTIENT OBTAINED BY DIVIDING THE NET PAYMENT BY THE DISCOUNTED PRESENT VALUE IS 65.000/0. BASED ON THE NET AMOUNT THAT YOU WILL RECEIVE FROM US AND THE AMOUNTS AND TIMING OF THE STRUCTURED- SETTLEMENT PAYMENTS THAT YOU ARE TURNING OVER TO US, YOU WILL, IN EFFECT, BE PAYING INTEREST TO US AT A RATE OF 12.71% PER YEAR. THE NET AMOUNT PAID TO YOU (THE PAYEE) BY US (THE TRANSFEREE) REPRESENTS AN ESTIMATE OF THE FAIR MARKET VALUE OF THE FUTURE PERIODIC PAYMENTS TRANSFERRED UNDER THE STRUCTURED SETTLEMENT AGREEMENT. NOTICE OF CANCELLATION RIGHTS: YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO 5:00 P.M. OF THE TWENTY-FIRST DAY FOLLOWING THE LATER OF THE EXECUTION OF THE PURCHASE AGREEMENT, OR THE DATE THE PAYEE BECOMES OBLIGATED UNDER THE PURCHASE AGREEMENT WITHOUT PENALTY OR FURTHER OBLIGATION. THIS CANCELLATION RIGHT CANNOT BE WAIVED IN ANY MANNER. TO CANCEL, YOU MUST PROVIDE WRITTEN NOTICE TO THE TRANSFEREE. WRITTEN NOTICE SHOULD BE MAILED OR DELIVERED TO THE ADDRESS BELOW BY 5:00 P.M. OF (THE TWENTY-FIRST DAY FOLLOWING THE TRANSACTION). IT IS BEST TO MAIL IT BY CERTIFIED MAIL, RETURN RECEIPT Account 10: 311881 SCHEDULE 1. PAGE 4 REQUESTED, AND TO KEEP A PHOTOCOPY OF THE SIGNED FORM AND YOUR POST OFFICE RECEIPT. ADDRESS TO WHICH CANCELLATION IS TO BE RETURNED: 321 HENDERSON RECEIVABLES ORIGINATION LLC 3993 HOWARD HUGHES PARKWAY SUITE 250 LAS VEGAS, NV 89169-6754 ATTENTION: VICE PRESIDENT - OPERATIONS IMPORTANT NOTICE: YOU ARE STRONGLY URGED TO CONSULT WITH AN ATTORNEY WHO CAN ADVISE YOU OF THE POTENTIAL TAX CONSEQUENCES OF THIS TRANSACTION. PLEASE BE ADVISED THERE ARE NO PENALTIES OR LIQUIDATED DAMAGES PAYABLE BY YOU IN THE EVENT OF ANY BREACH OF THE TRANSFER AGREEMENT BY YOU. THERE ARE NO BROKERS COMMISSIONS, SERVICE CHARGES, APPLICATION FEES, PROCESSING FEES, CLOSING COSTS, FILING FEES, ADMINISTRATIVE FEES, LEGAL FEES, NOTARY FEES AND OTHER COMMISSIONS, FEES, COSTS, EXPENSES AND CHARGES PAYABLE BY YOU OR DEDUCTED FROM GROSS AMOUNT OTHERWISE PAYABLE TO YOU OTHER THAN THE COMPLIANCE AND ADMINISTRATIVE FEE AND THE FILING AND RELATED EXPENSES FEE. IF YOU BELIEVE YOU WERE TREATED UNFAIRLY OR WERE MISLED AS TO THE NATURE OF THE OBLIGATIONS YOU ASSUMED UPON ENTERING INTO THIS AGREEMENT, YOU SHOULD REPORT THOSE CIRCUMSTANCES TO YOUR LOCAL DISTRICT ATTORNEY OR THE OFFICE OF THE ATTORNEY GENERAL. THE EFFECTIVE DATE OF THE TRANSFER AGREEMENT SHALL BE DEEMED TO BE THE DATE THAT THE AGREEMENT WAS SIGNED BY THE YOU (PAYEE). PLEASE BE ADVISED THAT PAYMENT TO YOU PURSUANT TO THE TRANSFER AGREEMENT IS CONTINGENT UPON COURT APPROVAL OF THE TRANSFER AGREEMENT. Account ID: 311881 SCHEDULE 1. PAGE 5 PLEASE BE ADVISED THAT PAYMENT TO YOU WILL BE DELAYED UP TO 30 DAYS OR MORE IN ORDER FOR THE COURT TO REVIEW AND APPROVE THE TRANSFER AGREEMENT. BY SIGNING BELOW YOU ARE CONFIRMING RECEIPT OF THIS DISCLOSURE AT LEAST 10 DAYS PRIOR TO RECEIPT OF THIS ONTRACT. ~IGN HERE I I CERTIFICATE OF SERVICE I, Michael D. Rentschler, Esquire, do hereby certifY that, on the date stated below, I served a copy of the foregoing Petition and the attachments upon the following by Certified Mail, return receipt requested and addressed to: Allstate Life Insurance Company 544 Lakeview Parkway, L3F Veroon Hills, IL 60061 Attn: Structured Settlement Department Allstate Settlement Corporation 3100 Sanders Road M3b Northbrook, IL 60062 Attn: Structured Settlement Department Date: ~~~ Michael D. Rentschler, Esquire 28 N. 32nd Street Camp Hill, PA 17011 (717) 975-9129 P A Supreme Court ID # 45836 (') r; :<-~'" ri~ i. ~~~'~ ~? -.Jj - . ~;;? ;~;' ::~ (;~,j ~;j z =< r-...) = = -.I .." I'"rJ OJ o -n .-4 :r n,:n I -oi" ~.o6 o -., .....;-1 -ri L-n ", -.- ,~() (5m ;g .n -< C1'I ". ::c o 6 1 ' J FEe 16 2007 f\ Jr. / iN THE MATTER OF JENNIFER CLAY : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, PENNSYLVANIA ~ NO. 07- W'O CIVil ORDER AND NOW, this day of rk~ a I ~ ,2007, upon consideration of the Petition for Approval of Transfer of Structured Settlement Payment Pursuant to the Structured Settlement Protection Act, a hearing is hereby scheduled to occur at the Cumberland County Courthouse, Courtroom .3 , ? e>I floor, on ~ J"t; , the ti 1 ~ day of IV" ~.J.. , 2007, at /. :30 :2. m., the Honorable Judge C; '-'t · Cit> presiding. , oJ Distribution: Michael D. Rentschler, Esquire ~ ~ ~ Allstate Settlement Corporation d>. , ~ Allstate life Insurance Company ~ I Court Administrator 321 Henderson Receivables Origination, llC ..l . )(,,07 d.,lk'O) c+- ii;N~H\1ASNN3d I ll\lj"'rr\ ,",! 'V-'l :..,.....lhln" I\J.J ~. tv'-.) :".: j \ ,'" <t:'~t'!y 'i V C iJ : II WV 91 83.:JLOOZ AtfrllONOi-lJ.Ocd 31-U :10 38l:tlo-cmH . IN THE MATTER OF JENNIFER CLA Y IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA NO, 07-880 CIVIL Jk\ ORDER AND NOW, this d~ day of March, 2007, upon consideration of the unopposed petition of Jennifer Clay a/kJa Jennifer Brown a/kJa Jennifer N, Brown a/kJa Jenna Brown ("Ms, Clay"), the Court hereby finds as follows: 1. The Court has jurisdiction over this matter pursuant to the Pennsylvania Structured Settlement Protection Act, 40 P.S. ~ 4001 et seq. 2. The transfer of the structured settlement proceeds, specifically one lump sum payment of $20,000,00 due on June 14,2011 and one lump sum payment of $25,000.00 due on June 14,2016 (the "Assigned Payments"), by Ms. Clay to 321 Henderson Receivables Origination LLC ("321 Henderson") as described in the purchase agreement between Ms, Clay and 321 Henderson (the "Purchase Agreement") and in the petition in this matter (the "Proposed Transfer") (i) does not contravene any applicable federal or state statute or the order of any court or responsible administrative or governmental authority or any applicable law limiting the transfer of workers' compensation claims, and (ii) is in the best interest of Ms. Clay, taking into account the welfare and support of Ms. Clay's dependents, 3. The Proposed Transfer complies with the requirements of the Structured Settlement Protection Act, 40 P.S. ~ 4001 et seq. and 215 ILCS 153/1 et seq" and does not contravene other applicable law. BE\360691 \2 4. Not less than 10 days prior to the date on which Ms. Clay first incurred any obligation with respect to the Proposed Transfer, 321 Henderson provided Ms, Clay a disclosure statement in full compliance with 40 P,S. g 4003(a)(2). 5. Ms. Clay has received or expressly waived, in a separate written acknowledgment signed by Ms. Clay, independent legal advice regarding the implications of the Proposed Transfer, including consideration of the tax ramifications of the Proposed Transfer. 6, Ms, Clay has given written notice of321 Henderson's name, address and taxpayer identification number to Allstate Settlement Corporation and Allstate Life Insurance Company ("Allstate Life") (collectively, "Allstate"), and has filed a copy of such notice with the Court. 7. Ms, Clay has timely filed and served on all interested parties, including Allstate, a notice of the Proposed Transfer and the application for its authorization in compliance with the requirements of 40 P .S. g 4004, 8, The underlying personal injury action was pending before the District Court, County of Arapahoe, State of Colorado, Civil Action No, 89 CV 1910, Division 4, at the time of settlement and was dismissed pursuant to the Order attached hereto as Exhibit "A," 9, Ms, Clay has consented, in writing, to the Proposed Transfer, Based upon the foregoing findings, IT IS HEREBY ORDERED that: 1. Pursuant to 40 P.S. ~ 4003, the Proposed Transfer is approved. Until the due date of the last Assigned Payment, the designated beneficiary under annuity contract no, 90480055 shall be the Estate of Ms. Clay, However, 321 Henderson's right to receive the Assigned Payments shall not be affected by Ms, Clay's death. 2. Allstate Life shall forward the Assigned Payments, within 7 days of the date due, by check made payable to "321 Henderson Receivables Origination LLC," at P.O, Box 7780- BE1360691\2 -2- 4244, Philadelphia, PA 19182-4244, as follows: one lump sum payment of $20,000.00 due on June 14,2011 and one lump sum payment of $25,000,00 due on June 14,2016, 3, In the event 321 Henderson further assigns or otherwise transfers the Assigned Payments (or any portion thereof or interest therein) to another person or entity (a "Reassignment"), Allstate will not itself be obligated to redirect the Assigned Payments (or any portion thereof) to any person or entity other than Henderson or to any payment address other than that specified herein, and Henderson shall remain obligated to comply with all terms and conditions herein. 4. All remaining Periodic Payments (and/or portions thereof), if any, that are not the subject of the Proposed Transfer and not previously assigned, shall be made payable to Ms. Clay and will be forwarded by Allstate Life, when due, to Ms. Clay's most recent known address or any payment address designated by Mr. Clay, subject to the consent of Allstate. 5, 321 Henderson shall defend, indemnify, and hold harmless Allstate, and its directors, shareholders, officers, agents, employees, servants, successors, and assigns, and any parent, subsidiary, or affiliate thereof, and their directors, shareholders, officers, agents, employees, servants, successors, and assigns, past and present, from and against any and all liability, including but not limited to costs and reasonable attorney's fees, for any and all claims made in connection with, related to, or arising out of the Purchase Agreement, the Proposed Transfer, the Assigned Payments, any Reassignment, or Allstate's compliance with the parties' Stipulation or this Order, except with respect to claims by 321 Henderson against Allstate to enforce Allstate's obligations to 321 Henderson under the parties' Stipulation. To the extent that 321 Henderson fails to honor this indemnification and defense obligation, Allstate may, in BE\360691\2 - 3 - addition to all other remedies afforded by law, satisfy the same by withholding to its own credit any remaining Assigned Payments, 6. Allstate's lack of opposition to this matter, or its or 321 Henderson's stipulation hereto or compliance herewith, shall not constitute evidence in this or any matter, and is not intended to constitute evidence in this or any matter, that: (a) payments under a structured settlement contract or annuity or related contracts can be assigned or that "anti-assignment" or "anti-encumbrance" provisions in structured settlement contracts or annuities or related contracts are not valid and enforceable; or (b) other transactions entered into by 321 Henderson and its customers constitute valid sales and/or secured transactions; or (c) Allstate has waived any right in connection with any other litigation or claims; or (d) 321 Henderson has waived any right other than as expressly set forth in the parties' Stipulation and/or this Order. 7, 321 Henderson and Ms. Clay, for themselves and for their respective directors, shareholders, officers, agents, employees, servants, successors, heirs, beneficiaries, contingent beneficiaries, executors, administrators, and assigns, and any parent, subsidiary, or affiliate thereof, and their directors, shareholders, officers, agents, employees, servants, successors, and assigns, past and present (the "Releasors"), hereby remise, release and forever discharge each other and Allstate, and its directors, shareholders, officers, agents, employees, servants, successors, and assigns, and any parent, subsidiary, or affiliate thereof, and their directors, shareholders, officers, agents, employees, servants, successors, and assigns, past and present (the "Allstate Releasees"), of and from any and all manner of actions and causes of action, suits, debts, dues, accounts, bonds, covenants, contracts, agreements, judgments, settlements, damages, claims, and demands whatsoever, in law or in equity, in connection with, related to, or arising out of any claim or allegation that was or could have been asserted in connection with, related to, BE\360691\2 -4- or arising out of the Purchase Agreement, the Assigned Payments, the Proposed Transfer, or the parties' Stipulation, which against each other or the Allstate Releasees, the Releasors have or had from the beginning of the world through the date of this Order, except for claims ofReleasors against the Allstate Releasees to enforce the Allstate Releasees' obligations to Releasors, if any, under the parties' Stipulation or this Order. Edward E, Guido, Judge ~/D~ R~ I?/~ ,fa \,.~ 11 (A'~ 'J\~ BE\360691\2 -5- '"I '-".'\1('10 ;' :<~,.(,~~l.! 1> fJ 0 :2 ~id 62 ~V~HaOl Atfv'10i'iOH.lCdd 3Hl ;jO 3~)lj:lO-(]:1l1:! EXHIBIT A BE\360691\2 03-29-'07 09:47 FROM- Og/28/2007 04:06 FAX 8109938585 Mar. 28, 2)07 '2~35PM 484-434-2263 DRINKER BIDDLE L T-930 P015/016 F-116 Idl016/017 No. 0245 P. 11/22 CC~~~ DtsnUCl COURT. C011N'lY or AlW'AII0E. STATE OF COLORADo ChG AdloIa He .. CV 1910, DtrtIIoIa /I OIlDER TO DISMISS 'WITH PREJtJDICE JENNIFER N. BR.OWN, . mIDor, b1 ad IUoIIp bel' 1IlOthcr, ..hind ........ .. .. ttftllCl, LQllt)A J. STEWART, P"~ YS. WASTE MANAGEMENT 0'6 COLORADO, INc., iJ/b/a COLORADO DISPOSAL, 1Ne., ...- DONAW r. AMES, Dehdu.... .. ._..~ THE COlJRT, M\Iia. ~ QaO "~,,,' lomt M'otioD to DismLw with PrcjudiR. the ]remiles alated thereia, and .he Court me; D01H ORDER that this matter fa hereby dtaDl!aed 'NitIl prejudice, each put)' to pay Ita 0WIl caslJ.. DONE th1s day of JUt. 2 S ~H" -"""0-' 1991. :BY nm cx)URT! JAMES F. MACRUM DISTIWl' JUDIE J... P. Macrum.lr. DJstrict Court ludIC 03-29-'07 09:47 FROM- b3/28/2007 04:08 FAX 610B838585 Mar. 28. 2( 07 12: 34PM 484-434-2263 DRINKER BIDDLE L T-930 P016/016 F-116 IdJ017/017 No. 0245 f', 10/L2 CC~~)f ". .. DISTRICT CO'UR.T, COllN'l'Y or ARArAHOE, STATE OJ CO!DlW)O CIlO AcdOJI No. BCV 1110, ~.. · - . . - 0- .- ~ :~ ~ t; ! 3 .,..., ,.... , ~ JOINT M0'l10N TO DISMISS W1TB PlUUVDICB JmItND'ER N.BROWN. .1IIfaor, b1 ad duo'- her mo..... IUItdI'8I padIH. .. _. LINDA J. STEWART, JllaIDd, va. WASTE MANAG:EMOIT 01' COLORADO, me.. MIl- COlDRADO DlSI'OSAL, 1Nc., ad DONALD f. AMES, ~ "l~~ COME NOW the parti.. by IIId dIrouJh their Ielpecti\'e attorneys. aqd borcby at.cwe this HoaanbJa Olurt for aa Order dlsmiJsiDJ ti cue'Ymh p1ejudkc, each pmy to pay 111 own "".. A& grouzW tberefor, the parties wou.ld Ihow UJltD tJaiI Coun u lo1IotPJ: 1. lb. panles horeln b8YI: amlcably resoIvcd &heir dIfl'emaca and bava ra.ehed. 8I11111'...e:maIlt to settle tbk matter. 2. AI a n:alllt. ClIo panics rcquat met thrs Court enter aD Orcfer dlsmissm, this b1.tNf wJtlll'rdj~ eBCh Part7 to PI)' ill own COIfs. WHEREAS, baaed. Oil the foreJOlaJ, aM partia rcquc:lt tbat this Omit eAter .a Order dilClRif.,iftJ Plalndffl Com,Jablit with. Prll'judi, . part1 to pay .its OWB costs. _pooll\llly submi- IhII ..:v d.r ofj'5# / rt.~ KJm avid Po!atto, ~1 of HALL " EVANS 1100 ScwnteeDdl Street Suite 11001Denver, C4Iorado S0202 (303) 628-3300 A'ITORNEYS FOil DEPENDANIS 1. oCNcDBW ct RJiILLY 18110 GayIOKd Street Domer. Colorado 80206-1211 (303) 39U037 ATTO~ POR PLAIN'J'JFP