HomeMy WebLinkAbout08-3819MARO & MARO, P.C.
By: Robert A. Maro, Esquire
Attorney I.D. No.: 89585
1115 West Main Street
Norristown, PA 19401
(610) 275-9600
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
RE: Joint Petition of 321 Henderson NO: 0$- ??? 9 Cival-arv.
Receivables Origination, LLC and
Shawn Dolan
JOINT PETITION FOR PARTIAL TRANSFER OF STRUCTURED
SETTLEMENT PURSUANT TO STRUCTURED SETTLEMENT PROTECTION
ACT. 40 P.S. 4000. ET SEO.
TO THE HONORABLE JUDGES OF SAID COURT:
And now comes your petitioner, 321 Henderson Receivables Origination, LLC,
by and through its attorneys, Maro & Maro, P.C., and joint petitioner, Shawn Dolan, and
in accordance with the applicable rules of Pennsylvania Civil Procedure, hereby
represents as follows:
1. Petitioner is 321 Henderson Receivables Originations, LLC. ("Buyer" or
Transferee"), with an office address located at 40 Morris Avenue, Bryn Mawr,
Pennsylvania, 19010.
2. Joint Petitioner is, Shawn Dolan ("Payee"), an adult individual who resides at
508 Evergreen Rd., New Cumberland, PA 17070.
3. This Joint Petition has been verified by the Transferee, 321 Henderson
Receivables Origination, LLC. and the Petition includes all necessary information as
prescribed by PA R.C.P. 229.2(d) et al and Section 3 of the Act, 40 P.S. §4001 et seq.
4. Pursuant to PA. R.C.P. No. 229.2(d)(3) there are four (4) attachments
incorporated herein as follows:
a. PA R.C.P. 229.2(d)(3)(i) Payee's Affidavit in Support of Petition.
Please see Attachment/Exhibit "1' ; and
b. PA. R.C.P. 229.2(d)(3)(ii) An Initial Order of Court Scheduling
Hearing;
C. PA. R.C.P. 229.2(d)(3)(iii) A certification by Robert A. Maro, Esquire,
attorney for transferee, 321 Henderson Receivables Originations,
LLC.; and
d. PA. R.C.P. 229.2(d)(3)(iv) A Final Order of Court Granting
he Petition.
5. Joint Petitioner, Shawn Dolan, is the beneficiary of an annuity
owned by The Travelers Casualty And Surety Company and issued by ING Life
Insurance and Annuity Company. The structured settlement provides payment to the
petitioner as described on Attachment/Exhibit "2".
6. Joint Petitioner, Shawn Dolan, was represented by independent counsel in this
transaction. Joint Petitioner, Shawn Dolan and his attorney have reviewed and discussed
the terms of this transaction together and fully understating the terms therein, freely and
voluntarily executed the Purchase Agreement, Exhibit "A" to the Purchase Agreement
and the Disclosure Statement. A letter of representation from the attorney for Shawn
Dolan is attached hereto, incorporated herein and marked Attachment/Exhibit 443".
7. Joint Petitioner, Shawn Dolan, proposes to enter into a purchase agreement
with 321 Henderson Receivables Origination L.L.C.., its nominees, successors, or
assigns, whose address is 40 Morris Avenue, Bryn Mawr, Pennsylvania, 19010, who will
purchase the following from Petitioner's structured settlement as follows:
A) 228 monthly payments of $850.00 each, beginning
on August 5, 2008 and ending on July 5, 2027
8. The structured settlement is currently owned by The Travelers Casualty And
Surety Company and issued by ING Life Insurance and Annuity Company, and the net
amount in return payable to Shawn Dolan is $71,000.00 from Buyer. A copy of the
Purchase Agreement, Exhibit "A' to the Purchase Agreement and Disclosure Statement is
attached hereto, made apart hereof, and designated Attachment/Exhibit 64499
.
9. The net amount payable to the payee after deduction of all commissions,
fees, costs, expenses, and charges is $719000.00.
10. Based on the net amount that the payee will receive from this transaction
$71,000.00 and the amounts and timing of the structured settlement payments that
would be assigned, the payee is, in effect, paying interest at a rate of 13.66% per
year.
11. The Buyer furnished Shawn Dolan with a Disclosure Statement pursuant to
40 P. S. 4003 See Attachment/Exhibit "4") at least ten (10) days prior to the date on
which Shawn Dolan first incurred any obligation to the Buyer.
12. PA R.C.P. 229.2(b) requires the petition to be filed in the county in which the
payee is domiciled See also Section 4 of the Act 40 P.S. §4004). PA.R.C.P. 229.2(c)
also requires both the Transferee and Payee to be parties to the Joint Petition. Both
requirements have been fulfilled herein.
13. Written notice of the Transferee's Names, address and taxpayer identification
number has been given to the Annuity Issuer and Structured Settlement Obligor. A copy
of the Notice to the structured settlement obligor is attached hereto as Attachment/Exhibit
"Y'. Joint Petitioners wills also serve written notice as required by 40 P.S. 4004 upon
all interested parties.
14. The Joint Petitioner's best interest would be served by granting the relief
requested herein for the following reasons. Joint Petitioner is currently signle and has no
minor children. Joint Petitioner has never sold payments under his annuity in the past.
Joint petitioner is self employed as a contractor/painter. The purpose of this partial
transfer is to assist Mr. Dolan with relocating and purchasing a home. Mr. Dolan feels
that by transferring his payments now, and receiving the lump sum, he will be able to put
more or a down payment on a home, thus lowering his mortgage payments per month.
Mr. Dolan is of sound mind and was advised by independent counsel regarding the tax
consequences of this transfer. Mr. Dolan feels this transfer is in his best interest. Based
on the foregoing which will be expanded upon at the time of trial, the transfer is clearly
within the best interest of Mr. Dolan.
WHEREFORE, Joint Petitioner's respectfully requests this Honorable Court to
enter the Initial Order attached to this petition which shall schedule a hearing so that
Transferee and Payee shall have the opportunity to discuss the purpose and reasons for
the transfer and after hearing thereon, respectfully request that this Honorable Court enter
a Final Order approving the Transfer of Structured Settlement Payments Rights as is
mentioned herein.
Maro & Maro, P.C.
By:
Attorney for Transferee
VERIFICATION
I, Maureen Healy, Vice President of 321 Henderson
Receivables Origination LLC, have read the foregoing Petition to Transfer Structured
Settlement Payment Rights between 321 Henderson Receivables Origination LLC and
a ^ and hereby aver that the statements contained
therein are true and correct to the best of my knowledge, information and belief.
This Verification is made subject to the penalties of 18 Pa.C.S.A. Section 4904
relating to the unworn falsification to authorities.
Maureen Healy, VP
G-as-)-00
Date
CERTIFICATION OF ATTORNEY FOR TRANSFEREE
I, Robert A. Maro, Esquire, attorney for Transferee, 321 Henderson Receivables
Origination L.L.C., hereby certify to the best of my knowledge, information and belief,
formed after reasonable inquiry, that the Transfer will comply with the requirements of
the Act (40 P.S. § 4000 et seq.) and will not contravene any other applicable federal or
state statute or regulation or the order of any court or administrative authority.
I, Robert A. Maro, Esquire, attorney for Transferee, 321 Henderson Receivables
Origination L.L.C., hereby verify that the facts and statements set forth herein are true
and correct to the best of my knowledge, information and belief. I understand that false
statements made herein are subject to the penalties of 18 Pa. C.S.A. Section 4904 relating
to unworn falsification of authorities.
Date
Attorney for Transferee, 321
Henderson Receivables Origination
L.L.C.
MARO & MARO, P.C.
By: Robert A. Maro, Esquire
Attorney I.D. No.: 89585
1115 West Main Street
Norristown, pA 19401
(610) 275-9600
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
RE: Joint Petition of 321 Henderson
Receivables Origination, LLC and ; NO:
Shawn Dolan
CERTIFICATE OF SERVICE
I, Robert A. Maro, Esquire, hereby certify that a true and correct copy of the
Petition for Transfer of Partial Structured Settlement has been served upon the following
entities via first class mail and/or certified return receipt requested and/or email on :
The Travelers Casualty And Surety Company
Corporation Service Company
2711 Centerville Road, Suite 400
Wilmington, DE 19808
ING Life Insurance and Annuity Company
Attn. Ida Colon
One orange way
Mail Stop C IS
Windsor, CT 06095-4774
Lawrence J. Rosen
Attorney for Shawn Dolan
1101 N Front Street
Harrisburg, PA 17102-3324
Shawn Dolan
508 Evergreen Rd.
New Cumberland, PA 1
Date: G-)-S06
By:
Attorney for 321 Henderson Receivables
Origination L.L.C.
ATTACIIMENT/EXMBIT "1"
Account ID: 374614
Payee's Affidavit in Support of
Petition to Transfer Structured Settlement Rights
I, Shawn Dolan, the payee, verify that the statements below are true and correct:
Payee's name, address and age: Shawn Doha/ 508 Evergreen Rd.
New Cumberland, PA / 32.
I• Marital status:
X Never Married; , Married;
Separated; _Divorced
If married or separated, name of spouse: N/A
3• Minor Children and other dependents:
Names, ages, and places of residence: None.
4• Income:
I am self - employed as a construction Worker /Painter where I earn
approximately $25,000.00 annually.
If presently married, spouse's monthly income and sources: N/A
5. Child support, alimony or alimony pendente lite:
Obligation to pay: Yes ?X No
If yes, state the amount of the obligation, to whom payable, and whether there are
6. Previous transfers:
Have you previously filed a petition to transfer payment rights under the
structured settlement that is the subject of this petition? Yes --X _No
If yes, for each petition that you filed,
Account ID: 374614
(a) If the transfer was submitted for court approval, list the
court, the case caption and case number, and state whether the
court approved or disapproved the transfer:
(b) If the transfer was approved,
(i) State the name of the transferee and identify (listing due
dates and payment amount(s)) the payments involved in the
transfer:
State the amount of money and the manner in which the
money was used:
(c) Have you ever transferred payments without court approval? If so,
please explain: No
7. Reasons for transfer:
explanation as to why a sale of a lesser amount of the structured settlement
amount will better serve your interests: I want to use the money from this transfer
to relocate a purchase home. The small monthly payments I currently receive will
not allow me to do so.
8. Payment of debts:
If you seek the transfer in order to pay debts, list each debt, including the name of
Describe in detail you reasons for the proposed transfer, including an
the creditor and the amount presently owed:
Account ID: 374614
Debt Creditor
Amount Owed
N/A
Verification
I verify that the statements made in this affidavit are true and correct. I understand
that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904, relating
to unworn falsification to authorities.
DATED:
Signature -
(g) the initial order of court shall be substantially in the following form:
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
COMMONWEALTH OF PENNSYLVANIA
IN RE: TRANSFER OF STRUCTURED
SETTLEMENT PAYMENT RIGHTS BY
SHAWN DOLAN '
• CONTROL NO.
-----------------------------------------------
On this day of
2_ ____, it is ordered that a hearing
on this Petition to Transfer Structured Settlement Payment Rights will be held on
in Courtroom at o'clock. The payee shall bring
income tax returns for the prior two (2) years to the hearing.
Within seven (7) days, the transferee shall give notice of the hearing date to the
payee, the structured settlement obligor, the annuity issuer. the
payee's spouse and any
person receiving child support, alimony, or alimony pendent elite. The transferee shall
attach a certificate of service to the notice of hearing date. A copy of the notice with the
ATTACHMENT/EXHIBIT "2"
Jun 23 08 10:20a LKQ Penn mar
ING.M
Scott Sweosen
Salior Policy Services Coordinator
June 18, 2008
SHAWN DOL,AN
508 EVERGREEN RD
NEW CUMBERLND, PA 17070
Dear Mr.. Dolan:. _ .
RE: Annuitant Name:
Account Number:
SHAWN DOLAN
SS W001000 WS00
7172661270
P- 1
This letter is to confirm that Shawn Dolan received and or,
payments under the above listed COMM t.
360 monthly guaranteed
then for life thereafter. of $850.00 from 08/0511
receive the following
through 07/0527 and
The provisions of the contract do not allow for withdrawals The owner
Travelers Casualty and Surety Company The issuer of th e a of this contract is
Insurance and Annuity company. p yments is No Life
If you have any questions, please call our toll free custom
and 5:00pm EST, at 1-800-238-6273, please select option
Sincerely,
Scott G. Swensen
ING Life Insurance and Annuity Cotnpaay
Payout Sa vices, 'M31
One Orange Way
Windsor, CT 06095
Tel.: 800-238-6273 option 2
Fax: 800.433-5366
r service line between 8:00am
x`srrr wrAww Qr
MPthaaWstA&*&, . =- M-,,..WPC
ATTACHMENT/EY,IMIT "3"
xxe? &, Aje?"q.?e
COUNSELORS AT LAW
1101 NORTH FRONT STREET
HARRISBURG, PENNSYLVANIA 17102-3324
Sanford a ICrevslry
Lawrence J. Rosen
Joshua M. Goldberger
June 11, 2008
J.G. WENTWORTH
40 MORRIS AVENUE
BRYN MAWR, PA 19010
>ti F Dolan
To Whom it May Concern:
I have provided representation to Shawn F. Dolan on the structured settlement
matter. I have provided him with legal, tax and financial advice regarding same.
Sincerely,
Lawrence J. Rosen
Tel. (717) 234.4583
Fax (717) 2343650
LJR:alr
ATTACHMENT EXHIBIT 44499
Account ID: 374614
PURCHAeir pC?E-iME.?
This is a Purchase Agreement. The date of this A s ! 1
Seller. 321 Henderson Receivables Origination is 200 0 Shawn Dolan is the
and/or assigns is the Buyer. In this A gination LLC, a Nev Limited Liability Company, its successors
Henderson Receivables Origination t?eement, Shawn Dolan is referred to as "You" or "Your" and 321
LLC or its nominee, is referred to as "we,,, "Us" or Our..
BACKGR UNDO THic ero???,r? ....
1. You or someone on your behalf signed a Settlement Agree mnt (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 ING
Life Insurance and Annuity Company (the "Annuity Company").
3. A list of the Payments being sold under this Agreement is attached to this Agreement as
Exhibit "A".
under 4. You desire to sell and assign to Us all of Your rights to receive allhaveor a
er the Release, as described on Exhibit "A", all of the other rights You uncl eRele ase a ndthey
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. >?umh, aae And ??
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
accepting the We and assignment of all of the Assigned Assets described above. and
b. The Gross ase Price is Seventy-One Thousand Five Hundred
Cnts (R-tot
l 500.00). The Net Purchase Price Lars and 00/100
Price"). The Net Purchase Price will be paid to You when isbothlYou pand Wee siP gnu
this
Agreement and We have completed Our internal process.
2. AeknOwledjLW
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
after Your death shall be sent 2)P8ymena Ch of the Assigned Assets
of Beneficiary Form
changing the beneficiary of the A ped Assets, after your de
ath
Receivables Origination LLC", as sole bnefic' , to "321 Henderson above the Change of Beneficiary FormJ. The Change of Beneficiary Form will s
referred to a
tate that the
instructions may never be revoked and that no change may be made in the instructions or
02008 321 HaWemn Re06,,sbks 0jriSination LLC
Account ID: 374614
in the payments (including as to the payee or the manner or lace of
making payments) without Our prior written consent. You will also, when thimaking such
signed by You and Us, deliver to Us, addressed as We ma Agreement is
instructions or documents, and copies of them, as We think
y require, such are necessary or proper to notices,
carry out this Agreement.
c. Before You and We sign this Agreement, You will deliver to Us an ack nowled
The Estate of Shawn Dolan, as primary benefic' the Assigned Assets gmeer of
of this Agreement. The Estate of Shawn Dolan will , of the terms
ally rights to any of the Assigned Assets, agree that they are not entitled to
d. You agree to sign all other documents which We may
forever nam as
only beneficiary of the Assigned Assets, including but not limited to an mg Us agreemen the
provide in Your Last Will and Testament
were sold to Us (a that all of Your rights to the Assigned Assets
"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 ReuresentAtiona ??a __
You now represent and wan-ant to Us that:
a. You own (and are selling and assigning to Us under this A
Assigned Assets, free and clear of all claims, liens charg greement) all of the
encumbrances, and agreements of any nature (other than this security interests,
when You and We sign this Agreement, no one other than Us WWI 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
terns.
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;
lii• will not create, or give any party (other than Us the right to lien, charge, security interest or encumbrance in, to or on acreate, any
ny 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.
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02008 321 Hendaaon ltMi,610 0rigkWi M LLC
Account ID: 374614
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 (1) 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 ri ghts 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 financing
transaction.
g. This Agreement is a valid sale, transfer and assignment to Us of the Assigned
Assets,
h. Your residence and legal address is as described in Paragraph 11 of this
Agreement. During the last years, You have lived at such address,
i. No representation or warranty of yours in this A
documents delivered in connection with this Agreement dement many of the
required by this Agreement, is inaccurate or contains any untrue r misl agreement
statement.
eadi
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
under the Internal Revenue Code. You understand that treatment
Agreement, you may be giving up this favorable tax treatment.. Yo 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.
L 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 guards of your
children. The Assigned Assets are not subject to any community property or
similar marital rights of any person.
02008 321 HMdMM ReceNAka oligWalim LLC
AccountID: 374614
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
rdocequestedentum aandtionYouwhicdohnot expect to receive from Us, a Form 1099 or any other
could make the transaction described by this Agreement
taxable to You in any way. You further understand s We have not given to
You any advice about any of your taxes in this transaction. You
Your own professional advisors concerning taxes. have relied on
o. As of the date of this Agreement, you are of legal age in the state noted as Your
address in Section 11 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 financial affairs and condition. With that full
understanding, You certify that (1) 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
bidden 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 firnm
having a paying job.
S. You promise to us that no broker, finder, 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.
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02008 321 Haxk3w Rec dvables Origination U.C
Account ID: 374614
U' You understand that it usually takes six to eight weeks to complete this process,
but that it could take longer. You utand that you have to obtain court
approval of this transfer. YOU UNDERSTAND THAT, DUE
TO OCCASIONAL DELAYS, WE WILL HOLD
BACK 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 HOLD BACK
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 AMOUNT'S OF
PAYMENTS RECEIVED By YOU PRIOR TO
FUNDING, IF SUCH AMOUNTS ARE NOT
COVERED BY THE HOLD BACK FUNDS.
4. You promise Us that:
a. You will not, and will not allow any other ply (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
th Assigned ang that could in any way interfere with or lessen our rights in
b. You will not do anything that will, or could in the future, violate the
Release, or any of the agreements
Agreement. You also agree to co required to be executed by this
the rights that We are buying o? with Us to help Us to obtain all of
Release.from you in this Agreement and in the
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. You also agree that we can do background
checks, including from the credit bureaus derived from credit bureau data,
in order to verify your legal address and other contact information for
purposes of this transaction.
d. You will not make any change in your instructions to the Annuity
Company regarding payments to be made to You.
5
02008 321 Henderson Receivables odgbmdon LLC
Account ID: 374614
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 obli on
gad
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's 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• ?1'O CA C i Arrnar YOU MAY CANCEL THIS
LATER THAN THE THIRD BUSINESS DAY FOLLOWING THE DATE YOU EXECUTE
THE
PURCHASE AGREEMENT, WITHOUT PENALTY OR FURTHER OBLIGATION. In order for the
cancellation to be effective, You must provide written notice of cancellation to US, c% Manager of
Operations at 3993 Howard Hughes Parkway, Suite 250, Las Vegas, NV 89169-6754.
6. r ur Fni ther,?r°- You agree that, from time to time, at your expense, sign and give to Us any and all documents to help us realize our rights and You Will
Agreement. This promise includes signing, filing or allowin benefits under this
statements, or amendments or assignments of those documents. You s to file financing or continuation
Us Us
sign our name and/or your name and file without Your signature such permit finan an
or cing others statements, for at is
permitted in Your state of residence. When You sign this Agreement,
if that is
a "Special Irrevocable Power of Attorney" You must retain the ser You will also sign and deliver to Us vices Opinion of Your attorney about the sale of Assigned Assets to Us, in form acc
of an eptabble o Us.and liver an
6
02008 321 He ndamw RMiv*jcs OrWna km LLC
Account ID: 374614
7• Coe nnatinn of Ren n u War -nt•
representations, warranties and '? ae Covenants All of Your
this Agreement is signed. poses made In this Agreement will continue to be relied on by Us after
8. Event of Detsnrr Your failure to comply with any term of this Agreement breach of any of Your representations in this Agreement will mean that You will be in default. We er 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
this You Perform
Agreement Your will be a promises or defaultto get money from You. Your failure to comply with any material terms of
.
anew residence eh 4 (c of You agree give US at least thirty (30) days written notice after your move to your are purchasing from You certain lump address from the address in Paragraph I I of this Agreement. If we
scheduled sum Payments, We will contact you at least 3 months before the
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 We will consider our Inability to
contact you to be an EVENT OF DEFAULT 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, accordance with the internal laws of the State of y ? our domicile withouconstrued and enforced in
thereof or elsewhere. or Court for the conflicts of law rules
Orders or Notice Transfers obtained in the following jurisdictions: AK,
AR, AL, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY,
LA, MS, MT, NC, NE, NJ, NM, NV, OH OK, OR, RI, SC, SD TN TX ' ' MD, ME, MI, MN, MO,
of those jurisdictions shall be applied in the event of a dispute regarding , the VA, transfer.) WA, WV and mithe laws
Proper place of venue to bring any action arising out of a breach ofthhisgg A o Y0 domcile is the
grcement.
10. ... a .This A
executors, successors and assigns and will mgt Our Agreement will hold responsible Your heirs,
Permitted assigns. Nothing in this Agreement is intended to givee anyoneeSother than Youbor Uscorr each of and
Our successors or assigns any benefits.
11. Notices, All notices and other communications under this Agreement
and will be made by delivery by means by which the sender obtains a receipt of delivery from thcarrier
(including without limitation, certified mail return receipt requested or ove
addressed to the party to whom a request or demand Is to be might courier services),
made.
be deemed given on the date which is one business day after the date sent by ov or ernight notice mail or request shall
after the date sent by certified mail. by ov or three days
The addresses of the parties are as follows:
If to You:
Shawn Doian
508 Evergreen Rd.
New Cumberland, PA 17070
7
02008 321 Henderwn Rmi,&,= Origlaatim LLC
Account ID: 374614
If to Us:
321 Henderson Receivables origination LLC
3993 Howard Hughes Parkway
Suite 250
Las Vegas, NV 89169-6754
Attention: Manager - operations
12. ft"WRU, 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. F e , Except as otherwise at1'umadvely set forth in this men We
agree that we will each pay our respective costs and a ` ? t You and
Agreement. expenses in connection with the carrying out of
of this
14. Huth lye section and subsection headings co
ed this Agreement are for
reference purposes only and will not affect in any way the meanin ontain in
g interpretation of this Agreement,
15. CBA r r , one or more Origin
signature. When they als of this Agreement may be signed with your or our
put together th 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. sA 'AI, We and anyone to whom We assign this Agree
title and interest in and to this Agreement, the Annuity and the Agn ssi edment may assign our right,
You and We agree that if there is an assignment by Us to As sts wit of t your approval.
You. someone else
You must look only to the person or company that We assign this A g responsible to
example, of the Purchase price) and performance of this A lpeement to for any payment (for
You will sign and deliver any such documents as We may Agreement. When asked by Us or any assignee,
Y require to perform this transaction, as assigned
17. Your no ae. You and Your spouse are fully aware of Your righ in
Assets. You and Your spouse fully give those rits the Assigned
the Assigned g You and Your spouse understand that by selling
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 re
ceiving 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 unde
spouse gives up any property right he or she may have in the Assigned Assets that your spouse could claim
because of Your marriage,
is. %firm clement. This Agreement and the Exhibits and other documents you signed
make up the entire understanding and agreement between You and Us about this A
Agreement replaces all prior agreements, whether written or oral, about this A gr This
may not be changed unless in a writing signed by You and Us. greement. This is Agreement Agreement
19. Lial&&&JUM You understand that Our liability to You under this
Agreement is strictly limited to the requirement to pay the Purchm price and under no circumstances will
We be responsible for consequential damages
20. Court &Zg aL You understand that court approval is required for this transfer.
You agree that you will obtain such court approval.
02008 321 Haukam Receivsbks Origination LLC
Account ID: 374614
21' zE ham, Attached to this purchase Agreement are the following Exhibits:
Exhibit "A" List of What payments We are Buying.
Intending to be legally 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 ORIGINATION LLC
C Il?
By:
Vice President-Operations
SIGN HERE
Spouse
Sworn to and a bed
before me this day of 200
Notary
NOW Al WA IMF
AMMM t MAMA
now koft
M O ? MOM Cowie
W Co?M1MMM ? Apr IF. MI
02008 321 Hendemw Receivables oligintion LLC
Account ID: 374614
ZX t- A
We are hmby purchasing from You under the Annuity:
A) 228 monthly payments of $850.00 each beginning on August 5, 2008 and ending on July 5, 2027
SIGN HERB
STATE OF Pk COUNTY OF
On this Itt day of n p 2001, before me, the above signed
sonally
me to be the person "4 osen-ame-is subscribed to the within Instrument and acknow epdged to mbefore
e, personally known to
a that he executed it
k40ta
"OVUM am
MMLMM
Nelo w Poft
MINONII? CM. DAWW COYNIr
Of CuewNIN101 faplrsis Apr 17, 2011
Account ID: 374614
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
FINANCIAL ADVISOR REGARDING ANY FEDERAL O AA R
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) 228 month 1-101
each, beginning on August 5,012-008 and ending on July p27 nts of $850.00
(THE REMAINDER OF THIS PAGE LEFT BLANK INTENTIONALLY]
Account ID: 374614
SCHEDULE 1 PAGE 2
THE 4GGREGATE AMOUNT OF THE PUR
$193900.00, CHASED PAYMENTS IS
THE DISCOUNTED PRESENT VALUE OF THE AGGREGATE
PAYMENTS AT 3.80% IS $138,198.37. THE DISCOUNTED PRESENT
VALUE IS THE CALCULATION OF THE
TRANSFERRED STRUCTURED SETTLEMENT PAYMENTS VALUE OF THE
FEDERAL STANDARDS FOR VALUING NTS UNDER
AMOUNT PAYABLE TO SELLER IS $71,500.00. S. THE GROSS
THE FOLLOWING EXPENSES ARE INCURRED BY THE SELLER
(YOU) AND WILL BE DEDUCTED FROM THE PUR
f;HASE PRICE:
COMPLIANCE AND ADMINISTRATIVE FEE: $0.00
LEGAL FEES TO PROCURE COURT APPROVAL (THIS IS AN
ESTIMATE OF WHAT YOU WILL BE CHARGED TO OBTAIN COURT
APPROVAL): $500,00
FILING AND RELATED EXPENSES FEE: $0.00
THE NET AMOUNT PAYABLE TO THE SELLER(YOU) IS $719000.00.
NO OTHER EXPENSES ARE INCURRED BY YOU.
THE DISCOUNTED PRESENT VALUE OF PAYMENTS SHALL BE
CALCULATED AS FOLLOWS: THE APPLICABLE FEDERAL RATE
3.80 D IN CALCULATING THE DISCOUNTED PRESENT VALUE IS
THE EFFECTIVE AN1AL DISCOUNT RATE FOR THIS
TRANSACTION IS 13.66%. 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 US9 LESS THE TOTAL AMOUNT OF
COMMISSIONS, FEES, COSTS, EXPENSES AND CHARGES PAYABLE
BY YOU.
Account ID: 374614
SCHEDULE 1 PAGE 3
THE NET AMOUNT THAT YOU WILL RECEIVE FROM US IN
EXCHANGE FOR YOUR FUTURE STRUCTURED SETTLEMENT
PAYMEN'T'S REPRESENTS 51.40% OF THE ESTIMATED CURRENT
VALUE OF THE PAYMENTS BASED UPON THE DISCOUNTED VALUE
USING THE APPLICABLE FEDERAL RATE.
THE QUOTIENT OBTAINED BY DIVIDING THE NET PAYMENT BY
THE DISCOUNTED PRESENT VALUE IS 51.40%.
BASED ON THE NET AMOUNT THAT YOU WILL RECEIVE FROM U
AND THE AMOUNTS AND TIMING OF THE STRUCTURED. S
SETTLEMENT PAYMENTS THAT YOU ARE TURNING
YOU WILL, IN EFFECT, BE PAYING INTEREST US AT AR TO US9
13.66% PER YEAR. THE NET AMOUNT PAID TO YOU ATE OF
(THE
BY US (THE TRANSFEREE) REPRESENTS AN ESTIMATE OF PAYEE)
FAIR MARKET VALUE OF THE FUTURE PERIODIC PAYMENTS
TRANSFERRED UNDER THE STRUCTURED SETTLEMENT
AGREEMENT.
NOTICE OF CANCELLATION RIGHTS:
YOU MAY CANCEL THIS TRANSACTION NO LATER THAN THE
THIRD BUSINESS DAY FOLLOWING THE DATE YOU EXECUTE
THE
PURCHASE AGREEMENT, WITHOUT PENALTY OR FURTHER
OBLIGATION.
THIS CANCELLATION RIGHT CANNOT BE WAIVED IN ANY
MANNER.
YOU MAY CANCEL THIS TRANSACTION NO LATER THAN THE
THIRD BUSINESS DAY FOLLOWING THE DATE YOU EXECUTE THE
PURCHASE AGREEMENT, WITHOUT PENALTY OR FURTHER
OBLIGATION.
.
Account ID: 374614
SCHEDULE 1 PAGE 4
IN ORDER FOR THE CANCELLATION TO BE EFFECTIVE, YOU MUST
PROVIDE WRITTEN NOTICE OF CANCELLATION TO US:
321 HENDERSON RECEIVABLES ORIGINATION LLC
3993 HOWARD HUGHES PARKWAY
SUITE 250
LAS VEGAS, NV 99169-6754
ATTENTION: MANAGER - 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.
COMMISSIONS, SERVICE CHARGES, APPLICATION FEE BROKERS
LI
PROCESSING FEES, CLOSING COSTS, FILING FEES, S,
ADMINISTRATIVE FEES, LEGAL FEES, NOTARY FEES AND OTHER
COMMISSIONS, FEES, COSTS, EXPENSES AND CHARGES BY YOU OR DEDUCTED FROM GROSS AMOUNT THERWISEABLE
PAYABLE TO YOU OTHER THAN THE COMPLIANCE AND
ADMINISTRATIVE FEE AND THE WING 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, WHICH YOU MUST OBTAIN.
v
Account ID: 374614
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
CONTRACT.
gW7!!!
DOLAN 4iRED
,
ATTACHMENT/EXHMIT "5"
321
HENDERSON RECEIVABLES
June 23, 2008
ING Life Insurance and Annuity Company
One Orange Way
Mail Stop CIS
Windsor, CT 06095-4774
Attn: Legal Department/Structured Settlements
The Travelers Casualty And Surety Company
Corporation Service Company
2711 Centerville Road, Suite 400
Wilmington, DE 19808
Attn: Legal Department/Structured Settlements
RE: Notice of Sale/Assignment of Payment Rights
Your Contract #. SSWOOIOOOWS00140321
Payee: Shawn Dolan
SS #: 193-54-0223
Dear Insurer:
ORIGINATION, LLC
Please be advised that 321 Henderson successors and
Receivables Origination LLC and/or its
assigns, have entered into a transaction with the above-ref
transfer certain of his/her rights to the a erenced annuitan
t who is seeking to
referenced annuity policy. We are p Nnents scheduled to be received under the above-
structured settlement transfer a ar currently seeking court approval pursuant to the applicable
information about the Pursuant to the statute, please note the following
haler:
321 Henderson Receivables Origination LLC
40 Morris Ave
Bryn Mawr PA 19010
Tax ID # 20-4728885
PLEASE NOTE: No payments under, this annuity should be held until the courts have entered order and we have forwarded this order to you. d a
Very truly yours,
321 Henderson Receivables Origination LLC
By: ?%'I)
Maureen Healy, Vice Pr ent
3993 Howard Hughes parkway o Suite 250 o Lae Vegas, NV 89169-6754
PHONE: (800) 454-9368 o FAX: (215) 567-7525 O E-MAIL:
JGW@JGWPMjNG.COM
WEB SITE: WWW,JQWFUNOING COM
00 {
V
00
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00
r
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
RE: Joint Petition of 321 Henderson NO: g - 3 ?11 cy,, i ( <nt
Receivables Origination, LLC and
Shawn Dolan
INITIAL ORDER OF COURT
On this 70 day of 2008, it is ordered that a hearing on this
Petition to Transfer Structured Settle ent Payment Rights will be held on
in Courtroom I/ at//,'36 o'clock. The payee shall bring
inc me tax returns for the prior two (2) years to the hearing.
Within sever (7) days, the transferee shall give notice of the hearing date to the
payee, the structured settlement obligor, the annuity issuer, the payee's spouse and any
person receiving child support, alimony, or alimony pendente lite. The transferee shall
attach a certificate of service to the notice of hearing date. A copy of the notice with the
certificate of service shall be filed with the court prior to the hearing.
BY THE COURT:
RS. OFHCE
OF THE PAMMOTAPY
2888 JUL -9 AM 9: 53
CLWERL;, `,l? UOUNTY
ftj'q Si VA IA
o?
FIN
f.
s
Maro & Maro, P.C.
By: Robert A. Maro, Esquire
Attorney I.D. No.: 89585
1115 W. Main Street
Norristown, PA 19401
(610) 275-9600 Attorney for 321 Henderson Receivables Origination, LLC
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
IN RE: Joint Petition of 321 Henderson Receivables NO: 2008-03819
Origination, LLC and Shawn Dolan
CERTIFICATE OF SERVICE
I, Robert A. Maro, Esquire, hereby certify that a true and correct copy of the
Initial Order of Court was served upon the Payee, The Structured Settlement Obligor,
The Annuity Issuer, the Payee's Spouse and any person receiving child support, alimony
or alimony pendente lite.
A copy of the Notice is attached hereto.
Date: July 15, 2008 y:
R b A. Maro, Esquire
Attorney for 321 Henderson Receivables
Origination, LLC
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
RE: Joint Petition of 321 Henderson NO: t
Receivables Origination, LLC and
Shawn Dolan
INITIAL ORDER OF COURT
On this T?' day of 2008, it is ordered that a hearing on this
Petition to Transfer Structured ettement Payment Rights will be held on
?,g_, in Courtroom y_ at '3 o o'clock. The payee shall bring
in 2° eturns for the prior two (2) years to the hearing.
Within sever (7) days, the transferee shall give notice of the hearing date to the
payee, the structured settlement obligor, the annuity issuer, the payee's spouse and any
person receiving child support, alimony, or alimony pendente lite. The transferee shall
attach a certificate of service to the notice of hearing date. A copy of the notice with the
certificate of service shall be filed with the court prior to the hearing.
BY THE COURT:
I KUli i,;UV 1 1 * hk--- , r?iCt r:r11:.n Testimony whereof, l here unto W my hang
tnd the SPi of said tt at Carlyle, a.
da It= - t•r--
Protl?onwer??
CX7
co
A J
} Y'1
?
? r
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
RE: Joint Petition of 321 Henderson NO: 0?-,3 gj C6wReceivables Origination, LLC and
Shawn Dolan
FINAL ORDER OF COURT
On this L $• Day of 4W w. *, , 2008, it is ordered that the Petition to
Transfer of Structured Settlement Payment Rights is granted.
The court specifically finds that:
(1) the payee has established that the transfer is in the best interests of the payee
or the payee's dependents;
(2) based on the certification by an attorney for the transferee, and the court
having not been made aware of any statute, regulation or order that would be
incompatible with the proposed transfer, the transfer will not contravene any
applicable federal or state statue or regulation, or the order of any court or
administrative authority;
(3) the transfer complies with the remaining requirements of the Structured
Settlement Protection Act, including Sections 3(a)(2), 3(a)(4), 3(a)(5) and
3(aX6);
(4) the payments that are to be transferred are designated as
follows:
A) 228 monthly payments of $850.00 each, beginning on
August 5, 2008 and ending on July 5, 2027
(5) the terms of this order shall survive the death of the payee and shall be
binding on the payee's heirs, beneficiaries and assigns;
(6) the payee shall receive from the transferee, as of r: mot the amount of
$71,000.00, from which no funds are owed for counsel fecs, administrative
fees, or other costs, fees or expenses.
BY THE COURT:
C -?
'y
.. ?. ,
f_ ; t co
t r 1