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HomeMy WebLinkAbout09-5929MARK THOMAS SOPHOCLES, LLC PA Supreme Court Attorney ID # 74998 21 Industrial Blvd., Suite 201 Paoli, PA 19301 Tel: (610) 651-0105 Fax: (610) 651-0106 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA- CIVIL DIVISION IN RE: ELIEZER CARABALLO-OCASIO A/K/A ELIEZE CARABALLO-OCASIO PETITION TO TRANSFER STRUCTURED SETTLEMENT PAYMENT RIGHTS No. 09- - 5qa9 aivi I Term PRAECIPE FOR HEARING Kindly submit the following matter for hearing on the determination of the Petition to Transfer Structured Settlement Rights in regard to Eliezer Caraballo-Ocasio which is being filed this 25th day of August 2009. Oral argument is requested. Respectfully submitted, Dated: August 25, 2009 MARK THOMAS SOPHOCLES, LLC MARK THOMAS SOPHOCLES, ESQ. PA ID # 74998 21 Industrial Blvd., Suite 201 Paoli, PA 19301 610.651.0105 MARK THOMAS SOPHOCLES, LLC PA Supreme Court Attorney ID # 74998 21 Industrial Blvd., Suite 201 Paoli, PA 19301 Tel: (610) 651-0105 Fax: (610) 651-0106 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA- CIVIL DIVISION IN RE: ELIEZER CARABALLO-OCASIO A/K/A ELIEZE CARABALLO-OCASIO PETITION TO TRANSFER STRUCTURED SETTLEMENT PAYMENT RIGHTS No. 09- PETITION FOR APPROVAL OF TRANSFER STRUCTURED SETTLEMENT PAYMENT RIGHTS 1. This Petition is brought pursuant to the provisions of the Pennsylvania Structured Settlement Protection Act, 40 P.S. §4001 et seq. and Pa. R.C.P. 229.2. 2. Petitioner and Transferee is Settlement Funding, LLC, 3301 Quantum Boulevard, Boynton Beach, FL 33426. 3. The Payee, Eliezer Caraballo-Ocasio a/k/a Elieze Caraballo-Ocasio, (hereinafter "Payee") is an adult individual of full age and who resides at 11 Cottage Court, Mechanicsburg, PA 17050-3171 in Cumberland County, Commonwealth of Pennsylvania. 4. This Court has venue pursuant to the Structured Settlement Protection Act, because the Payee is domiciled in Cumberland County, Pennsylvania. 5. Caraballo-Ocasio suffered personal injuries, and as a result, entered into a Settlement Agreement and Release providing that Caraballo-Ocasio would receive payments as follows: 480 monthly payments each in the amount of $2,863.32 commencing on December 6, 2007 through and including November 6, 2047 (the Periodic Payments). 6. The Annuity Owner is Hartford- Comprehensive Employee Ben. Svc. Co. located at 200 Hopmeadow Street, Simsbury, CT 06089 7. The Annuity Issuer is Hartford Life Insurance Co. located at Structured Settlements, 200 Hopmeadow Street, Simsbury, CT 06089 On August 20, 2009, Caraballo-Ocasio executed an Absolute Assignment Agreement (the "Transfer Agreement") a true and correct copy is attached and incorporated herein as Exhibit "B" that provides for the assignment of the following payments: 296 monthly payments each in the amount of $700.00 commencing on November 6, 2009 through and including June 6, 2034 (the "Assigned Payments") 9. The Petitioner has provided to the Payee a Disclosure Statement, a true and correct copy of which is attached hereto as Exhibit C, setting forth, inter alia, the amounts and due dates of the Structured Settlement Payments to be transferred as set forth in paragraph 8 herein above and in paragraph A of Exhibit C. 10. The net amount payable to the Payee after deduction of all commissions, fees, costs, expenses, and charges is $41,139.61 minus any advances made to Payee against the amount payable to Payee. 11. Based on the net amount that the payee will receive from this transaction $41,139.61, the amounts and timing of the structured settlement payment that would be assigned, the payee is, in effect, paying interest at a rate of 21.18% per year. 12. After due consideration, the Payee is satisfied that the transfer is in his best interests for the reasons set forth in the Affidavit attached hereto as Exhibit D and incorporated herein by reference. 13. The Payee has received the notice required by 40 P.S. §4003(b) as evidenced by Exhibit F hereto. 14. The Payee has given the notice required by 40 P.S. §4003(a)(6) as evidenced by Exhibit G hereto. 15. Attached hereto as Exhibit H is the certification required by Pa. R.C.P. 229.2(d)(3)(iii). 16. Payee has executed a statement confirming that he waived independent legal advice including considerations of any tax ramifications of the transfer WHEREFORE, the Petitioner prays this Honorable Court to enter its Initial Order scheduling a hearing on this Petition. Respectfully submitted, Dated: August 25, 2009 MARK THOMAS SOPHOCLES, LLC VERIFICATION AND CERTIFICATION I, Mark Sophocles, Esquire as authorized outside counsel for Settlement Funding, LLC verify that the statements made in this Petition are true and correct and to the best of my knowledge, information and belief, formed after reasonable inquiry, that the transfer will comply with the requirements of the Act and will not contravene any other applicable federal or state statute or regulation or the order of any court or administrative authority. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904, relating to unsworn falsification to authorities. Date: August 25, 2009 MARK SOPHOCLES Mark Thomas Sophocles (PA ID #74998) MARK THOMAS SOPHOCLES, LLC 21 Industrial Blvd., Suite 201 Paoli, PA 19301 Tel: (610) 651-0105 Fax: (610) 651-0106 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA- CIVIL DIVISION IN RE: ELIEZER CARABALLO-OCASIO A/K/A ELIEZE CARABALLO-OCASIO PETITION TO TRANSFER STRUCTURED SETTLEMENT PAYMENT RIGHTS No. 09- NOTICE OF PROPOSED TRANSFER OF STRUCTURED SETTLEMENT PAYMENT RIGHTS To: Hartford-Comprehensive Employee Ben. Svc. Co. 200 Hopmeadow Street Simsbury, CT 06089 (Settlement Obligor) Hartford Life Insurance Co. Attention: Structured Settlements 200 Hopmeadow Street Simsbury, CT 06089 (Annuity Issuer) Settlement Funding, LLC 3301 Quantum Boulevard Boynton Beach, FL 33426 Attn: Court Order Group (Transferee) Eliezer Caraballo-Ocasio 11 Cottage Court Mechanicsburg, PA 17050-3171 (Petitioner) Please take notice that a Petition to Transfer Structured Settlement Payment Rights has been filed in the Court of Common Pleas of Cumberland County, Pennsylvania. An Order has been issued by the court requiring that responses or objections of the transferee, structured settlement obligor or the annuity issuer, be brought before the court either in writing or in person at a hearing set on or after September 15, 2009 or for , at AM/PM in Courtroom , before the Honorable .(A copy of the Scheduling Order dated , 2009, is included with this notice). You are entitled to support, oppose or otherwise respond to the payee's petition, either in person or by counsel, by filing written comments with the court prior to the hearing or by attending the hearing. Provided with this notice is a copy of the Petition to Transfer Structured Settlement Payment Rights, including as attachments thereto a copy of the Transfer Agreement, and a copy of the Transfer Disclosure Statement required by 40 P.S. § 4003 (2). Pursuant to 40 P.S. § 4003 (6), notice of the transferee's name, address and taxpayer identification number are as follows: Settlement Funding, LLC 3301 Quantum Boulevard Boynton Beach, FL 33426 (TIN: 58-2292928) Respectfully submitted, MARK THOMAS SOPHOCLES, LLC Dated: August 25, 2009 MARK THOMAS SOPHOCLES, ESQ. PA ID # 74998 21 Industrial Blvd., Suite 201 Paoli, PA 19301 610.651.0105 CERTIFICATE OF SERVICE I, Mark T. Sophocles, hereby certify that a true and correct copy of this Notice of Proposed Transfer of Structured Settlement Payment Rights, the Petition to Transfer Structured Settlement Payment Rights and the Transfer Disclosure Statement, and the Order of Court Scheduling a Hearing Date have been served via Certified Mail Return Receipt Requested and Federal Express mail upon the persons and entities and at the addresses listed below, this 25`h day of August 2009. Hartford-Comprehensive Employee Ben. Svc. Co. 200 Hopmeadow Street Simsbury, CT 06089 (Settlement Obligor) Hartford Life Insurance Co. Attention: Structured Settlements 200 Hopmeadow Street Simsbury, CT 06089 (Annuity Issuer) Settlement Funding, LLC 3301 Quantum Boulevard Boynton Beach, FL 33426 Attn: Court Order Group (Transferee) Dated: August 25, 2009 Eliezer Caraballo-Ocasio 11 Cottage Court Mechanicsburg, PA 17050-3171 (Petitioner) Respectfully submitted, MARK THOMAS SOPHOCLES, LLC MARK THOMAS SOPHOCLES, ESQ. PA ID # 74998 21 Industrial Blvd., Suite 201 Paoli, PA 19301 610.651.0105 VERIFICATION I, KURT MOODY, In-House Counsel of Settlement Funding, LLC d/b/a Peachtree Settlement Funding, have read the foregoing Petition to Transfer Structured Settlement Payment Rights, and hereby aver that the statements therein are correct to the best of my personal knowledge, information and belief. This statement and verification is made subject to the penalties of 18 Pa. C.S.A. §4904 relating to unworn falsification to authorities. a-)- DATE: August P, 2009 KURT MOODY MARK THOMAS SOPHOCLES, LLC PA Supreme Court Attorney ID # 74998 21 Industrial Blvd., Suite 201 Paoli, PA 19301 Tel: (610) 651-0105 Fax: (610) 651-0106 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA- CIVIL DIVISION IN RE: ELIEZER CARABALLO-OCASIO A/K/A ELIEZE CARABALLO-OCASIO PETITION TO TRANSFER STRUCTURED SETTLEMENT PAYMENT RIGHTS No. 09- FINAL ORDER OF COURT On this day of 2009, 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 statute 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(a)(6); (4) the payments that are to be transferred are designated as follows: 296 monthly payments each in the amount of $700.00 commencing on November 6, 2009 through and including June 6, 2034 (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; (5) the payee shall receive from the transferee, the net amount of $41,139.61 from which no funds are owed for counsel fees, administrative fees, or other costs, fees or expenses. (6) The Annuity Owner, Hartford-Comprehensive Employee Ben. Svc. Co. shall send the Assigned Payments to Settlement Funding, LLC at P.O. Box 116476, Atlanta, GA 30368-6476 or to such other address as designated by Settlement Funding, LLC; it is further ordered (7) ORDERED that Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company shall, as to all parties except Transferee, be discharged from any and all liability for the Assigned Payments; and, it is further (8) ORDERED that the Transferee shall be liable to Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company for any liabilities, taxes or costs of any kind, including reasonable costs and attorneys' fees arising from compliance by Hartford- Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company with this order and/or arising as a consequence of the Transferee's failure to comply with applicable law; and that, if, as a consequence of the Transferee's failure to comply with applicable law, the Transferee owes any amount to Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company, then the Transferee expressly grants to Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company the right to recover any liabilities, taxes, costs of any kind, and attorneys' fees, as well as their attorneys' fees relating to the above-captioned action; and it is further (9) ORDERED that this Order in no way modifies or negates the ownership or control of the underlying contract by Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company and is entered without prejudice to the rights of Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company and the lack of opposition by Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company to this transfer, and their compliance with this Order, shall not constitute evidence in this or any other matter regarding: (i) the assignability of payments under a structured settlement agreement or annuity contract or related contracts or whether such payments can be assigned; (ii) the enforceability of provisions that restrict and/or preclude assignment of payments under a structured settlement agreement or annuity contract or related contracts or orders; (iii) the validity of other transactions entered into by Transferee; (iv) whether Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company have waived any right in connection with any other litigation or claims or rights other than the rights to the Assigned Payments as described above; or (v) whether Settlement Funding, LLC has waived any right in connection with any other litigation or claims or rights other than the rights to the Assigned Payments as described above; and, it is further (10) ORDERED that after Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company change(s) the address for the Assigned Payments to the above designated address ("Designated Address"), then Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company shall not again be required to change the address for the Assigned Payments; however, if for reasons beyond the control of Transferee, or due to Transferee being merged with or acquired by another individual or entity, or for traditional address change purposes (i.e., if Transferee's address is no longer a viable address for Transferee to receive payments) the Designated Address is no longer valid, then Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company will make payments to a new address upon the designation, in a notarized writing by Transferee to Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company, of the new address; moreover, if Transferee provides information to Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company which, to the satisfaction of Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company, justifies the requested change, Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company may, at their discretion, change the address for the Assigned Payments; furthermore, in the event that Transferee further assigns rights to the Assigned Payments (or any portion of them) to any other person or entity, then Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company will not themselves be obligated to redirect the Assigned Payments (or any portion of them) to any person or entity other than Transferee, and Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company shall have no duty or obligation to any person other than Transferee; and it is further (11) ORDERED That, if prior to the issuance of this Order or within thirty (30) days after the entry of this Order, Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company Life has made any of the scheduled Assigned Payments to the Payee that came due and owing under the settlement and annuity in those time periods, it is adjudged that Hartford-Comprehensive Employee Ben. Svc. Co. and Hartford Life Insurance Company has fulfilled their obligations to the Payee and to the Transferee with respect to said payments. (12) ORDERED that any further transfer of structured settlement payment rights by the Payee shall be made in compliance with all of the requirements of Applicable Acts; and it is further (13) ORDERED that this order is binding on any and all successors of the Payee, of other interested parties, and of the Transferee; and it is further (14) ORDERED that the death of the Payee prior to the due date of the last of the Assigned Payments shall not affect the transfer of the Assigned Payments from Payee to Settlement Funding, LLC, and Payee understands he is giving up his rights, and the rights of his heirs, successors and/or beneficiaries, to the Assigned Payments; and it is further (15) ORDERED that the Payee shall not incur any penalty, forfeit any application fee or other payment, or otherwise incur any liability to Transferee or any other person based on any failure of the transfer to satisfy the Applicable Acts; and it is further ORDERED that (INSERT PROPER HARTFORD ENTITY NAMES HERE) is directed to issue a formal acknowledgement letter of the transfer within twenty (20) days of the date of the receipt of this Order. The formal acknowledgement letter shall be delivered to Settlement Funding, LLC at 3301 Quantum Blvd., 2nd Floor, Boynton Beach, FL 33426; and it is further ORDERED that this constitutes a Final Order of the Court. Verifirafion I verify that the statements made in this affidavit are true and correct. T understand that false statements herein are made subject to the penalties of 18 Pa_C.S. §4904, relating to unswom falsification to authorities, DATE: 4C?tgatriballoo -Oc asio aWa Flieze Caraballo-Ocasio 00/01 39Cd HIIWS Nvsns Z8Z0ZELLIL 9Z:b0 600Z/0Z/80 ABSOLUTE ASSIGNMENT AGREEMENT (THE "AGREEMENT") August 20, 2009 I, Eliezer Caraballo-Ocasio a!k/s Elieze Caraballo-Ocasio, (`1`, "Me" or "Assionor) residing at 11 Cottage Ct. Mechanicsburg, PA 17OW-3171 am entitled to 480 monthly payments each in the amount of $2,863.32 commencing on December S. 2007 through and Including November 6, 2047 then continuing for life thereafter (the "Periodic Payments" on account of the settlement of a certain personal injury claim, the settlement of which is memorialized in that certain settlement agreement (the "Settlement Agreement"). The Periodic Payments are due to me from Hartford-Comprehensive Employee Ben. Svc. Co. (the "Settlement Obligor") under the terms of the Settlement Agreement and are being funded by an annuity Issued by Hartford Life Insurance Company (the "Annuity Issuer") bearing annuity contract number CCK0539543. A. I hereby sell, assign and convey to Settlement Funding, L.LC (the "AssigneW) and its assigns through an assignment all of my rights to and interest in and to the following payments due or to become due under the Settlement Agreement: 296 monthly payments each In the amount of $700,00 commencing on November 6. 2009 through and including June 6, 2034 (the "Assigned Payments"}; and In consideration for this assignment, Assignee shall pay to me the sum of $43,339.69 (the "Assignment Price"). B. I hereby make the following unconditional representations, warranties and promises: 1• No one other than me has any interest or claim of any kind or nature in, to or under the Assigned Payments I am assigning hereunder. 2• 1 am not indebted to anyone that would affect in any way either the assignment of the Assigned Payments referenced above or.Assignee's absolute rights to receive same. 3. 1 agree to conduct my affairs so as to ensure that Assignee obtains all of the benefits of the assignment contemplated hereby. C. 1 agree that the following shall be considered an event of default by me under this Absolute Assignment Agreement: 1_ The representations set forth in Paragrepha 13 1 and S 2 above are at any time not true. 2. Failure by me to perform the promise set forth in Paragraph 9 3 above. 1 Failure by the Settlement Obligor or the Annuity Issuer to make any one or more of the Assigned Payments as a result of any act by me, my estate or any of my heirs. 4. Failure by the Settlement Obligor or Annuity Issuer to forward one or more Assigned Payments to Assignee as a result of any act by me, my estate or any of my heirs. 5. Failure by me to forward promptly to Assignee any Assigned Payment received by me from the Settlement Obligor or the Annuity Issuer. a.. Failure by me to fulfill any other obligation of mine under this Agreement. D. The following are conditions precedent to Assignee's obligation to pay me the Assignment Price: 1- Assignee shall be satisfied, in its sole discretion, that there are no claims or interests of any kind or nature whatsoever that do or may affect Assignee's rights to or interest in the Assigned Payments and Assignee's ability actually to receive same on the dates and in the amounts set forth herein, 2. Assignee shall have received a final non-appealable court order, or a signed acknowledgment from Settlement Obligor and the Annuity Issuer satisfactory to Assignee in its sole discretion (such court order or acknowledgement together are hereinafter referred to as the "Order"), authorizing the transfer by assignment of the Assigned Payments (which may continue to be made out to my name) to Assignee, and directing that the Periodic Payments due an or after the day of the Order be forwarded, or authorizing the forwarding of the Periodic Payments, directly to Assignee. 3. Assignee shall have received final financing approval from applicable funding source(s). E, Under this Agreement and only to the extent permitted by law Assignee and I intend to create a security interest under Article 9 of the Uniform Commercial Code of the state designated in Paragraph F below, in my rights to and interest in the Assigned Payments, which rights have been assigned to Assignee as General Intangibles 0t1/t10 39dd HIIWS NVSnS zezozcLLIL 9Z:b0 6002/0Z/80 under Article 9 of the Uniform Commercial Code of the state designated in Paragraph 1= below. This Agreement shall also function as a security agreement. This secuirty interest secures payment of the rights assigned and performance of my obligations under Paragraph 8 above. Assignee may direct any account debtor, obligor on an instrument, including, without limitation, the Settlement Obligor or Annuity issuer, to.make periodic payments directly to assignee as contemplated by the Uniform Commercial Code. Assignee may file a UCC-1 financing statement to perfect its rights hereunder. interpreted in a aas otherwise required by ccordance with the low of the state oflresfddsnre of law, Ass gnor on the date of this Agreement. ARBITRATION Any and all controversies, claims, disputes, rights, interests, suits or causes of action arising out of or relating to this Agreement and the negotiations related thereto, or the breach thereof, shall be settled by binding arbitration administered by the American Arbitration Association. The demand for arbitration shall be filed in writing with the other party to this Agreement and with the American Arbitration Association offices In your state of residence. The arbitration shall be held in the largest city in your state of residence. The arbitration shall be held before a single arbitrator selected in accordance with the Commercial Arbitration Rules of the American Arbitration Association in effect at the time that the demand for arbitration is fled. Discovery, specifically including interrogatories, production of documents and depositions shall be at the discretion of the arbitrator and to the extent permitted shall be conducted In accordance with, and governed by the Federal Rules of Civil Procedure. A demand for arbitration shall be made within a reasonable time after the claim, dispute or other matter in question has arisen. In no event, shall the demand for arbitration be made after the date when institution of legal or equitable proceedings based on such claim, dispute or other matter in question, would be barred by the applicable statute of limitations- No arbitration arising out of or relating to this Agreement shall include, by consolidation or joinder or in any other manner, an additional person or entity not a party to this Agreement, except by written consent of the parties hereto, containing a specific reference to this Agreement and signed by the entity sought to be joined. Consent to arbitration involving an additional parson or entity shall not constitute consent to arbitration of any claim, dispute or other matter in question not described in the written consent or with a person or entity not named or described therein.. The foregoing agreement to arbitrate and other agreements to arbitrate with an additional person or entity duly consented to by parties to this Agreement, shall be specifically enforceable In accordance with applicable law in any court having jurisdiction thereof. The award rendered by the arbitrator shall be final, and judgment may be entered upon it in accordance with applicable law in any court having jurisdiction thereof. Such arbitrator shall identify the substantially prevailing party and shall include legal fees and expenses for the substantially prevailing party.. This provision does not apply to the extent inconsistent with applicable state law regarding the transfer of structured settlement payments.. IR such case any disputes between the parries will be governed in accordance with the laws of the domicile state of the payee and the domicile state of the payed is the proper venue to bring any cause of action arising out of a breach of the agreement. G. I hereby grant to Assignee an Irrevocable Power of Attorney with full powers of substitution to do all acts and things that I might do regarding the Assigned Payments and any and all rights I have under the Settlement Agreement with respect to the Assigned Payments, including, without limitation, the power to endorse checks, drafts or other instruments, the power to alter, edit and change payment instructions and/or beneficiary designations and any other act which, in the sole discretion of Assignee as my Attorney-In-Fact Is necessary or expedient for it to obtain all of the benefits of the bargain contemplated by this transaction. This power of attorney is coupled with an interest and shall survive my death or disability. H- In the event that prior to the consummation of the transaction contemplated hereby I receive any of the Assigned Payments, or any portion thereof, the Assignment Price shall be reduced in like amount and the terms of this Agreement regarding the payments tD be assigned shall be deemed to be adjusted accordingly. In the event Assignee receives or otherwise comes into possession of any of ft Periodic Payment(s) or portion(s) thereof which are not included in the payments being absolutely assigned to Assignee hereunder, Assignee snail forward such amount(s) to me at time address set forth above within seven (7) days of receipt of such amount(s). 0b/90 39t/8 HlIWS NVSnS Z8ZOZELLTL 9Z :t70 600Z/0Z/80 t. Assignee shall be entilted to discharge any adverse claims against Assignor or any of the Assignee! Payments whether or not such adverse claims are disclosed. Assignee may, provided Assignee furnishes prior written notice to Assignor, pay any and all amounts necessary or, if the Assignment Price has been deposited Into an escrow account, instruct the escrow agent to pay any and all amounts necessary to discharge such liens or other adverse claims, and the Assignment Price shall be reduced by the amount of any such payment. Adverse claims may include disclosed amounts to be deducted by Assignee from the Assignment Price to pay Assignee, as servicer for Peachtree Finance Company, LLC, to enable Assignor to obtain Peachtree Finance Company, LLC's release of its encumbrance on a portion of the Assigned Payments, which portion of Assigned Payments relate to prior transfer transaction(s) consummated prior to the effective date of the applicable transfer act(s) which encumbrance must be released for the transaction contemplated herein to be consummated. J. I know that it will take some time for the Setflemerit Obligor and the Annuity Issuer to receive and process the court order once it is granted, I would like to receive the Assignment Price or a portion thereof as soon as possible thereafter. Accordingly, I hereby request Assignee to pay me a portion of the Assignment Price as soon as possible after the court order is granted and authorize Assignee to hold In escrow an amount it deems necessary or advisable from the Assignment Pdce (the "Escrow Amount) until all conditions precedent have been satisfied, including, without 11mitation, the receipt by Assignee of the Settlement Obligor and the Annuity Issuer's acknowledgment of the terms of the court order in writing and their agreement to honor and comply witch same. At such time or earlier as Assignee may determine, I understand that Assignee will send the Escrow Amount to me minus any Assigned Payments that the Annuity Issuer and/or Settlement Obligor sent to me while the Settlement Obligor and the Annuity Issuer were processing the court order. K. This Agreement shall take effect on the date it is signed by me (the Assignor) or on such later date prescribed by applicable statutory taw. L. All disclosure statements are a material part of this Agreement and shall be read in pari materia herewith. In witness whereof I hereunto set my hand. tll-'d .0 l9;4VV 0,'a-a/k/a Elleze Carabaflo-Ocasio STATE OF COUN'T'Y a4RC I! Y OF On the day of uu , in the yeari2001 before me, the undersigned, personally appeared Eliezer Carabailo-8cawo, personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument; and acknowledged to me that he/shelthey executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument, -2L ?Aotary My commission expires an 511 4 XO 1 A ?----?----- PIE.EASE DO NOT SIGN THIS Accepted: DOCUMENT UNTIL 08/20/2009 Settlement Funding, L.L.C. Title: NO AK tli?llt Date: =WARM Y 11MON Molar, lubfo MAMPM WA Gila CC3f?l'fY W Co1AaMINgn tMplrei MoY 14, 2012 0b/90 39Vd HINS NVSilS zeZOZELLIL 9Z:b0 6002/OZ/80 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PETITION OF SETTLEMENT ) FUNDING LLC d/b/a PEACHTREE ) SETTLEMENT FUNDING TO ) No. TRANSFER STRUCTURED ) SETTLEMENT PAYMENT RIGHTS ) Payee's Affidavit in Support of Petition to Transfer Structured Settlement Rights I, Eliezer Caraballo-Ocasio a/k/a Elieze Caraballo-Ocasio, the payee, verify that the statements below are true and correct: 1. Payee's name, address and age: Eliezer Caraballo-Ocasio a/k/a Elieze Caraballo- Ocasio, residing at 11 Cottage Court, Mechanicsburg, PA 17050-3171 and I am 28-years old. 2. Marital Status: x Never Married; Married; Separated; Divorced If married or separated, name of spouse: 3. Minor children and other dependents: Names, ages, and places of residence: Aracelys Ocasio, age eight, and she lives with me at the above address. 4. Income: (a) Payee's monthly income and sources: I am not currently employed and actively searching for proper employment. I will continue to receive monthly structured settlement payments of $700.00 through October 2010. (b) If presently married, spouse's monthly income and sources: 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 arrearages: 6. Previous transfers: Have you previously filed a petition to transfer payment rights under the structured settlement that is the subject of this petition? X Yes No If yes, for each petition that you filed, (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: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA IN RE: AMENDED PETITION OF SETTLEMENT FUNDING, LLC DB/A PEACHTREE SETTLEMENT : FUNDING TO TRANSFER No. 09-1538 STRUCTURED SETTLEMENT PAYMENT RIGHTS (PAYEE, ELIEZER C. OCASIO) (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: The transferee was Settlement Funding, LLC and the payments involved in the transfer were monthly payments of $2,163.32 each, commencing on June 6, 2009 through and including January 6, 2034. (ii) State the amount of money and the manner in which the money was used: I received $149,664.00, which was used to purchase a house. (c) Have you ever transferred payments without court approval? NO. If so, please explain: 7. Reasons for transfer: Describe in detail your reasons for the proposed transfer, including an explanation as to why a sale of a lesser amount of the structured settlement will not better serve your interests: I recently purchased a house in the Mechanicsburg area with the proceeds from my last transaction. I also made certain upgrades to the house and the current value of the house is $200,000.00. My fiance and I have decided to sell the house and move to the Orlando, Florida area where I will have more employment opportunities in the hospitality industry. Accordingly, I will use the $41,000.00 that I will receive from this transaction, along with the proceeds of the sale of my house in Mechanicsburg, for the outright purchase of a four-bedroom house in the Orlando area. A sale of a lesser amount of the structured settlement will not allow me to purchase a new house in this manner. 8. Payment of debts: If you seek the transfer in order to pay debts, list each debt, including the name of the creditor and the amount presently owed: N/A Debt Creditor Amount Owed Peachtree E-,TLFMENT FUNDING 4.' Notice to Annuity Issuer and Structured Settlement Obligor Hartford-Comprehensive Employee Ben. Svc. Hartford Life Insurance Company Co. 200 Hopmeadow Street 200 Hopmeadow Street Simsbury, CT 06089 Simsbury, CT 06089 (ISSUER) (OBLIGOR) RE: Transfer of structured settlement rights by Eliezer Caraballo-Ocasio Annuity Contract #: CCX0539543 DOB: 3/21/1981 Payments to be Transferred: 296 monthly payments each in the amount of $700.00 commencing on November 6, 2009 through and including June 6, 2034. This letter shall serve as formal notice to you, as required by PA ST 40 PS §4003(a)(6) of Eliezer Caraballo-Ocasio's pending transfer of certain structured settlement payment rights. Pursuant to PA ST 40 PS §4003(a)(6), the transferee's name and address is: Name: Settlement Funding, LLC Address: 3301 Quantum Boulevard Boynton Beach, FL 33426 Taxpayer I.D.: 58-2292928 Any other statutory requirements that may apply to this transaction will also be followed. 3301 Quantum Boulevard • Boynton Beach, FL 33426 Phone: (561) 962-3900 • Fax: (561) 962-7217 August 14, 2009 Hartford-Comprehensive Employee Ben. Svc, Co. 200 Hopmeadow Street Simsbury, CT 08089 Re; Annuity Contract No. CCX0639643 Claimant: Eltezer Caraballo-Ocasio SSA 582-81=1979 Dear Sirs: Please change your records to show the Estate of Eliezer Caraballo-Ocasio as the beneficiary after my death under the above-captioned settlement agreement and annuity contract. Kindly confirm that you have made this modification to your records by signing In the space provided below and mailing to: Settlement Funding, LLC, 3301 Quantum Boulevard. Boynton Beach, FL 33428-6822. Regards, --) _ alk/a Elieze STATE OF COUNTY OR On the ? day of in the year*2004 before me, the undersigned, personally appeared Errezer Caraballo-t7oasio7 personally known to me or proved to me on the basis of satisfactory evidence to be the Individual(s) whose name(s) is (are) subscribed to the within Instrument and acknowledged to rrte that helshelthey executed the same in WherAheir capacity(ies), and that by hisihedtheir signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument I I& AA ??1.. Notary Niy commission expires on 5 ,q ?"1>1 INIGNUM SWM M I" MI? ra0b/LT 39dd HlIWS NdSnS ZeZOZELLTL 9Z:b0 600Z/0Z/80 August 14, 2009 Hartford Life Insurance Company 200 Hopmeadow Street Simsbury, CT 06089 Re. Annuity Conduct Na CCX0532W Claimant FJ!ezer Caraballo-Ocasio SS#: 582-81-1979 Dear Sirs; Please change your records to show the Estate of Eliezer Caraballo-Ocasio as the beneficiary after my death under the above-captioned settlement agreement and annuity contract. Kndly confirm that you have made this modification to your records by signing in the space provided below and mailing to: Settlement Funding, LLC, 3301 Quantum Boulevard, Boynton Beach, FL 33428-8822 Regards, --? ..-. ME-.F Caraballo-Ocasio STATE OF T.L- , COUNTY OR CITY OF On the -'L#- day of in the yeaPA00 before me, the undersigned, personally appeared Ellezer Carabaft-Ocasio, personally known to me Orr-proved to me on the basis of satisfactory evidence to be the Individual(s) whose name(s) is (are) subscribed to the within instrument, and acknowledged to me that he/she/ihey executed the same In hisThedthelr capacity(les), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. JUA..j -;'A -'&? f Notary My Commission expires on !IQ?AlIAL MIL lumwi M No Hartford Life Insurance Company M? Cc" By. bated: s W* 1 4. 2412 0b/81 39Vd HlIWS NdSnS Z8ZOZELLTL 9z:b0 600Z/0Z/80 DEPENDENTS OF EUEZER CARARALLQ-4CASi4 "Dependents" include your spouse a>ffd minor children an d all other family members and other persona for whom you are lesally oblisated to nror?ide subnort inclndina Alien n?? I have dependent(s) m listed below: a46zerllo-Ocasia alida Elieze (• aballo-Acasio - S4., ? Date ""a elations>ri DOB Age 0b/5Z 39Vd HlIWS NVsns Z8ZOZELLZL 9Z41e 690Z/0Z/89 PENNSYLVANIA TRANSFER DISCLOS PE Payee: Ellazar Caraballo-ocasio alkla Elieze Caraballo-Ccasio; resident of: PA A. Amounts and due dates of the structured settlement payments to be transferred: 296 monthly payments each in the amount of $700.00 commencing on November 6, 2009 through and including June 6, 2034. B: Aggregate amount of such payments: $207,200.00 C. (1) Discounted present value of such payments: $139,437.79 (2) The discount rate used In determining such discounted present value: 3.40 percent as of August 10, 2009. D. Gross amount payable to the Payee in exchange for such payments: $43,339.61 E. Itemized listing of all brokers' commissions, service charges, application or processing fees; closing costs, filing or administrative charges, legal fees, notary fees and other commissions, fees, costs, expenses and charges payable by the Payee or deductible from the gross amount otherwise payable to the Payee: Legal Fees: $2,000.00; Processing Fee: $200.00 F. Net amount payable to Payee after deduction of all commissions, fees, costs, expenses and charges described above: $41,139.61 minus any advances made to Payee against the amount payable to Payee. G. The quotient, expressed as a percentage, obtained by dividing the net payment amount by the discounted present value of the payments: 29.60% N. Amount of any penalty and the aggregate amount of any liquidated damages, inclusive of penalties, payable by the Payee In the event of any breach of the transfer agreement by the Payee: NONE 0b/8Z 39dd HlIWS NdSns Z8ZOZELLTL 9Z:b0 600Z/0Z/80 Payee acknowledges receipt of, and acknowledges to have read and understood, the above disclosure statement and Information required to be disci by Payee's applicable state statute(s). Initials: BY signing below you are confirming that you received a copy of this disclosure at ! t 3 jdaprior to executing your transfer agreement. Elie r Caraballo- aaslo alk/a Elieze Carabailo-Ocasio Date 0b/6Z 39dd HlIWS NVSIIS ZBZOZELLTL 9Z:b0 600Z/OZ/80 NOTICE (PA) Payee: Eliezer Caraballo-Ocasio afkla Eliexe Caraballo-Ocasio IMPORTANT NOTICE: You are strongly urged to consult with an attorney who can advise you of the potential tax consequences of this "ransaction. l acknowledge receipt of the above notice. By signing below you are confirming that you received a copy of this notice at least 10 day"rior to executing your transfer agreement. Caraballo-Ocasio alida Ellexe Caraballo-Oeasio bate 0b/0E 39Vd HlIWS Nvsns Z8Z0ZELLZL 9Z :b0 600Z/0Z/80 ACKNOWLEDGEMENT (PA) Payee: Eliezer Caraballo-Ocasio a/k/a Elleze Caraballo-Ocasio (Please Initial the following statement) I expressly waive independent .legal advice regarding the implications of the transfer, including considerations of the tax ramifications of the transfer. EC (initials) Elie r Caraballo-Ocasio atk/a Elleze Caraballo,Ocasio b -r-P Date 0b/Z8 39b8 HlIWS NVsnS ZBZOZELLIL 9Z:b0 GOOZ/0Z/80 CONNECTICUT TRANSFER DISCLOSURE Payee: Elieier Caraballo-Ocasio a/k/a Elieze Camballo-Ocasio; resident of. PA A. Amount and due dates of the structured settlement payments to be transferred: 296 monthly payments each in the amount of $700.00 commencing on November 6, 2009 through and including June 6, 2034. B. Aggregate amount of the payments: $207,200.00 C, Discounted present value of the payments: $139,437.79; the calculation of current value of the transferred structured settlement payments under federal standards for valuing annuities and is determinod by applying a (discount) rate of 3.40% as of August 10, 2009. D. Gross advance amount: $43,339.61 E. Itemized listing of all applicable transfer expenses, other than attorney's fees and related disbursements payable In connection with the transferee's application for approval of the transfer, and tho transferee's best estimato of the amount of any of those fees and disbursements: Processing Fee $200.00 F. Estimate of the amount of attorney's fees: $2,009.00 G. Net advance amount: $41,139.61 H. Amount of any penalties or any liquidated damages payable by the Payee in the event of any breach of the transfer agreement by the Payee: NONE I. You have the right to cancel the transfer agreement, without penalty or further obligation, not later than the third business day after the date the agreement is signed by you, J. You are advised to seek independent professional advice regarding the transfer.' 0b/VC 39Vd HlIWS Nvsns Z8ZOZCLLZL 9Z:b0 6002/0Z/80 Payee acknowledges receipt of, and acknowledges to have read and understood, the above disclosure statement and information required to be dis by Payee's applicable state statute(s). lnitiais13y signing below you are confirming that you received a copy of this disclosure leas , im- prior to executing your transfer agreement. .f 1 or Caraballo-Ocasio a/k/a Elieze Carabailo-Ocasic 11 ni Date 0b/9£ 30Vd HiIWS NdSnS Z8ZOZ£LLIL 9Z:b0 600Z/0Z/80 APR-28-2009(TUE) 10:0 P. 002/003 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA IN RE: AMENDED PETITION OF SETTLEMENT FUNDING, LLC d/b/a PEACHTREE SETTLEMENT FUNDING TO TRANSFER No.09-1538 STRUCTURED SETTLEMENT - PAYMENT RIGHTS - (PAYEE, ELIEZER C. OCASIO) - FINAL ORDER On this 29" day of 2009, it is ordered that the Amended Petition to Transfer Structured Settlement Payment Rights is granted. T)Ze court specifically finds that: (1) the payee, Eliezer C. Ocasio, has established that the transfer is in the best interests of the payee or, his dependents, taking into account the welfare and support of payee's dependents, if any: (2) based on the certification by an attorney for the transferee, Settlement Funding, LLC, 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 Federal or State statute or regulation, or the order of any court or responsible 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(a) (6); RPR-28-2009ME) 10;43 P 003/003 (4) the payments that are to be transferred are designated as follows: 296 monthly payments each in the. amount of $2,163.32 commencing on June 6, 2009 through and including January 6, 2034 (the "Assigned Payments"). (5) the Structured Settlement Obligor is Hartford- Comprehensive Employee Ben. Svc. Co., and the Annuity issuer is Hartford Life Insurance Company. The Strucured Settlement Obligor and Annuity issuer shall forward the Assigned Payments, when due, to Settlement. Funding, LLC, at P.O. Box 116476, Atlanta, GA 30368-6476 or to such other address as designated by Settlement Funding, LLC. (6) the terms of this order shall survive the death of the payee and shall be binding on the payee's heirs, beneficiaries and assigns. (7) the payee shall receive from the transferee the gross amount of $150,115.00. BY THE COURT: J. TRUE COPYRE ORD Iri Testimo6y'uAh rcof, f hcre'unto set my and and_the; seal of, said".Cour? a# Carlisle; Pe. W. . ' .-'?.,.. day, of ..?..» ? ?Qthonota'y 5 . 1` L - - OF THE 2C,03 faire;; 3I 1i N 13: oo 78.50 P-D AIW C?'? ?3a Rte`o-61g9(o(v MARK THOMAS SOPHOCLES, LLC PA Supreme Court Attorney ID # 74998 21 Industrial Blvd., Suite 201 Paoli, PA 19301 Tel: (610) 651-0105 Fax: (610) 651-0106 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA- CIVIL DIVISION IN RE: ELIEZER CARABALLO-OCASIO A/K/A ELIEZE CARABALLO-OCASIO PETITION TO TRANSFER STRUCTURED SETTLEMENT PAYMENT RIGHTS No. 09 - s9 a-f INITIAL ORDER OF COURT On this 3 day of , 2009, it is ordered that a hearing on this Petition to Transfer Structured Settlement Payment Rights will be held on /009`0f in courtroom at lb %" Q, r4 • years to the hearing. o'clock. The payee shall bring income tax returns for the prior two (2) 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 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: J. ?FOW Y 4F _b ? ?: 5a Ito SEP ? 51 9/18/0-F - C,?x MZ2LLC?- 40 IN RE: ELIEZER CARABALLO- IN THE COURT OF COMMON PLEAS OF OCASIO a/k/a ELIEZE CUMBERLAND COUNTY, PENNSYLVANIA CARABALLO-OCASIO CIVIL ACTION - LAW NO. 09-5929 CIVIL IN RE: PETITION FOR APPROVAL OF TRANSFER OF STRUCTURED SETTLEMENT PAYMENT RIGHTS ORDER AND NOW, this yday of September, 2009, hearing in the above-captioned matter set for October 9, 2009, is rescheduled for Tuesday, October 6, 2009, at 11:15 a.m. in Courtroom Number 4, Cumberland County Courthouse, Carlisle, PA. BY THE COURT, 4 A? Kevin X. Hess, J. ? Mark Thomas Sophocles, LLC 21 Industrial Blvd., Suite 201 Paoli, PA 19301 For the Petitioner :rlm (20f 7 rru_4U__?' -r fy%l 2009 SEP 15 it I I : Cl J r 1, it ," ; _v `, ?" MARK THOMAS SOPHOCLES, LLC PA Supreme Court Attorney) D # 74998 21 Industrial Blvd., Suite 201 Paoli, PA 19301 Tel: (610) 651-0105 Fax: (610) 651-0106 IN THE COURT O COMMON PENNSYLVAT\ ;AS OF CUMBERLAND COUNTY CIVIL DIVISION IN RE: ELIEZER CARABALO-OCASIO A ELIEZE CARABALLO-OCASIO PETITION TO TRANSFER STRUCTURED SETTLEMENT PAYMENT RIGHTS I Civil Docket No. 2009-5929 On this day of October, 2009, it i ordered that the Petition to Transfer Structured I Settlement Payment Rights is granted. The court specifically finds that: (1) the payee, Eliezer Cara> allo-Ocasio a/k/ Elieze Caraballo-Ocasio, has established that the transfer is in the best interests of the payee o the payee's dependents, taking into account the welfare and support of his dependents, if any; (2) based on the certification by an attorney or the transferee, Settlement Funding, LLC, and the court having not been made aware of any sta te, regulation or order that would be incompatible with the proposed transfer, the tr fer will not contravene any applicable federal or state statute or regulation, or the order of any court or responsible administrative authority; (3) the transfer complies w?th the remaining requirements of the Structured Settlement Protection Act, including Secti ns 3(a)(2), 3(a)( A), 3(a)(5) and 3(a)(6); (4) the payments that are to be transferred are designated as follows: monthly payments each in the amount of $70.00 commencing on November 6, 2009 through and including June 2034 (the "Assigned Payments") (5) the terms of this order shall survive the c payee's heirs, beneficiaries and, assigns; (6) the payee shall receive ? om the transfer (7) The Annuity Owner is Hartford-Compre Annuity Issuer is Hartford Life, Insurance Comp shall send the Assigned Payments, when due, to Atlanta, GA 30368-6476 or to such other addres III /a'0to - 40°9 coP? c s ?? t to ?4Ny S?P?p de 5 of the payee and shall be binding on the the gross amount of $43,339.61. a-.i ?.A- q Jot, X39. L !, nsive Employee Ben. Svc. Co. and the my. The Annuity Owner and the Annuity Issuer Settlement Funding, LLC at P.O. Box 116476, 3 as designated by Settlement Funding, LLC. BY THE COURT: