Loading...
HomeMy WebLinkAbout09-6765MARK 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: MICHAEL BENSON A/K/A MICHAEL W. BENSON PETITION TO TRANSFER STRUCTURED SETTLEMENT PAYMENT RIGHTS No. 09- rlt-.S 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 Peachtree Settlement Finance Co., LLC, 3301 Quantum Boulevard, Boynton Beach, FL 33426. 3. The Payee, Michael Benson a/k/a Michael W. Benson, (hereinafter "Payee") is an adult individual of full age and who resides at 3803 Glenwood Ave, #9, Camp Hill, PA 17011-6945 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. Michael Benson a/k/a Michael W. Benson suffered personal injuries, and as a result, is entitled to receive payments as follows: 144 monthly payments each in the amount of $569.79 commencing on November 8, 2006 through and including October 8, 2018 (the "Periodic Payments"). 6. The Annuity Owner is American General Annuity Service Corporation, 2929 Allen Parkway, Houston, TX 77019. 7. The Annuity Issuer is American General Life Insurance Company, 2727A Allen Parkway, Houston, TX 77019. 8. On October 2, 2009, Michael Benson a/k/a Michael W. Benson executed an Absolute Assignment Agreement (the "Agreement") a true and correct copy is attached and incorporated herein as Exhibit "A" that provides for the assignment of monthly payments as follows: 104 monthly payments each in the amount of $569.79 commencing on March 8, 2010 through and including October 8, 2018 (hereinafter "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 Payment 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 $25,145.97 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 $25,145.97, the amounts and timing of the structured settlement payment that would be assigned, the payee is, in effect, paying interest at a rate of 22.80% per year. 12. After due consideration, the Payee is satisfied that the transfer is in his best interest for the reasons set forth in the Affidavit attached hereto as Exhibit C and incorporated herein by reference. 13. The Payee has received the notice required by 40 P.S. §4003(b) as evidenced by Exhibit D hereto. 14. The Payee has given the notice required by 40 P.S. §4003(a)(6) as evidenced by Exhibit E hereto. 15. Attached hereto as Exhibit F is the certification required by Pa.R.C.P. 229.2(d)(3)(iii). 16. Payee has been advised to seek 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 to approve this Petition. Respectfully submitted, Dated: October 8, 2009 .0 L MARK THOMAS SOPHOCLES, LLC VERIFICATION AND CERTIFICATION I, Mark Sophocles, Esquire as authorized outside counsel for Peachtree Settlement Finance Co., 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: October 8, 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: MICHAEL BENSON A/K/A MICHAEL W. BENSON PETITION TO TRANSFER STRUCTURED SETTLEMENT PAYMENT RIGHTS No. 09- NOTICE OF PROPOSED TRANSFER OF STRUCTURED SETTLEMENT PAYMENT RIGHTS To: American General Annuity Service Corporation 2929 Allen Parkway Houston, TX 77019 (Settlement Obligor) American General Life Insurance Company 2727A Allen Parkway Houston, TX 77019 (Annuity Issuer) Peachtree Settlement Finance Co., LLC 3301 Quantum Boulevard Boynton Beach, FL 33426 Attn: Court Order Group (Transferee) Michael Benson a/k/a Michael W. Benson 3803 Glenwood Ave, #9 Camp Hill, PA 17011-6945 (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 October 28, 2009 or for 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: Peachtree Settlement Finance Co., LLC 3301 Quantum Boulevard Boynton Beach, FL 33426 (TIN: 26-3234552) Respectfully submitted, Dated: October 8, 2009 MARK THOMAS SOPHOCLES, LLC MARK THOMAS SOPHOCLES, ESQ. PA ID # 74998 21 Industrial Blvd., Suite 201 Paoli, PA 19301 610.651.0105 at AM/PM in 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 8th day of October 2009. American General Annuity Service Corporation 2929 Allen Parkway Houston, TX 77019 (Settlement Obligor) American General Life Insurance Company 2727A Allen Parkway Houston, TX 77019 (Annuity Issuer) Peachtree Settlement Finance Co., LLC 3301 Quantum Boulevard Boynton Beach, FL 33426 Attn: Court Order Group (Transferee) Dated: October 8, 2009 Michael Benson a/k/a Michael W. Benson 3803 Glenwood Ave, #9 Camp Hill, PA 17011-6945 (Petitioner) Respectfully submitted, MARK THOMAS SOPHOCLES, LLC ARK THOMAS SOPHOCLES, ESQ. 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: MICHAEL BENSON A/K/A MICHAEL W. BENSON 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: 104 monthly payments each in the amount of $569.79 commencing on March 8, 2010 through and including October 8, 2018 (hereinafter "assigned payments") (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, the net amount of $25,145.97 from which no funds are owed for counsel fees, administrative fees, or other costs, fees or expenses. (7) The Annuity Owner is American General Annuity Service Corporation, 2929 Allen Parkway, Houston, TX 77019 and the Annuity Issuer is American General Life Insurance Company, 2727A Allen Parkway, Houston, TX 77019. The Annuity Issuer and the Annuity Owner send the Assigned Payments to Peachtree Settlement Finance Co., LLC at P.O. Box 116476, Atlanta, GA 30368-6476 or to such other address as designated by Peachtree Settlement Finance Co., LLC. BY THE COURT: J. VERIFICATION a, I, KURT MOODY, In-House Counsel of Peachtree Settlement Finance Co., LLC, 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 unsworn falsification to authorities. i DATE: October 8, 2009 KURT MOODY 10 ABSOLUTE ASSIGNMENT AGREEMENT (THE "AGREEMENT") October 4, 2009 I, Michael Benson alkla Michael W. Benson, ("I", "Me" or "Assignor") residing at 3803 Glenwood Ave #9, Camp Hill, PA 17011-6945 am entitled to 144 monthly payments each in the amount of $669.79 commencing on November 8, 2009 through and including October 8, 2018 (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 dated December 9, 2005 (the "Settlement Agreement"). The Periodic Payments are due to me from American General Annuity Service Corporation (the "Settlement Obligor") under the terms of the Settlement Agreement and are being funded by an annuity issued by American General Life Insurance Company (the "Annuity Issuer") bearing annuity contract number 419875. A. I hereby sell, assign and convey to Peachtree Settlement Finance Co., LI,C (the "Assignee") 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: 104 monthly payments each in the amount of $569.79 commencing on March 8, 2010 through and including October 8, 2018. (the "Assigned Payments"); and In consideration for this assignment, Assignee shall pay to me the sum of: $27,346,97 (the "Assignment Price" Y 6. 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 Paragraphs B 1 and B 2 above are at any time not true.. 2. Failure by me to perform the promise set forth in Paragraph B 3 above. 3. 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 achy 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. 61 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. 09/8T 39Vd dIHO 3171-18 09EIZEZLTL 817:ZZ 800Z/Z0/T0 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 on or after the day of the Order be forwarded, or authorizing the foiwai ling 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 under Article 9 of the Uniform Commercial Code of the state designated in Paragraph F below. This Agreement shall also function as a security agreement. This security 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--t financing statement to perfect its rights hereunder. F. Except as otherwise required by applicable statutory law, this Agreement shall be governed by and interpreted in accordance with the law of the state of residence of the Assignor 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 filed. 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 parry 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 person 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 Ors/6T 39Hd dIHO 3x118 b9ETZ£ZLTL Bb:ZZ 800Z/Z0/T0 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. 16 such case any disputes between the parties will be governed in accordance with the laws of the domicile state of the payee and the domicile state of the payee 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 1 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 to be assigned shall be deemed to be adjusted accordingly. In the event Assignee receives or otherwise comes into possession of any of the Periodic Payment(s) or portion(s) thereof which are not included In the payments being absolutely assigned to Assignee hereunder, Assignee shall forward such amount(s) to me at the address set forth above within seven (7) days of receipt of such amount(s). 1. Assignee shall be entitled to discharge any adverse claims against Assignor or any of the Assigned 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, instruot 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, on behalf of 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 Settlement 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 Price (the "Escrow Amount") until all conditions precedent have been satisfied, including, without limitation, 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 with same. At such time or earlier as Assignee may determine, I understand that Assignee will send the Escrow Amount to me 05/0Z 39vd &HO 3n-M bSETZEZLTZ Bb:ZZ 800Z/Z0/T0 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 law. L. All disclosure statements are a material part of this Agreement and shall be read in par[ materia herewith. In witness whereof I hereunto set my hand. Michael Benson a/k/a Michael W Benson STATE OF 1`t COUNTY OR CITY OF On the 1~ day of X 2.t , In the year _Q)"'l before me, the undersigned, personally appeared Michael Benson, 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/she/they executed the some in hisiher/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. My Commission expires on 9 P-I to Notary PLEASE DO NOT SIGN THIS DOCUMENT UNTIL 10/04/2009 Accepted: Peachtree Settlement Finance Co., LLC By: Settlement Funding, LLC, Manager i- -. rn - By: J C,.U Title: Date: &9 COMMONWEALTH OF PENNSYLVANIA Notarial Sea! usa A. Seat', NOW PubNa atyOfHa+rishmg, 06WKrt C4)U* * OXffldsston E)Vree J* 24, x011 Member, Peonsylvanla Assocraaon at Noterles VS/TZ 39vd dIH3 3n-m b5£TZ£ZLTL 80:ZZ BO0Z/Z8/Te DEPENDENTS OF MICHAEL BENSON AIKIA MICHAEL W. BENSON I have no ehildren/dependent(s); Michael Denson aWa Michael W. Benson (cat ` (05 Date 05/6£ 33dd dIHO 3n-M bG£IZ£ZLiL Bb:zz Boaz/za/ia 1N THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PETITION PEACHTREE ) SETTLEMENT FINANCE CO., LLC ) No. TO TRANSFER STRUCTURED ) SETTLEMENT PAYMENT RIGHTS ) Payee's Affidavit in Support of Petition to Transfer Structured Settlement Rights I, Michael Benson, the payee, verify that the statements below are true and correct: 1. Payee's name, address and age: Michael Benson residing at 3803 Glenwood Ave 09 Camp Hill, PA 17011-6945 and I am 20 years old. 2. Marital Status: x_ Never Married; Married; ____Separated; Divorced Ifmarried or separated, name of spouse: 3. Minor children and other dependents: Names, ages, and places of residence: n/a 4. Income: (a) Payee's monthly income and sources: I am not c=ntly employed. I am r,,.,. however, seeking ernpl6vment. I will continue to receive payments from my Structured settlement in the amount of $569.79 a month until March 2010. (b) If presently married, spouse's monthly income and sources: 5. Child support, afimony or alimony pendente lite: 08/ZZ 39Vd dIN3 3n-0 0GETZEZLTL ep:ZZ 800Z/Z0/T0 Obligation to pay: Yes -x-,- No If yes, state the amount of the obligation, to whom payable, and whether there are auearages: 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, (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: (ii) 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: 05/EZ 3-9Vd dIHO 3n-E 0GETZEZLIL 80:ZZ 8002/Z0/T0 ?. 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 am currently in need of dependable transporUtion in order to seek and maintain employment as well as for other day-to-day necessities Therefore I intend to use $12.000.00 of the procee from t?s transaction to purchase a reliable, pre-owned vehicle and $2,000.00 to pre-pay My car insurance for one year. I will then use $8,400.00 to pre-pay the rent on my apartment for one year. The remaining fund of approximately $2,600.00 will be used to help cover my living ex0„epses until 1 am earning a steady income from employment. A sale of a lesser amount will not allow me to accomplish these goals. 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 $ it 09/17Z 39b'd dIH3 3ms PSEtZEUTL Bti:ZZ 800Z/Z0/T0 Verifleation 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 unswom falsification to authorities. DATE: O ((v I Michael Benson aWa Michael W. Benson 09/92 39dd caHo wis 09£TZ£ZLTL 80:ZZ 8002/z0/i0 TEXAS TRANSFER DISCLOSURE Payee: Michael Benson alkla Michael W. Benson; resident of: PA A. Amounts and due dates of the structured settlement payments to be transferred: 104 monthly payments each in the amount of $569.79 commencing on March 8, 2010 through and including October 8, 2018. B. Aggregate amount of the payments: $59,258.18 C. Discounted present value of the payments to be transferred (i.e. This is the calculation of current value of the transferred structured settlement payments under federal standards for valuing annuities determined by applying the most recently published (discount) rate of 3.40% as of September 23, 2009): $60,623.07 D. Gross advance amount: $27,345.97 E. Itemized listing of all applicablb transfer expenses, other than attorney's fees and related disbursements payable in connection with the transferee's application for approval of the transfer, and the transferee's best estimate of the amount of those expenses: Processing Fee: $200.00 F. Estimate of the amount of attorney's fees: $2,000.00 G. Net advance amount: $25,145.97 minus any advances made to the Payee or on Payee's behalf, or claims satisfied, against the amount payable to Payee. H. Amount of any penalties or liquidated damages payable by the Payee in the event of any breach of the transfer agreement by the Payee: NONE 1. You have the right to cancel the transfer agreement, without penalty or further obligation, not, later than the third business day after the date you signed the agreement. J. Payee is advised to seek independent professional advice regarding the transfer. 05/80 39Vd dIH3 Wig b9ETZEZLTL 80:ZZ 800Z/Z0/T0 K. An estimate of the Administrative fee(s) being charged by the Annuity Owner and or the Annuity Issuer to be paid by the transferee (not the consumer) as a result of the transfer: American General Life Insurance Company .$600.00 Payee acknowledges receipt of, and acknowledges to have read and understood, the above disclosure statement and information required to be disclosed by Payee's applicable state statute(s). Initials: __,e ,713 By signing below you are confirming that you received a copy of this disclosure at least 3 days prior to executing your transfer agreement. Michael Benson alkla Michael W. Benson y l-(C Qg Date 05/60 39dd dIH3 3n is b9ETZEUTL GO= 800Z/Z0/t0 PENNSYLVANIA TRANSFER DISCLOS,,,_ URE Payee: Michael Benson alkla Michael W. Benson; resident of: PA A. Amounts and due dates of the structured settlement payments to be transferred: 104 monthly payments each in the amount of $569.79 commencing on March 81 2010 through and including October 8, 2018. B. Aggregate amount of such payments: $59,258.16 C. (1) Discounted present value of such payments: $50,623.07 (2) The discount rate used in determining such discounted present value: 3.40 percent as of September 23, 2009. D. Gross amount payable to the Payee in exchange for such payments: $27,345.97 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: $25,145.97 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: 49.67% H. 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 1. An estimate of the Administrative fee(s) being charged by the Annuity Owner and or the Annuity Issuer to be paid by the transferee (not the consumer) as a result of the transfer: American General Life Insurance Company - $500.00 091L0 39d8 8IH9 3n'19 OSETZEZLTL 8ti:ZZ 800Z/Z0/10 Payee acknowledges receipt of, and acknowledges to have read and understood, the above disclosure statement and information required to be disclosed by Payee's applicable state statute(s). Initials: ?' 13 By signing below you are confirming that you received a copy of this disclosure at least 10 days prior to executing your transfer agreement. Michael Benson a/k/a Michael W. Benson zO D Date b9/89 30Vd dIHO 3ms b9ETZEZLTL 80:ZZ 800Z/Z0/T0 NOTICE (PAS Payee: Michael Benson alk/a Michael W. Benson IMPORTANT NOTICE: You are strongly urged to consult with an attorney who can advise you of the potential tax consequences of this transaction. I acknowledge receipt of the above notice. By signing below you are confirming that you received a copy of this notice at least 10 days prior to executing your transfer agreement. Michael Benson alkla Michael W. Benson /o 0 Date 109/60 30Vd dIHO 3mS VSETZEZLTL 810:zZ 800Z/Z0/T0 ACKNOWLED ,SEMEN, T (Payee. Michael Benson alk/a Michael W. Benson (Please initial the following statement) expressly waive independent legal advice regarding the implications of the transfer, including considerations of the tax ramifications of the transfer. A,8 - (Initials) Michael Benson a/k/a Michael W. Benson Date VS/TT 30Vd dIHO 3ma b9ETZEZLTL Bb:ZZ 800Z/Z0/10 peachtree ETTtEMENT FUNDING Notice to Annuity Issuer and Structured Settlement Obligor American General Annuity Service American General Life Insurance Company Corporation 2727A Allen Parkway 2929 Allen Parkway Houston, TX 77019 Houston, TX 77019 (ISSUER) (OBLIGOR) RE: Transfer of structured settlement rights by Michael Benson Annuity Contract #: 419875 DOB: 11/8/1988 Payments to be Transferred: 104 monthly payments each in the amount of $569.79 commencing on March 8, 2010 through and including October 8, 2018. This letter shall serve as formal notice to you, as required by PA ST 40 PS §4003(a)(6) of Michael Benson'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: Peachtree Settlement Finance Co., LLC Address: 3301 Quantum Boulevard Boynton Beach, FL 33426 Taxpayer I.D.: 26-3234552 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 AMERICAN ? uctumd Settlement GENERAL up Annuity Application Amerioant Cenral We Miannce Cwnpm% Iftudon, Tx 1. 1EASWM Namt.. Led Filet Middle LEE Benson Address Steil M Sfala ZIP 261 Valle Road Etters PA 17319 Sax D810011110 Sold S=* NWtW DnIM Telephone M 11-08-1988 540-29-7060 ( ) t mool- Estate of Michael Benson GARY htmy Bmdum . SSN RdaYoaaahlp Serxradary Baaelolary SSN ReaY00110 * PAYEE (IF OT1191 Name: teat Fist Middle TNAN Aridness: Stern Ck Slade IIp MEA311RI116 LIFE) Sex Dade of dill Sandal Sealy Naraaber D"WAR 0 Tud0 taaae 4. ,IONS tlanae: tart Hint Middle UF'F, Address Steet CRY Sole ZIP F ANY Isex Dale of WA SocY Saas? Mintier On- N Tdeplaoale ? ?xD Nam AI/ W American General Annuity Service Corporation 76-0446159 Addlees: Suet 010 Sko ap 205 E. 10th Avenue Amarillo TX 79101-3546 The owner IS: ? Owner ? Ferias lip CICUIPogiao ? Yu dW FLAN AMJED FOR AND SCHEDULE OF FRYMENIV $569.79 payable monthly, guaranteed for 144 months, beginning 11-08-2006 Aaraant paid wm flab applca do t ti 1.00 Vatrable O msideration ? Cxaead If adr ftW dW attaded. WE the annuity applied for replace or be in w change for any existing ft inamince or ardo ty in ft or any Wier Company? Q Yes V No If Yes, on anrlpenny, ammalat, year leaned sad reason Any persona who, with iraM to defraud or tenoning NO he/she is faeilt ling a fraud against an Insurer, submits an application or flies a claim coining a false or deceptive statement commits Insurance Maud, which is a alms and may aub)eot the person to criminal sad CNN penalties. I have read tie above statements or they have been read to me. I represent tits above statements are true and complete to. the best of my knowledge and belief. I agree Mat this appkakn steal be pad of the arms ty polm{les) Issued by to American General Ufe Insurance Company, Application is made with the Imowledge and consent of the proposed measuring We(ves). I agree that any annuity policy Issued upon this application shall be a policy of the state In whlh the Owner resides at the time of application. .. ? So" at Amarillo Texas an _ CA' 5 American General Annuity Service Corporation brx DOW Sagnaee d OWN FOR AGENT USE ONLY: I represent that the Information given on this application Is true and complete to the best of my knowledge and belief . To the best of your l pdWtge, Is Is saran being purchased to replace or change any existing insurance or annuity? ? Yes K) No , Structured Financial Associates, Inc. Aged or Cempmy Name (770) 393-1 028 ApdwCwoftN. Telephone Na ...? o- r.o u- o wy - am "WWWW g "WX am= YL9 sax OM and Md bf Anshan Galore( Cbrporaeon ad xs abddades, k dk&V AMK(= Cameral M Wram CcnWV AQDM -M AMERICAN GENERAL LIFE INSURANCE COMPANY This is a Single Premium Immediate Annuity Contract. The guaranteed payments, if any, are stated on the Payment Schedule page of the Policy. READ THIS CONTRACT CAREFULLY. This Policy explains how the annuity works, and is a legal contract between the Owner and the Company. All payments and benefits will be payable subject to the terms of this Policy. Examine the Payment Schedule page and attached Application. If any errors or omissions are found, immediately contact the Company. THIS POLICY IS NON-PARTICIPATING - DIVIDENDS ARE NOT PAYABLE. PLEASE READ THIS POLICY CAREFULLY. THE POLICY IS IRREVOCABLE AND HAS NO CASH VALUE OR SURRENDER VALUE AND CANNOT BE COMMUTED OR SURRENDERED. THIS POLICY IS A LEGAL CONTRACT BETWEEN THE OWNER AND AMERICAN GENERAL LIFE INSURANCE COMPANY. For information, service or to make a complaint, contact your servicing agent or the Company's Administrative Office at: American General Life Insurance Company 205 East 101n Avenue, Amarillo, TX 79101 01015 Uniform Qualified Assignment and Release 'Claimant' Michael Benson, a minor, by and through his parent and natural guardian, Donna Benson 'Assignor' Progressive Northern Insurance Company 'Assignee' American General Annuity Service Corporation 'Annuity Issuer" American General Life Insurance Company 'Effective Date' D 7' 0?8 -40ck5 This Agreement is made and entered into by and between the parties hereto as of the Effective Date with reference to the following facts: A. Claimant has executed a settlement agreement or release dated bece4,,c6&r q .2005' (the 'Settlement Agreement") that provides for the Assignor to make certain periodic payments to or for the benefit of the Claimant as stated in Addendum No. 1 (the "Periodic Payments'); and B. The parties desire to effect a "qualified assignment" within the meaning and subject to the conditions of Section 130(c) of the Internal Revenue Code of 1986 (the "Code'). 3. The Assignee's liability to make the Periodic Payments is no greater than that of the Assignor immediately preceding this Agreemerk, ,A "nee is not required to set aside specific 'assets to secure the Periodic Payments. Tt?* C,jaimaA*haJ,no rights against the Assignee greater" ftri a general creditor. None of the Periodic Payments may Op a9calerated, deferred, increased or ddowea$ed V& per not be anticipated, sold, assigned or encumbwvo 4. The obligation assumed by,Aa? ignes with respect to any required payment shat be discharged upon the mailing on or before the due date of a valid check in the amount spedifed to the address pf r". 5. This Agreement shall be governed by and interpreted in accordance with the laws of the State of Pennsylvania. NOW, THEREFORE, in consideration of the foregoing and other good and valuable consideration, the parties agree as follows: 1. The Assignor hereby assigns and the Assignee hereby assumes all of the Assignors liability to make the Periodic Payments. The Assignee assumes no liability to make any payments not specified in Addendum No. 1. 2. The Periodic Payments constitute damages on account of personal injury or sickness in a case involving physical injury or physical sickness within the meaning of Sections 104(x)(2) and 130(c) of the Code. 6. The Assignee may fund the Periodic Payments by purchasing a 'qualified funding asset within the meaning of Section 130(d) of the Code in the form of an annuity contract issued by the Annuity Issuer. All rights of ownership and control of such annuity contract shall be and remain vested in the Assignee exclusively. 7. The Assignee may have the Annuity Issuer send Payments under any "qualified funding asset" Purchased hereunder directly to the payee(s) specified in Addendum No. 1. Such direction of Payments shall be solely for the Assignee's convenience and shall not provide the Claimant or any payee with any rights of ownership or control over the "qualified funding asset' or against the Annuity Issuer. 8. Assignee's liability to matte the Periodic Payments shall continue without diminution regardless of any bankruptcy or insolvency of the Assignor. 9. In the event the Settlement Agreement is declared terminated by a court of law or in the event that Section 130(c) of the Code has not been satisfied, this Agreement shall terminate. The Assignee shall then assign ownership of any 'qualified funding asset' purchased hereunder to Assignor, and Assignee's liability for the Periodic Payments shall terminate. 11. The Claimant hereby accepts Assignee's assumption of all liability for the Periodic Payments and hereby releases the Assignor from all liability for the Periodic Payments. 10. This Agreement shall be binding upon the respective representatives, heirs, successors and assigns of the Claimant, the Assignor and the Assignee and upon any person or entity that may assert any right hereunder or to any of the Periodic Payments. Assignor. Progressive Northern Insurance Company Assignee: American General Annuity Service Corporation BY 14.da. i 0 \LL i in Mt Authorized Representative I?CZ rM.S 2SLL?d:?Ne Claimant: Michael Benson, a minor, by and through his parent and natural guardian, Donna Benson A- By: n n 4 .1 Authorized Re tl q 1110E FF198106,T True: 1V55TA National Structured Settlements Trade Association Addendum No. 1 Description of Periodic Payments Periodic Payments: To Michael Benson, the sum of $569.79 payable monthly, guaranteed for 144 months, beginning 11 /0812006, and ending 10/08/2018. . ? o ? n InltialEs ' ?P/F Assignor: ;DaL-- AMERICAN GENERAL Frw?rrcut Gaour MW KW WOW LKe k Tarim LielUPW% LlDtnstwn TX ctured Settlement Annuity Application 1. IEASl1RR1G Name: mast t=ryst Twiddle LIFE Benson Address Sheet CRP Stale Zip 261 Valle Road Etters 17319 sex gate of lfrm social Secu* Wxreer Daytime Tdeplale M 11-08-1988 540-29-7060 ( ) t »- Estate of Michael Benson 1xItrLY hfrmy. Bene6rivr . sSN Reiaiahrhip secorifty endeby SSN Rdafiomfhip * PAYEE {IF OTHER Hams: Last Find triddis THAN Addre= Street 04 Slate Zhp MEASSING LWQ Sex Date of &it social wanly Number Dayime Telephone { ) 4. mfr WASUBW Name Last Fret Kiddie tN£ Address: Sheet city Stain Lp F ANY Sex Dais of SO Social sec riy Number f)a?hheTetepihahe L 0 M®I OF Name: Tax ID ANUff American General Annuity Service Corporation 76-0446159 Address siroet CRY Vale zip 205 E. 10th Avenue Amarillo 7X 79101-3546 The OWW Is: 11 Owner 0 Parkaft CK111paa6on 01U911911 PLAN ANUM FOit AND SC1EDILAE OF PAYMBFM $569.79 payable monthly, guaranteed for 144-months, beginning 11-08-2006 Mrourt paid with this amilcafti: fi 1.00 Witiabte Consideration 0 Ov* N M tional sheet attached. Will the amhuRy applied for replace or be In ex+thauhpe for any existing go Insurance or annuity In ttds or any Wo Company? 0 Yes KI No N yes. on cimipsw, amoi K year Issued and reason Any person who, with intent b defraud or knowing that beldw Is facilitating a fraud against an insurer, submits an appUe km or fffes a claim eonntalnhhg a false or timpthre statement, commits kimrance Iraud, which Is a crime and may sub)ect the person to airy" and cMl peretkies. I have read the above statements or they have been read tp me. I represent the above statements are true and complete to-the (nest of my InnoNdedge and belief. 1 agree that ft application strati be part of the arnulty poky(les) Issued by the American General Life I scram Company A pplication is made with the knowledge and consent of the proposed measuring OWes). I agree that any annuity poliq issued upon this application slid be a of the state in which the rresides at Vie time of application. .. ? . /, Signed at r Amarillo - an City shMe American General Annuity Service Corporation Ducar x slpr an of &MW FOR AGENT UW ONLY, t represent that the Information given on this application is true and complete to the best of my knowledge and belief . To the best of your I wl ge, is is surane being purchased to replace or change any existing insurance of annuity? ? Yes K. No Structured Financial Associates, Inc. SIp1a n OF Awnt Aged a Canpny rm ( 770) 393-1 028 Pow 1rco1w"No. TEhsplalE No. A9.000{r -MV! -- n-- -uuA 611E ma*1D rcalte Wd WVh awk owed and teed by knmicat Gm-al Wp-fbn"ns Macias, nrdUft Maim Gannet lire kmra= affpfx AMERICAN GENERAL LIFE INSURANCE COMPANY This is a Single Premium Immediate Annuity Contract. The guaranteed payments, if any, are stated on the Payment Schedule page of the Policy. READ THIS CONTRACT CAREFULLY. This Policy explains how the annuity works, and is a legal contract between the Owner and the Company. All payments and benefits will be payable subject to the terms of this Policy. Examine the Payment Schedule page and attached Application. If any errors or omissions are found, immediately contact the Company. THIS POLICY IS NON-PARTICIPATING - DIVIDENDS ARE NOT PAYABLE. PLEASE READ THIS POLICY CAREFULLY. THE POLICY IS IRREVOCABLE AND HAS NO CASH VALUE OR SURRENDER VALUE AND CANNOT BE COMMUTED OR SURRENDERED. THIS POLICY IS A LEGAL CONTRACT BETWEEN THE OWNER AND AMERICAN GENERAL LIFE INSURANCE COMPANY. For information, service or to make a complaint, contact your servicing agent or the Company's Administrative Office at: American General Life Insurance Company 205 East 10th Avenue, Amarillo, TX 79101 01015 Uniform Qualified Assignment and Release 'Claimant Michael Benson, a minor, by and through his parent and natural guardian, Donna Benson 'Assignor' Progressive Northern Insurance Company 'Assignee' American General Annuity Service Corporation 'Annuity Issuer' American General Life Insurance Company 'Effective Date' b 7 `4b ,4006 This Agreement is made and entered into by and between the parties hereto as of the Effective Date with reference to the following facts: A. Claimant has executed a settlement agreement or release dated -QeCe44,69-*- Q 20 05' (the 'Settlement Agreement') that provides for the Assignor to make certain periodic payments to or for the benefit of the Claimant as stated in Addendum No. 1 (the "Periodic Payments'); and 13. The parties desire to effect a 'qualified assignment" within the meaning and subject to the conditions of Section 130(c) of the Internal Revenue Code of 1986 (the *Code*). 3. The Assignee's liability to make the Periodic Payments is no greater than that of the Assignor immediately preceding this Agreeme& A*ignee is not required to set aside specific assets to secure the Periodic Payments. TtpgjaimaWhad no rights against the Assignee greater0on a gen&il creditor. None of the Periodic Payments may Pp accelerated deferred, increased or d4ree$ed Vd' pjay not be anticipated, sold, assigned _or encumbRred, ., 4. The obligation assumed by,A3- signee with respect to any required payment shah be' se dschimged upon the mailing on or gore the due date 4a "lid check in the amount spedified to the address of r?rsrd. , 5. This Agreement shall be governed by and interpreted in accordance with the laws of the State of Pennsylvania. NOW, THEREFORE, in consideration of the foregoing and other good and valuable consideration, the parties agree as follows: The Assignor hereby assigns and the Assignee hereby assumes all of the Assignor's liability to make the Periodic Payments. The Assignee assumes no liability to make any payments not specified in 6. The Assignee may fund the Periodic Payments by purchasing a 'qualified funding asset within the meaning of Section 130(d) of the Code in the form of an annuity contract issued by the Annuity Issuer. All rights of ownership and control of such annuity contract shall be and remain vested in the Assignee exclusively. Addendum No. 1. 7. The Assignee may have the Annuity Issuer send payments under any 'qualified funding asset' 2_ The Periodic Payments constitute damages on purchased hereunder directly to the payee(s) account of personal injury or sickness in a case specked in Addendum No. 1- Such direction of involving physical injury or physical sickness within payments shall be solely for the Assignee's the meaning of Sections 104(a)(2) and 130(c) of the convenience and shall not provide the Claimant or Code. any payee with any rights of ownership or control over the ' aified funding assEY, or-aga;nst-Ahe Annuity Issuer. 8. Assignee's liability to make the Periodic Payments shall continue without diminution regardless of any bankruptcy.or insolvency of the Assignor. 9. In the event the Settlement Agreement is declared terminated by a court of law or in the event that Section 130(c) of the Code has not been satisfied, this Agreement shall terminate. The Assignee shall then assign ownership of any "qualified funding asset" purchased hereunder to Assignor, and Assignee's liability for the Periodic Payments shall terminate. 10. This Agreement shall be binding upon the respective representatives, heirs, successors and assigns of the Claimant, the Assignor and the Assignee and upon any person or entity that may assert any right hereunder or to any of the Periodic Payments. Assignor. Progressive Northern Insurance Company Authorized Representative Title: Cht l+N S r?se:r ? Claimant: Michael Benson, a minor, by and through his parent and natural guardian, Donna Benson 11. The Claimant hereby accepts Assignee's assumption of all liability for the Periodic Payments and hereby releases the Assignor from all liability for the Periodic Payments. Assignee: American General Annuity Service Corporation y J it ?? N :1 By- n Authorized Re*e fativie ?jp? VICE of" DENT ' Title: c! ST IN ational t3tructuz v110 11 ? Settlements J Trade Association Addendum No. 1 Description of Periodic Payments Periodic Payments: To Michael Benson, the sum of $569.79 Payable monthly, guaranteed for 144 months, beginning 1110812006, and ending 10/08/2018. ) .,n •, 7 Lutiais Claimant.. C ?'r43.5D I?c?.. { MARK THOMAS SOPHOCLES, LLC PA Supreme Court Attorney ID # 74998 21 Industrial Blvd., Suite 201 Paoli, PA 19301 Tel: (610) 651-0105 Fax: (610) 651-0106 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA- CIVIL DIVISION IN RE: MICHAEL BENSON A/K/A MICHAEL W. BENSON PETITION TO TRANSFER STRUCTURED SETTLEMENT PAYMENT RIGHTS No. 097(,,$' INITIAL ORDER OF COURT On this day of 2009, it is ordered that a hearing on this Petition to Transfer Structured Settlement Payment'R.ights will be held on ? j dV4 in cotittroom &t Ali., *-.5 at g, 30 Aty\ 4-" 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 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: ant 'OF THE: 2009 OCT 19 PIN 2: 2O ?.