HomeMy WebLinkAbout05-1192
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSYL VANIA
CIVIL DIVISION
INRE:
PETITION OF GLENN L. MONTGOMERY
TO TRANSFER STRUCTURED
SETTLEMENT PAYMENT RIGHTS
No. OS -/Iq~ Cio~L/~
PETITION TO TRANSFER STRUCTURED
SETTLEMENT PAYMENT RIGHTS
Petitioner, Glenn L. Montgomery, brings forth the following Petition to Transfer
Structured Settlement Payment Rights pursuant to, and in compliance with, the Structured
Settlement Protection Act, 40 P.s. ~~ 4001-4009, and in support states as follows:
I. The Petitioner is Glenn L. Montgomery, an adult individual whose date of birth is
December 9, 1951, and who resides at 110 South Queen Street, Shippensburg, Cumberland
County, Pennsylvania, 17257. This Court has venue pursuant to the Structured Settlement
Protection Act, because the Petitioner is domiciled in Cumberland County, Pennsylvania.
2. On or about June 4, 1985, Petitioner was injured in an accident. Thereafter in
1987, Petitioner entered into a Release of Claim (the "Agreement") with the tortfeasor's
insurance company. The Agreement provided for an immediate lump sum payment to Petitioner
and Petitioner's attorneys, and 420 guaranteed monthly payments to Petitioner each in the
amount of $1,395.00, commencing May I, 1987, through and including April I, 2022, and for
the rest of Petitioner's lifetime thereafter. A true and correct copy of the Agreement is attached
as Exhibit "A."
,
3. The obligation to make the monthly periodic payments is held by Hartford
Casualty Insurance Company, successor to Hartford Accident & Indemnity Company, the
Structured "Settlement Obligor" as defined by 40 P ,So g 4002. Hartford Casualty Insurance
Company is located at 4040 Vincennes Circle, Suite 100, Indianapolis, IN 46268.
4. The obligation was funded by the purchase of an annuity (Annuity Contract
Number 4,027,722-0) from The Manufacturer's Life Insurance Company, USA, the "Annuity
Issuer." Id. The Manufacturer's Life Insurance Company, USA, is located at 500 Boylston
Street, Boston, MA 02116-3739, A true and correct copy of the annuity policy including
confirmation of benefit schedule, and ownership of the annuity policy, is attached as Exhibit
'~B."
5. On February 19, 2005, Petitioner executed a Structured Settlement Payment Right
Purchase and Assignment Agreement (the "Purchase Agreement"), a true and correct copy is
attached and incorporated herein as Exhibit "C." The Purchase Agreement provides for the
assignment of Petitioner's right and interest in receiving 208 monthly payments, each in the
amount of $1,395.00, beginning with the payment on January 1, 2005, through to and including
April I, 2022 (the "Assigned Payments"), to Structured Asset Funding, LLC, and its successors
and assigns (the "Transferee"). Structured Asset Funding, LLC ("SAF") is a Florida Limited
Liability Company with its principal place of business at 1250 East Hallandale Beacb Blvd.,
Penthouse A, Hallandale, FL 33009.
6. The Purchase Agreement was executed by the Transferee on Febnmry 23, 2005.
7. Additionally, as set forth in further detail in his Affidavit dated February 19,
2005, attached and incorporated herein as Exhibit "D," Petitioner avers that:
a. He desires to sell the Assigned Payments to Structured Asset Funding,
LLC.
2
b. He is fifty-three (53) years old and married to Cassandra Phillips
Montgomery.
c. The transaction contemplated by the Purchase Agreement is in his and his
family's best interest, it will improve the quality of their lives, and he has
thoroughly considered all of the ramifications of the transaction. He has
determined that the transfer is fair and reasonable, and that it will not
subject he or his dependents to economic hardship now or in the future.
d. He is in need of the money to use for repairs to his home, mainly to repair
the garage and remodel two bathrooms.
e. He has been advised to obtain independent professional advice.
8. Petitioner has been provided, and has acknowledged receipt at least 10 days prior
to receipt of the Purchase Agreement, of the "Transfer Disclosure" required by 40 P .S. S 4003
(a)(2) attached and incorporated as Exhibit "E." As set forth in greater detail in the Transfer
Disclosure, the following terms have been disclosed to the Petitioner:
a. The amounts and due dates of the structured settlement payments to be
transferred are: 208 monthly payments, each in the amount of $1,395.00,
beginning with the payment on January I, 2005, through to and including
April 1, 2022.
b. The aggregate amount of the structured settlement payments to be
transferred is $290,160.00.
c. The discounted present value of the payments transferred using the most
recently published applicable federal rate for determining the value of an
annuity is $207,775.35.
d. The federal discount rate used to determine the discounted present value is
the effective annual rate of 4.20% as of 12/04.
e. The gross amount payable to Petitioner in exchange of the transferred
payments is $116,056.22.
f. The good faith itemized listing of all broker's commiSSions, service
charges, legal fees, notary fees, costs etc. deductible from the gross
amount otherwise payable to the Petitioner is: $2,500.00 for
transaction/legal costs.
3
g. The net amount payable to Petitioner after deduction of the above
commissions, legal fees, etc., is $113,556.22. (With the exception of
$103,751.22 (the "payoff amount" effective on or before December 30,
2004) that will be deducted from the net amount payable and will be paid
to Stone Street Services, Inc. ("Stone Street"), to enable Petitioner to
obtain Stone Street's release of its encumbrance on a portion of the
payments set forth in paragraph 8a above relating to a prior transfer
transaction that was consummated prior to the effective date of the
Pennsylvania Structured Settlement Protection Act. The exact Payoff
Amount to be paid and remitted to Stone Street by Transferee on
Petitioner's behalf will be determined on the closing date for this
transaction).
h. The quotient is 54.65%.
1. The amount of penalty and aggregate amount of any liquidated damages
inclusive of penalties payable by the Petitioner in the event of any breach
of the Purchase Agreement by the Petitioner is: $0.00.
J. He was strongly urged to consult with an attorney who could advise him
of the potential tax consequences of the transaction.
9. Petitioner has been provided, and has acknowledged receipt prior to entering into
the Purchase Agreement, of the written "Important Notice" in bold print 12-point type required
by 40 P.S. ~ 4003 (b). A true and correct copy of Petitioner's acknowledgement of the receipt of
the ~ 4003 (b) notice is attached as Exhibit "F."
10. Petitioner acknowledges that he has been advised to obtain independent
professional advice regarding the tax consequences of the transaction, however he has declined
such advice, as further acknowledged in the Affidavit of Independent Professional Advice
("IPA") attached as Exhibit "G."
II. On January 24, 2002, "The Victims of Terrorism Tax Relief Act," PL 107-134,
115 Stat. 2427, was enacted, which in part, amends the Internal Revenue Code of 1986. The Act
amends 26 U.S.C.A. ~ 5891 and now provides for favorable tax treatment of "structured
settlement payment factoring transactions" that are approved in advance by a qualified court
4
order approving the transaction. 26 U.S.C.A. 9 5891 (b)(I). A "structured settlement payment
factoring transaction" is defined as "a transfer of structured settlement payment rights (including
portions of structured settlement payments) made for consideration by means of sale,
assignment, pledge, or other form of encumbrance or alienation for consideration." 26 U.S.C.A.
9 5891 (c)(3)(A) (parentheses in original). A "structured settlement" is defined as an
arrangement established by "agreement for the periodic payment of damages excludable from the
gross income of the recipient under [Internal Revenue Code] section 104 (a)(2)..." and under
which the periodic payments are "of the character described in subparagraphs (A) and (B) of
section 130(c)(2)." A true and correct copy of 26 U.S.C.A. 95891 is attached hereto as Exhibit
"H."
12. 26 U.S.C.A. S 5891 (d)(I) was also added by the Act and provides:
[I]f the applicable requirements of sections 72, 104(a)(I), 104(a)(2), 130,
and 461(h) were satisfied at the time the structured settlement involving
structured settlement payment rights was entered into, the subsequent
occurrence of a structured settlement factoring transaction shall not
affect the application of the provisions of such sections to the parties to
the structured settlement (including an assignee under a qualified
assignment under section 130) in any taxable year.
(Emphasis added).
Accordingly, a favorable tax result is in effect at the time the Payee and the Transferee
propose to enter into the Purchase Agreement.
13. Since a favorable tax result is in effect, approvals of the Settlement Obligor and
the Annuity Issuer to the proposed transfer are not required. 40 P.S. S 4003 (a)(5)(i)(A).
14. The structured settlement did not arise out of a workers' compensation claim.
5
15. Petitioner has seriously contemplated this transaction, and due to his personal
circumstances and needs, believes that this assignment is in his best interests, taking into account
the welfare and support of Petitioner's dependents.
16. Petitioner acknowledges that counsel, Jones, Gregg, Creehan & Gerace, LLP has
not been engaged to render professional advice with respect to the advisability, or the
implications of the transfer, including the tax ramifications of the transfer. Counsel has been
engaged solely to prepare and present the within Petition, based upon Petitioner's independent
determination and/or professional advice obtained from others, with respect to the advisability
and ramifications of the transfer.
WHEREFORE, Petitioner prays that this Honorable Court grant this Petition to Transfer
Structured Settlement Payment Rights.
Respectfully submitted,
Jones, Gregg, Creehan & Gerace, LLP
By:
/2e~ ~[,Jl______
Robert L. Monks
PA I.D.# 52760
411 Seventh Avenue
Suite 1200
Pittsburgh, PA 15219
412-261-6400
Counsel for Petitioner,
Montgomery
Glenn
L.
6
VERIFICATION
I, Glenn L. Montgomery, have read the foregoing Petition
to Transfer Structured Settlement Payment Rights and hereby aver
that the statements contained therein are true and correct to the
best of my knowledge, information and belief.
This Verification is made subject to the penalties of 18
Pa. C. S .A. Section 4904 relating to the unsworn falsification to
authorities.
f!;!~
Dated: cJ. -,;r~I)"-
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STRUCTURED SETTLEMENT PAYMENT RIGHT
PURCHASE AND ASSIGNMENT AGREEMENT
This Structured Settlement Payment Right Purchase and Assignment Agreement (the "Agreement") is being
entered into by and between Structured Asset Funding. LLC. 1250 East Hallandale Beach Blvd.. Penthouse A. Hallandale.
FL 33009 ("Purchaser') and Glenn L Montgomery ("Seller"). 110 S. Queen Street. Shippensburg. PennsylvaOla 17257.
This Agreement is dated and effective as of Purchaser's execution of the Agreement (or the date that IS otherwise required
hy applicable law).
RECIT ALS
A. Seller. or Seller's predecessor in intereM. has previously entered into a settlement. release. indemnity.
compromise. andior other agreement or document. and/or was ~ubject to a court order. judgment. or decree. in connection
with the settlement of a lawsuit amior personal injury or Mongful death claim. The decree. order. judgment. release.
settlement. indemnity. compromise and/or other agreement is set forth and descrihed in more detail in Exhibit '.A" attached
hereto and. together ",th any amendments, modifications. and revisions to same. shall hereafter be referred to in this
Agreement as the "Settlement Agreement." Pursuant to the Settlement Agreement. Seller is entitled to receive censin
periodic settlement payments in the dollar amounts and on the dates set forth and described in tllC Settlement Agreement.
(The payments which are due and payable to Seller pursuant to the Settlement Agreement shall hereafter be referred to as
the "Settlement Payments").
B. Hartford Casualty Insurance Company (the "Settlement Obligor" or "Hartford". sometim" referred to as
the "Annuity Owner") agreed to make the Settlement Payments to Seller under the terms of the Settlement Agreement
and/or assumed the obligation to make the Settlement Payments due Seller under the Settlement Agreement pursuant to a
qualified assignment and/or other assignment. assumption or similar agreement (the qualified assignment, assumption
agreement. or similar agreement or document is set forth and described in Exhibit "A" and shall hereafter be referred to as
the "Qualified Assignment"). In order to fund it.< obligation to make the Settlement Payments. the Settlement Obligor
purchased and/or caused to be issued an annuity (the "Annuity") by The Manufacturers Life Insurance Company. USA (the
"Annuity Issuer" or "Manufacturers"). (The Annuity is set forth and described in Exhibit A.) The Annuity Issuer is
obligated to make censin payments under the terms of the Annuity (the "Annuity Payments"). in the amounts and on dates
which correspond to the Settlement Payments. Seller is the "Annuitant" or "Payee" named in the Annuity and/or is the
beneficiary of the original named AnnuitantlPayee named in the Annuity or is otherwise entitled to receive the payments to
be made under the tenus of the Settlement Agreement, Qualified Assignment. and/or Annuity. Copies of the Settlement
Agreement, Qualified Assignment, and the Annuity (if available) and/or a payment letter from the Annuity Issuer or
Annuity Owner have been provided to the Purchaser. The Settlement Agreement, the Qualified Assignment, the Annuity.
and any agreements, releases. letters, assignments, judgments, orders, decrees and other documents which reflect or
evidence the Settlement Payments and the payment obligations of the Settlement Obligor, Annuity Owner, and Annuity
Issuer shall hereafter be collectively referred to as the "Settlement Documents."
C. Purchaser desires to purchase and acquire from the Seller. and the Seller desires to sell, assign, transfer.
and convey to Purchaser, certain of the Settlement Payments and, to the extent that Seller has any right. interest, or claim in
or to the payments due and payable under the Annuity, in and to the Annuity Payments, in the amounts and on the dates due
and payable to Seller, as set forth and described in Exhibit A. (The payments which are the subject of this Agreement and
which are to be sold. assigned, and transferred to Purchaser by Seller shall hereafter be referred to as the "Periodic
Payments".)
D. As used herein, "Term" means the period beginning with the earlier of the Closing Date (as hereinafter
defmed) or the date of the first Periodic Payment and ending with the last Periodic Payment which is the subject of this
Agreement. The "Transaction" shall refer to the assignment of the Periodic Payments by Seller to Purchaser, as set forth
and described in this Agreement. The "Transaction Documents" shall refer to this Agreement and any and all other
PURCHASE AND ASSIGNMENT AGREEMENT - Page 1 of 16 (; {;/1
Seller's Initials
I
Exhibit C
I
agreements, applications, letters. contracts. pleadings, affidavits. and other documents executed. signed. and/or submitted
bv the Seller in connection with the Transaction. "Coun Order" shall refer to the order or judgment rendered or to be
r~ndered in connection with the coun approval of the Transaction in accordance with an applicable state statute as provided
in Section 5.5.
NOW. THEREFORE. in consideration of the mutual covenant'. representations. warranties and agreements
contained herein and for other good and valuable consideration. the receipt and sufficiency of which is hereby
acknowledged, and subject to the terms. conditions. provisions. and contingencies set forth herein and in the other
Transaction Documents. the parties agree. covenant. and promise a~ follows:
AGREEME"iT
ARTICLE I
PURCHASE AND SALE OF PERIODIC PA y!\tENTS
1.1 Purchase and Sale. Subject to the tenns. conditions. provisions. contingencies. and limitations of this
Agreement. Seller hereby sells. assigns. transfers. and conveys to the Purchaser. and Purchaser purchases and acquires from
Seller, the Periodic Payments. Seller makes such sale and assignment of the Periodic Payments to Purchaser tree and clear
of any and all right. title. interest or claim in or to the Periodic Payments or any lien. pledge. mongage. security interest.
charge. adverse claim. right or equity of redemption. or other encumbrance of or in the Periodic Payments of any nature or
description whatsoever (collectively the "Encumbrances").
1.2 Purchase Price. In return for the sale and assignment to Purchaser of Seller's right. title, and interest in
the Periodic Payments, and the other promises. covenants. and undenakings of Seller contained herein. including the right
offrrst refusal granted to Purchaser pursuant to Section 8.18 below. Purchaser agrees to pay to Seller the amount set forth
and described in Exhibit A as the "Purchase Price." Purchaser will pay the Purchase Price to Seller on the Closing Date (as
defmed in Section 2.3 hereof). The Seller acknowledges and agrees that the Purchase Price shall be adjusted. if necessary,
by subtracting an amount equal to the sum of (i) all Periodic Payments received by Seller, or received by a person or entity
entitled to received the Periodic Payments on behalf of the Seller, from and after the date hereof through and including the
Closing: and (ii) any payments and advances made prior to Closing to or on behalf of Seller, including, but not limited to.
any monies and amounts paid on Seller's behalf to Seller's independent advisors or creditors or to any other person or
entity at Seller's request and on Seller's behalf. Purchaser shall not be ohligated to make any payments or advances to
Seller or on Seller's hehalfprior to Closing and any payments and advances made by Purchaser pursuant to this Section 1.2
shall be made. ifat all, in Purchaser's sole and absolute discretion.
1.3 Manner of Pavrnent: Risks: Detennination of Purchase Price. The Seller may elect to have the Purchase
Price paid by wire transfer to such account or accounts of the Seller that has been designated by Seller in writing prior to
the Closing, or by a check drawn on any deposit account maintained by the Purchaser. The Purchase Price was detennined
by ann's length negotiation between the Purchaser and Seller and represents the agreement reached between said panies in
light of, amongst other things, prevailing economic conditions and factors and the risks and expenses assumed and incurred
by Purchaser relative to the Transaction.
ARTICLE 2
CLOSING
2.] Closine Defined. The closing of the Transaction contemplated by this Agreement (the "Closing") shall
occur on a date designated by the Purchaser, which date shaH be as soon as reasonably practicable after entry of the Coun
Order and after the Purchaser, in its sole and absolute discretion, has detennined that all of the conditions and contingencies
required by this Agreement and the other Transaction Documents have been satisfied, have occurred, and/or havy been
PURCHASE AND ASSIGNMENT AGREEMENT - Page 2 of 16 a L'I(
Seller's Initials
perfonned and complied with, as the case may be, and that no event or condition has occurred or exists that would require
this Agreement to be terminated. Seller agrees to use Seller's best effons to take such actions, or refrain from taklOg such
actions, as requested by Purchaser, which arc reasonably necessary to secure the Court Order and close the Transaction in
accordance \\ith this Agreement.
o 0 Timinc of Closinc. The Seller and the Purchaser hereby acknowledge that each of them will be
simultaneously taking various actions necessary to satisfy. perform. and fulfill the conditions and conllngencies required for
closing the Transaction and that some conditions and contingencies are subject to various actions that must be completed by
persons or entities that are not parties to this Agreement (i.e. entry of the Court Order). Therefore. it is not ros.~ible w
predict the precise dale on which the Closing will occur and Purchaser makes no representations regarding same.
2.3 Closinc Date. The day on which funds representing the Purchase Price (adJusted. if necessary. as
provided in Section 1.2) are paid and delivered to the Seller shall be the ..Closing Date.'. All events that are to occur on the
Closing Date shall, for all purposes. be deemed to occur simultaneously. except to the extent that a specific order of
occurrence is otherwise prescribed herein.
ARTICLE 3
REPRESENTATIONS AJIOD W ARR<\JIOTlES OF SELLER
In order to induce Purchaser 10 enter into this Agreement. pay the Purchase Price and purchase the Periodic
Payments. the Seller represents and warrants to the Purchaser as follows:
3.1 Authoritv and Enforceability. The Seller has all requisite power and authority and has taken all action
necessary to execute and enter into this Agreement and each of the Transaction Documents, to conclude the Transaction
contemplated in this Agreement, and to perform the Seller's obligations under this Agreement. This Agreement has been.
and each of the Transaction Documents have been or will be by Closing, duly executed and delivered by the Seller. This
Agreement is, and each of the Transaction Documents will be at Closing, a legal. valid and binding obligation of the Seller
enforceable against the Seller in accordance with their terms.
3.2 No Breach or Default: No Violation of Law: No Consents. The execution and delivery by the Seller of
this Agreement and the Transaction Documents and the conclusion of the Transaction contemplated by this Agreement and
the Transaction Documents does not and will not: (i) constitute a breach of, or result in a default under, or give rise to any
right of tennination, cancellation or acceleration of any obligation or the loss of any material benefit under, the Settlement
Documents: or (ii) breach or violate any existing contract or agreement of the Seller or any obligation of the Seller under
any court or administrative orders, writs, judgments or decrees: or (iii) violate any statute or regulation: or (i\") except for
the court approval referenced in Section 5.5, require the consent. authorization. or approval of any other person. entity.
court, regulatory agency, administrative body, or any federal, state, local or other governmental agency or authority.
3.3 The Settlement Documents. Copies of the Settlement Documents have been, or will be prior to Closing.
provided and delivered to Purchaser. The copies of the Settlement Documents provided to Purchaser are true and correct
and include all amendments, supplements, addendums, or modifications thereof and have not been changed or altered in
any way by the Seller. The Settlement Documents are legal, valid and binding obligations of the panies to said agreements
and documents and are enforceable against each such pany in accordance with their terms. None of the Settlement
Documents are in default nor have any of them been breached or violated by the parties obligated under same.
3.4 Title to the Periodic Pavrnents. The Seller owns outright, and has good, marketable and defensible title
to, the Periodic Payments, free and clear of any Encumbrances. Except as specifically and expressly disclosed to Purchaser
in writing prior to entering into this Agreement, Seller has not previously sold, transferred, assigned, pledged, encumbered,
mongaged, alienated or granted a security interest in any of the Periodic Payments or any of the Settlement Payments.
Except as specifically and expressly disclosed to Purchaser in writing, none of the Periodic Payments or Settlement
Payments have ever been attached, levied, foreclosed upon, seized. restricted, assigned, transferred, pledged, encumbered.
PURCHASE AND ASSIGNMENT AGREEMENT -- Page 3 of 16 CC;sf
Seller's Initials
or subjected to garnishment or any other legal process or proceeding. Closing of the Transaction "ill vest in Purchaser
good, marketable and defensible title to the Periodic Payments, free and clear of any and all Encumbrances. Closing of the
Transaction shall divest Seller of all right, title. interest, claim. and demand. either at law or in equity. in and to the Periodic
Payment""
3.5 Caoacttv: Mantal Status. Proof of IdentificatIOn Seller has furnished to Purchaser true. correct and
complete documents concerning any prior divorce, annulment. marital separation. property settlement agreement marriage.
premarital agreement. custody. guardianship. trusteeship, bankruptcy. assignment for benefit of creditors. or other legal
proceedmg affecting Seller's capacllY or title to the Periodic Payments. The true. current marital status of the Seller is set
fonh in the Application executed in connection with this Transaction and the full. true. and correct name and mailing
address of Seller's spouse. if any. is also set fonh in the Application. If Seller has heen divorced. annulled or legally
separated prior to the date of this Agreement. Seller has provided to the Purchaser a true, correct, complete and legible copy
of the Seller's prior divorce or annulment decreers) and related propeny settlement agreements. Seller shall provide true
and accurate copies of Seller's driver's license and/or government issued ID card and Seller's social security identification
card or other evidence of Seller's social security number acceptable to Purchaser in its sole and absolute discretion. Seller
shall also provide to Purchaser, if requested by Purchaser. a coPY of a check stub or bank record evidencing SeJler\ receipt
or a direct deposit of a recent Periodic Payment or Settlement Payment. which shall match and or correspond to the
Settlement Documents.
3.6 No Judgments Or Actions. Except as specifically and expressly disclosed to Purchaser in writing in
connection \\ith this Transaction, there are no unsatisfied, outstanding judgments or liens against Seller and there is no
action, suit. or proceeding pending or threatened against or affecting the Seller or the Seller's assets. including. without
limitation, the Periodic Payment.' Or the Settlement Payments. in or before or by any court. department. connnission. board.
bureau, agency. or other governmental authority. The Seller has received no notice (whether oral or written) that any such
proceeding is pending or contemplated.
3.7 No Brokers. Except as specifically disclosed by the Seller in writing, no broker, agent or finder has acted
for the Seller in connection with this Agreement or the transactions contemplated by this Agreement and no brokerage.
sales, or other connnission or finder's fee shall be eamed, due or payable to any person by the Purchaser in connection with
the Transaction on account of any act or omission of the Seller.
3.8 Consultation with Advisors: Seller's Creditors. Seller has been advised by the Purchaser, in writing. to
consult with the Seller's financial. accounting. tax and legal advisors in connection with the Transaction and has either (i)
consulted with such advisors or (ii) has had the opporttmity to do so and knowingly and voluntarily chose not to seek such
advice. The execution and delivery of this Agreement and the other Transaction Documents by the Seller and the
consummation of the Transaction have not been concealed from. and will not hinder, delay, or defraud any creditor of the
Seller. To the extent that Seller was required by applicable law to receive, or has received, independent professional advice
regarding this Transaction, the person or person with whom Seller consulted is set forth in Exhibit A or in some other
document delivered to Purchaser.
3.9 Full Disclosure: No Adverse Facts. The representations and warranties of the Seller in this Agreement
and in the other Transaction Documents and the information furnished to the Purchaser and its representatives in connection
with the Transaction do not and will not include any untrue or misleading statement affacl. Seller is not aware of any fact
or matter which might (i) diminish the value of the Periodic Payments or the rights and benefits of the Purchaser to be
acquired under this Agreement; or (ii) impair or delay the Purchaser's ability to receive and collect the Periodic Payments.
3.10 Aoolication. Beneficiaries. and Deoendents. Seller has completed, signed, and delivered to Purchaser an
Application in connection with the Transaction. All of the information stated in the Application is true and correct as of the
date of this Agreement and at Closing. Seller has also disclosed to Purchaser the true and correct identity and age of
Seller's spouse and minor children and other dependents. Seller has also disclosed to Purchaser the true and correct identity
of any beneficiary or other person properly and legally designated by Seller to receive the Settlement Payments and/or
Annuity Payments following the death of Seller.
PURCHASE AND ASSIGNMENT AGREEMENT - Page 4 of 16
t(~
S.ller's Initials
3. I I Prior or Pending {nsolvencv or BankrulltCY Proceedmgs, or Other Legal Proceedings. Except as set forth
on the Application. Seller has not been a party to any bankruptcy, reorganization, receivership. insolvency. or similar
proceeding. If Seller has been a party to any such proceeding. Seller has provided to Purchaser a true and correct copy of
the Seller's discharge from such proceedings andlor an appropriate court order approving the Transaction contemplated by
this Agreement.
3.12 Other Obligations. Except as specifically and expressly disclosed to PurchaRer in writing in connection
with this Transaction, seller is not in default on any obligation for child support or alimony or for the payment of state.
fedcral. or local taxes. including federal income taxes.
3.13 Other Attemllts to Assign: Cessation of Other Negotiations: Exclusivity. Except as specifically and
expressly dISclosed to Purchaser in writing in connection with thIS Transaction. Seller has not, and has not attcmpted to.
sell. assign. transfer, or convey any of the Settlement Payments 10 any nther person or entity. nor has Seller altempted to
pledge. encumber or mortgage the Settlement Payments with or 10 any other person or entity. To the extent that Seller ha;
previously had discussions or negotiations with other persons or entities regarding the possible sale. assignment. transfer.
mortgage. encumbrance. pledge or other conveyance of the Settlement Payments. Seller hereby represents and warrants that
all such discussions or negotiations have ceased and any and all contracts. agreements. letters of intent and other
documents relative said discussions andfor negotiations have been and. 10 the extent necessary. hereby are cancelled.
tenninated. and rescinded. Seller has no other obligations to any other person or entity relative to the Pcriodic Payments
and. except as expressly disclosed to Purchaser in writing. has no other obligations to any other person or entity relative to
any of the Settlement Payments. To the extent that Seller has any obligations to any other funder, person, or entity relative
to the Periodic Payments, Seller hereby authorizes Purchaser to satisfy said obligations at Closing. Seller represents and
warrants that. upon signing this Agreement. Seller has ceased any and all discussions and negotiations with any other
person or entity relative to the Periodic Payments and shall deal exclusively with Purchaser regarding said payments.
3.]4 Disclosure Statement. Seller acknowledges that Purchase has previously provided to Seller a Disclosure
statement prepared and delivered in accordance with applicable law which sets forth certain of the main tenns of the
Transaction. Seller has read and understands said Disclosure Statement and has had the opportunity to review and discuss
the Disclosure Statement and this Transaction with an attorney, CPA, accountant, or other professional or advisor of
Seller's choice.
3.15 Place of Residence. Seller represents and warrants that Seller resides in the State and at the address
designated on Exhibit A of this Agreement.
3.16 Compliance with State Statutes. Seller represents and warrantS that Seller has or will comply with all
applicable State and Federal statutes in connection with this Transaction.
ARTICLE 4
ADDITIONAL AGREEMENTS OF THE SELLER
4.1 Duty to Cooperate: Periodic Pavrnents Held in Trust: Guarantv. The Seller shall cooperate with and shall
take all reasonable action necessary to provide the Purchaser the practical benefits of the bargain obtained under this
Agreement. specifically including, without limitation, the duty to deliver immediately to the Purchaser any checks, funds or
other fonn of payment made under the Settlement Documents which may be hereafter received by the Seller or anyone
(other than the Purchaser) claiming by or through the Seller, to the extent that such payment constitutes a Periodic Payment.
Any such Periodic Payment that is at any time received by the Seller or any person claiming by, through, or under the Seller
(directly or indirectly) shall be received and held by the Seller (or such other person) in trust for the benefit of the
Purchaser. The Seller shall immediately deliver and pay such Periodic Payments to the Purchaser. After Closing of the
Transaction, the Seller shall have no interest in any Periodic Payment other than that of a trustee for the benefit of the
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Purchaser. Seller hereby guarantees the prompt performance of all of the duties and obligations set forth herein and in all
of the Transaction Documents.
4.2 Power of Attorney. Seller hereby grants to Purcha.ser an lrrevocable Power of Attorney with full power:;
of substitution to do all acts and things that Seller might do regarding the Periodic Payments and any and all rights Seller
may haye under the Settlement Agreement: Seller understands and intends that by doing so. Seller is giving to Purchaser all
of the power and right that Seller ha.s under the Settlement Agreement to endorse checks. drafts or other instruments. to
aher. edit and change payment instructions and/or beneficiary designations andlor to perfonn in Sellers name any other act
which. in Purcha.ser's sole judgment a.s Seller's Attorney-in-Fact. Purchaser feels is necessary or expedient for Purchaser to
obtain the bargain contemplated by this transaction. This power of attorney is coupled with an interest and shall survive
Sellers death Or disability.
4.3 Security A~reement. Purchaser and Seller intend to create a security inlerest in the right~ wand inlerest
in the PeriodlC Payments due to me under the Settlement Agreement which Seller is assigning to Purchaser under thIS
Agreement as "General Intangibles" to the extent pennitted under Article 9 of the Uniforn1 CommercIal Code which is in
effect in the state in which l reside. Seller understands thai this Agreement shall also function as a Security Agreement.
This Securi.y Agreement secures payment of the rights assigned by Seller to Purchaser and the performance of Sellers
obligations and representations set forth under this Agreement. Seller hereby authorizes Purchaser 10 direct any account
dehtor. or obligor on an instrument. including. without limitation. the Settlement Obligor or Annuity Issuer. to make the
Periodic Payments directly to Purchaser, and. as contemplated by the Uniform Commercial Code. Purchaser is authorized
to file a UCC-] financing statement to perfect its rights and the security interest intended '0 be created under this
Agreement.
4.4 Seller's Protection of Third Parties. The Seller releases and waives all claims and objections against each
of the Annuity Issuer, the Owner, the Settlement Obligor and any other person, entity. or party obligated under the
Settlement Documents to make the Settlement Payments, the Annuity Payments. and the Periodic Payments (collectively
the "Obligors") for (i) making the Periodic Payments to the Purchaser following entry of the Court Order contemplated in
Section 5.5 and Closing of the Transaction; (ii) for allowing, permitting, facilitating and/or cooperating with the Purchaser
and Seller in connection with the Transaction and this Agreement and entry of the Court Order: (iii) for not appearing or
objecting in the proceeding in which the COUl1 Order was entered: (iv) for failing or refusing to assert any claim that the
Periodic Payments were not transferable or assignable: and (v) for honoring the Court Order. Seller agrees to indemnify,
hold harmless and defend the Obligors in connection with the releases and waivers set forth in this section 4.3 and from and
against any future claims to or against the Periodic Payments by any person other than the Purchaser or the Purchaser's
lawful assigns.
4.5 Access to Information. The Seller agrees and hereby authorizes the Purchaser to obtain and perform
credit checks and obtain credit reports on the Seller and secure and perform other information and investigations including,
without limitation, lien searches, searches for abstracts of judgments or other claims against the Seller, criminal background
checks, checks of court records, and contacting Seller's present and previous employers, landlords, creditors, and
references. Seller hereby authorizes Purchaser to contact the Settlement Obligor. the Annuity Issuer, andlor the Annuity
Owner and any other person or entity obligated to make the Settlement Payments andlor Annuity Payments to verify any
and all information relative to the Settlement Payments and/or the Annuity Payments. Seller hereby authorizes, directs,
instructs, and consents to the release by the Settlement Obligor, the Annuity Issuer, andlor the Annuity Owner and any
other person or entity obligated to make the Settlement Payments and/or Annuity Payments of any and all information to
Purchaser relative to the Settlement Documents andlor the Settlement Payments. The Purchaser shall be under no duty or
obligation to perform any such check or investigation and the Seller shall place no reliance on the Purchaser's actions in
doing so. Seller further authorizes and consents to Purchaser recording, verifying. and/or registering information regarding
this transaction in the National Association of Settlement Purchasers Anti-Fraud database for any lawful purpose.
4.6 Disclosure of Misreoresentations and Breaches. The Seller shall immediately notify the Purchaser if an)'
of the representations or warranties of the Seller in this Agreement or any of the Transaction Documents are determined by
PURCHASE AND ASSIGNMENT AGREEMENT -- Page 6 of 16
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Seller's Initials
the Seller to have been incorrect. inaccurate, or misleading when they were made, or which are later delermined by the
Seller to be incorrect. inaccurale or misleading.
4.7 Further Assurances. At anv time and from time to lime, the Seller shall promptly execute. upon
Purchaser's request. all other documents, and p~rform or refrain from performing such additional acts. as may be necessary
or reasonably requested by the Purchaser to conclude the Transaction and to assure lhe Purchaser's receIpt of all of the
benefils of the Transaction, including the Periodic Payments.
4.R ThIS is Not a Loan. THE SALE OF THE PERIODIC PAYMENTS BY THE SELLER TO THE
PURCHASER IS AND SHALL CONSTITUTE AN ABSOLUTE AND IRREVOCABLE ASSIG1'o:~IENT A1'>D
CONVEY ANCE BY THE SELLER TO THE PURCHASER OF THE PERIODIC PAYMENTS, AND THE SELLER
ACKl'OWLEDGES AND AGREES THAT THIS TRANSACTION IS NOT INTENDED IN ANY RESPECT TO BE A
LOAl\ FROM THE PURCHASER TO THE SELLER OR TO CREATE ANY TYPE OF LENDER BORROWER
RELATIONSHIP. PARTNERSHIP OR OTHER JOINT OWNERSHIP ARRANGEMENT BETWEE1'o: THE SELLER
AND THE PURCHASER UPON THE CLOSING OF THIS TRANSACTION THE SELLER SHALL HA \"E NO RIGHT
OR ABILITY TO FINANCE OR REFINANCE THE PERIODIC PAYMENTS WITH PURCHASER OR ANY OTHER
PERSO" OR ENTITY.
4.9 Prior or Other Negotiations. To the extent that Seller has previously engaged in negotiatIOns or
discussions or ha'.; signed or executed a contract with other parties or entities regarding the sale, assignment. transfer.
conveyance, mortgage. encumbrance, or pledge of the Periodic Payments, Seller has terminated all such negotiations or
discussions and/or has canceled and rescinds all contracts, or agreements with such parties or entities. By signing thIS
Agreement, Seller hereby authorizes Purchaser to rescind, terminate and cancel, on Seller's behalf, all discussions.
negotiations, contracts, and agreements with such persons or enlilies. Seller agrees to work and deal exclusively with
Purchaser 10 consummate the Transaction and to complele and effect the sale of the Periodic Payments and secure the Coun
Order. To the extent that Seller has any obligations to any third party, person or enlity relative to the Periodic Payments,
Seller hereby authorizes Purchaser to satisfy such obligations at Closing.
4.] 0 Beneficiaries. Seller acknowledges and agrees that Purchaser shall be entitled to receive the Periodic
Payments to the exclusions of any beneficiary, heir, executor, representative, or dependent of Seller. To the extent deemed
necessary by Purchaser and/or if requested by Purchaser, Seller shall execute and sign any document, agreement waiver,
beneficiary change, or other documenl to reflect, evidence, and confirm thaI Purchaser shall be entitled to receive the
Periodic Payments to the exclusion of Seller and/or Seller's heirs, beneficiaries, representatives, dependents. and executors.
Upon consummation of this Transaction, entry of the Court Order, and Closing, Seller and Purchaser agree. acknowledge
and confum that any beneficiary, heir, exeCUlor, representative and/or dependent of Seller shall be absolutely and forever
divested of any right, title, claim or interest in the Periodic Payments.
ARTICLE 5
CONDITIONS TO CLOSING
The obligations of the Purchaser to effecl the Transaction contemplated in this Agreement shall be subject to the
performance and satisfaction, prior to the Closing Date, of each of the following conditions, unless waived in writing by lhe
Purchaser:
5.1 Deliverv of Documents. The Seller shall have delivered to the Purchaser duly executed originals
(including all attachments and exhibits) of the following documents, (if applicable which shall be the sole delermination of
Purchaser), each of which shall be in form, scope and substance satisfactory to the Purchaser in its sole and absolute
discretion:
(i) This Agreement, along with all required schedules, exhibits and addendums hereto;
PURCHASE AND ASSIGNMENT AGREEMENT - Page 7 of 16
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Seller's Initials
(ii) The Seller's Affidavil certifying cenain infonnalion ahoul the Seller. in fonn and substance acceptable 10
Purchaser, in its sole and absolute discretion:
(iii) The original or true and accurate copies of the Setllemenl DocumenlS:
(i\') A signed Spousal Consent fonn; copie' of prior di'"orce and/or annulment decrees. including property
divisions and settlemencs: a currenl driver's license or governmenl issued ID card: a social security card or other
evidence or Seller's social security number. acceptable to Purchaser. in its sole and absolute discretion: if
requested by Purchaser; copies of a recent check. payment stub or bank account records and statements sh(l'wing a
deposit to Seller':-; account a recent Settlement Pa~ment
(\") A Security Agreemenl and related UCC-I form,. ifreque'ted by Purchaser:
(vi) A completed and signed Application:
(vii) Executed Irrevocable Special Power of Attorney in favor of the Purchaser. its successors, assigns or
designees, and granling. among other powers. the power 10 endorse and negotiate all checks and other instruments
distribuled by the Annuity lS'uer, or other person. in payment of the Periodic Paymenls, as provided herein;
(viii) Executed copies of all other agreements. documenls. inslruments. certificates, opinions of counsel. reports or
other writings of any nature what:soever required by this Agreement or deemed necessary. advi&able or desirable
by Purchaser to consummate the Transaction.
5.2 Representations And Warranties. All of the Seller's representations and warranties in this Agreement
shall be true and correct on and as of the Closing Date with the same effect as though such representations and warranlies
were made on and as of the Closing Date. All of the Seller's represenlalions and warranties set forth in Ihis Agreement
shall survive the Closing and shall remain effective during Ihe Term of this Agreement.
5.3 Perfonnance Of Obligations. The Seller shall have performed. observed, satisfied, and complied with all
covenants under this Agreement and the Transaction Documents on or before the Closing Date.
5.4 Absence of Liens. The Purchaser shall perfonn, at ils own expense. such credit checks and lien searches
on the Seller as the Purchaser deems necessary. and Purchaser may offset from any sums due 10 the Seller the amount of
any lien, or other obligation of Seller that Purchaser determines may affect its rights 10 receive the Periodic Payments. If
requested by Purchaser, Seller agrees to obtain confinnation from the IRS or other taxing authorities that there are no
outstanding federal, stale or local tax liabilities (whether income tax or otherwise) beyond the currenl tax year in which this
Agreement shall be executed.
5.5 Court Approval of the Transaction. Seller understands and acknowledges that the Transaction
contemplated by this Agreement must be approved by a court of competent jurisdiction in accordance with an applicable
state transfer statute and must be structured, consummated, closed and approved in accordance with certain applicable
Federal law. A further condition and contingency to the Closing of the Transaction is that the Purchaser and/or the Seller
shall have procured and/or received a fmal court order. judgment. or decree (the Court Order, as previously defined)
approving the sale, assigmnent, and Ifansfer of the Periodic Payments 10 Purchaser. Seller shall cooperate wilh and assist
Purchaser, in all respecls, to secure said Court Order. If the Court Order is denied, Purchaser may, but shall have no
obligalion 10, appeal such denial. If, however, Purchaser does pursue an appeal of such denial, Seller shall fully cooperale
and assist Purchaser in connection with said appeaJ.
5.6 Other Requirements. Such other requirements as Purchaser may in writing inform Seller, in Purchaser's
sole discretion, are required to be satisfied.
PURCHASE AND ASSIGNMENT AGREEMENT - Page 8 of 16
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Seller's Initials
ARTICLE 6
WAIVER OF RESTRICTIONS; INDEPEJ'iDENT ADVICE; EXEMPTIONS; INDE!\fNITIES
6.1 Restrictions on Assienabilit\'. Seller acknowledges that. to the extent that the Settlemenl Documents
purpon 10 contain any restriction on the ability. right. or power of the Seller to assign. sell. transfer. mongage. encumber.
alienate. or convey the Periodic Payments. that such restrictions were included in the Settlement Documents for Seller's
benefit and not for the benefit or protection of any other person. Seller. on behalf of himself and his heirs. beneficiaries.
executors. administrators. successors. and legal representatives. hereby WAIVES AND RELEASES all rights and benefits
of the Seller in, to. or under, any and all restrictions on assignability contained in the Settlement Documents. To the extent
that any such restrictions were included to insure favorable tax treatment or benefits for the Seller or for any other purpose.
Seller ~cknowledges that Seller is not relying upon any representation or warranty of the Purchaser with respecllo the lax
consequence.s of the Transaction or the waiver contained herein.
6.2 Independent Advicc. Seller acknowledges and agrees that (i) Seller has had the opponunity 10 receive
legal, tax. financial. accounting andior business or personal advice regarding the Transaction from Sellcr's own legal. tax.
financial. accounting and/or other advisors and has either received such advice or has knowingly and voluntarily waived
and declined the opponunity to seek such advice: (ii) Seller has not received any financial. accounting. tax. legal. business.
or other advice from the Purchaser: and (i'.l Seller has relied solely upon the advice of Seller's own financial. accounting.
tax, legal. business and other advisors in entering inlo Ihis Agreement and consummating the Transactions. SELLER
FURTHER ACKNOWLEDGES THAT SELLER IS FULLY AWARE OF THE ECONOMIC CONSEQUENCES OF THE
TRANSACTION CONTEMPLATED BY THIS AGREEMENT. THIS IS AN IMPORTANT FINANCIAL
TRANSACTION AND SELLER SHOULD CONSULT WITH HIS/HER OWN ADVISORS REGARDING SAID
TRANSACTION.
6.3 Waiver of Exemotions. SeIler has signed this Agreement and is entering into this Transaction of his own
free wiIl and volition and hereby expressly and voluntarily W AlVES and RELEASES all rights and benefits of SeIler in. to,
or under all applicable laws and statutes and all provisions and principles of the common law. regulations. and any
constitution which purport to exempt the Periodic Payments and/or any payments due or payable under the Settlement
Documents from any claims or damages by. through or on behalf of Purchaser or its successors or assigns or which exempt
the Periodic Payments from execution, attachment, garnishment. seizure or other process by Purchaser. which may be
necessary to enforce this Agreement or allow Purchaser to receive the practical benefits of the Transaction.
6.4 Indemnities. The Seller funher agrees and covenants (both for Seller and on behalf of SeIler's heirs.
executors. administrators, representatives, successors, and assigns): (i) to release, indemnify and hold the Purchaser
harmless from any claim that the Periodic Payment Rights were not assignable: (ii) to never claim. either in a suit or in the
defense of an action by the Purchaser or any other person, that the Periodic Payment Rights were not assignable. The Seller
indemnifies and agrees to hold the Purchaser harmless from any claims for brokerage. sales, or other commissions or
finder's fees in respecl of this transaction alleged to be due because of any act or omission of the Seller and from any loss,
cost, liability, or expense (including attorneys' fees and expenses at all appellate levels) of defending any such claims;
provided. however, that the foregoing indemnification shall not extend to any such item that was expressly approved for
payment by the Purchaser in a writing signed by the Purchaser. The Purchaser agrees that upon its discovery of facts giving
rise to a claim for indemnity under the provisions of this Agreement, including receipt by it of notice of any demand.
assertion, claim, action or proceeding, judicial or otherwise, formal or informal. by any person with respect to any matter as
to which any of the indemnified parties are entitled to indemnity under the provisions of this Agreement. the Purchaser will
give prompt notice thereof in writing to the Seller: provided, however. that any delay in giving or failure to give such notice
shaIl not limil the righls of the Purchaser or any indemnified party to indemnity hereunder except to the extent that the
Seller is shown to have been damaged by such delay or failure.
6.5 Seller's Protection of Third Parties. Seller acknowledges that the Settlement Agreement, Annuity and/or
other Settlement Documents may contain provisions that restrict or purpon to restrict the assignment of the Periodic
Payments. Seller hereby (i) releases the Annuity Owner. the Annuity Issuer, the Settlement Obligor and all othewrsons or
PURCHASE AND ASSIGNMENT AGREEMENT - Page 9 of 16 (;, 6t.;
Seller's Initials
entities obligated to make the Periodic Payments pursuant to the terms of the Settlemenl Agreemem andlor Annuity from
any claims. causes of action. or liability. for complying with Seller's instructions regarding Ihe Periodic Payments: (ii)
releases and waives all claims. causes of action. or liability against the Annuity O"l1er, the Annuity Issuer. and Selllement
Obligor and all other persons or entities obligated to make the Periodic Payments for failing and refusing to oppose Ihe
Transaction hosed on the presence of anti-assignment or anti-encumbrance language in the underlying Settlement
Documents or for any other reason; (iii) for making and sending Ihe Periodic Payments to Purchaser in accordance with the
terms of thIS Agreement and the Coun Order: (iv) for allowing. pennilling, facilitating. cooperating with, and or not
opposing the Transaction and entry of the Coun Order; (v) for not appearing or objecling in the proceeding in which the
Court Order was entered; (vi) for failing or refusing to assert that any claim. defense. or position thaI the Periodic Payments
were not transferable or assignable: and (vii) for honoring and complying with the Coun Order. Seller and Purchaser
acknowledge and agree that the Annully OWl1er. Annuity Issuer. and or Selllement Obligor will discharge their obligation
to make the Periodic Payments due under the Selllement Agreement an<i'or Annuity by delivering said Periodic Payments
to Purchaser in accordance with thIS Agreement and the Coun Order. Seller agrees to indemnify. hold harn,less. and
defend the Ohligors in connection with the releases and waIvers set fonh in this section 6.5. Seller and Purchaser agree to
mdemnify. hold harmless. and defend Obligors from and against any future claims to or against the Periodic Payments by
any person or entity other than the Purchaser and the Purchaser"s successors and assign1'i. Seller agrees that this protection
of third panics shall be binding upon Sellcr and Scller's heirs. executors. administrators, representatives. successors. estate.
and any person or entity claiming by. through or under Seller (directly or indirectly). and shall survive the consummation of
this Agreement.
ARTICLE 7
TERMINATION & RESCISSION
7.1 Termination. Unless otherwise agreed or extended in writing by the Purchaser and the Seller, this
Agreement shall automatically terminate one hundred eighty (180) days from the date hereof if any condition to the
Purchaser's obligations hereunder has not been satisfied prior to that date, unless the failure to satisfy such conditions is the
result of a material breach of this Agreement by the Seller. Provided, however. that if the Purchaser has filed and is
working to secure the Coun Order, then this Agreement may not be lerminaled by Seller until and unless the Coun Order
proceeding is resolved and decided. one way or another, except with the written consent of Purchaser. Purchaser may
terminale this Agreement at anytime. even after the proceeding to secure the Court Order has been filed. ]n the event of
terminalion of this Agreement as provided in this Anicle. this Agreement shall forthwith become void and of no funher
force or effect, and there shall be no liability or obligation on the pan of any of the panies hereto or any of their respeclive
officers, directors, employees, agents. altorneys. panners. trustees. affiliates, or associates, except that the obligations of the
panies set fonh in Anicles 6, 7 and 8 shall survive the termination of this Agreement for a period of five (5) years from and
after the date of termination hereof To the extent that the termination of this Agreement results from the willful breach by
the Seller of any of the Seller's representations, warranties, covenants or agreements set fonh in this Agreement, nothing
herein shall prejudice the ability of the Purchaser from seeking damages from the Seller for any breach of this Agreement,
including, without limitation, attorneys' fees and the right to pursue any remedy at law or in equity. The rights and
remedies pr01ided 10 the Purchaser in this Aniele are cumulative of any other right or remedy the Purchaser may have
under this Agreement or otherwise.
7.2 Rescission. Unless prohibited, expanded, or otherwise provided by applicable law, Seller shall have a
three (3) day right of rescission after execution of this Agreement, during which Seller may rescind and cancel this
Agreement without any funher duty. liability, or obligation 10 Purchaser. ]f applicable law provides for a longer period
during which the Seller may rescind this Agreement. then Seller shall have until the end of the time period provided by
applicable law to rescind and cancel this Agreement without any further duty, liability, or obligation to Purchaser. Seller
must exercise any right of rescission by notifying Purchaser, in writing, of Seller's intent 10 rescind and cancel this
Agreement within the time period provided by this section 7.2 or applicable law. as the case may be. NOlice of Seller's
intent to rescind and/or cancel the contract shall be timely as long as it is delivered to Purchaser or post-marked by the
deadline for exercising such right of rescission and cancellation.
~Af
Seller's Initials
PURCHASE AND ASSIGNMENT AGREEMENT - Page 10 of 16
ARTICLE 8
GENERAL PROVISIONS
8.1 Notice,. Any notice or demand given under thi, Agreement ,hall be given by (il hand delivering it. (ii)
mailing it by certified or registered mail. postage prepaid. return receipt requested. or (iii) o\'ernight courier service such as
Federal Express. in each case addressed to the Purchaser or to the Seller. at the addresses set forth on age I of this
Agreement or at such other place as either pany may specify in writing to the other part)'. Each party may designate a
change of address by notifying the other party of such change at least fifteen (15\ days before such change of address is to
become effective. A notice given under thil' Agreement shall be deemed received three (3) days ancr il is mailed or when it
is delivered according to the requirements of this paragraph.
g.:! Governing Law. This Agreement. the T ransaclion Documents. and the rights. duties. and obligations of
the parties under said documents and agreements. shall be governed. interpreted. construed. and enforced in accordance
with the laws of Pennsylvania and the United States of America.
8.3 Entire Agreement. This Agreement. the exhibits. and the Transaction Documents set forth the entire
agreement of the Seller and the Purchaser with respect to the Transaction and supersede all prior agreements. arrangements.
and understandings relating to the Transaction. whether oral or \\Titten.
8.4 Amendment Waiver. This Agreement and the Transaction Documents may be amended. modified.
superseded or canceled. and any of the terms. provisions. representations. warranties.. covenants or conditions hereof or
thereof may be waived only by a written instrument signed by all of the parties hereto. ln the case of a waiver of an
obligation, tenn, or provision of this Agreement, any such waiver must be in writing and signed by the party waiving
compliance. The failure of any party to require perfonnance of any provision of this Agreement or any of the Transaction
Documents shall in no way affect the right to enforce the same. No waiver by any party of any condition contained in this
Agreement or any of the Transaction Documents, or of the breach of any tenn, provision. representation, warranty or
covenant of same shall be deemed to be or construed as a further or continuing waiver of any such condition or breach, or
as a waiver of any other condition or of the breach of any other tenn, provision, representation. warranty or covenant.
8.5 Severabilitv and State Law Savings Clause. If any provision of this Agreement or any Transaction
Document is held to be to any extent unenforceable, invalid or inconsistent with any applicable state and or federal law.
then the parties hereto agree that such provision shall be deemed to be modified for purposes of perfonnance of this
Agreement or any Transaction Document to the extent necessary to render it lawful and enforceable, or if such a
modification is not possible without materially altering the intention of the parties hereto. then such provision shall be
severed from the agreement or document for purposes of the perfonnance or enforcement of same. The validity of the
remaining provisions of the Agreement and the Transaction Documents shall not be affected by any such modification or
severance. Any such froding of un enforceability, invalidity or inconsistency ofa provision or this Agreement in any given
jurisdiction shall not prevent the enforcement of any such provision or any other provision of this Agreement in any other
jurisdiction to the maximum extent pennitted by law.
8.6 Availabilitv of Eauitable Remedies. Since a breach of the provisions of this Agreement by the Seller
could not adequately be compensated by money damages, the Purchaser shall be entitled, either before or after the Closing,
in addition to any other right or remedy available to the Purchaser, to an injunction restraining such breach or a threatened
breach and to specific perfonnance of any such provision of this Agreement, and in either case, no bond or other security
shall be required in connection therewith, and the Seller hereby consents to the issuance of such injunction and to the
ordering of specific perfonnance.
8.7 Attornevs' Fees and Court Costs. In the event of any action at law or in equity between the parties hereto
to enforce any of the provisions hereof, the unsuccessful party to such action or litigation shall pay to the successful party
all costs and expenses, including, without limitation, actual attorneys' fees expended or incurred in connection therewith by
PURCHASE AND ASSIGNMENT AGREEMENT -- Page 11 of 16
Seller's Initials
such successful party: and if the successful party shall recover judgment in any such action or proceeding. such costs,
expenses and attorneys' fees may be included in and as a part of such judgment
8.8 Headin~s: Gender: Numbers: Intemretation. All of the headings contained in this Agreement are for
purposes of convenience or reference only, and shall not be deemed to be a part of this Agreement or to affect the meaning,
construction. interpretation or scope of this Agreement or any of the provisions hereof in any way. All reterence!" in this
Agreement to the masculine, feminine. or neuter gender. shall. where appropriate. be deemed to include all other genders.
All plurab used in this Agreement or any Transaction Document shall. where appropriate, be deemed to be singular. and
vice versa. and shall refer solely to the parties hereto except where otherwise specifically provided. The normal rule of
contractual construction that any ambiguities in a contract are to be resolved against the drafting party shall nol he used in
the interpretacion of this Agreemem. any of the Transaction Documents. or any amendments or e:xhihib to same and no
presumptions regarding the interpretation of said documents and agreements shall be made as a result of the draflmg of said
agreement and documents.
8.9 Survival. All of the representations, warranties. covenants. agreements. indemnifications. obligations.
duties, and Iiabiltties of the Seller and the Purchaser set forth in this Agreement and the other Transaction Documents shall
survive until the tenth (10th) anniversary of the Purchaser's actual receipt of good funds representing the last of the Periodic
Payments, and shall not be deemed merged into the Transaction Documents.
8.10 Binding Effect Subject to the restrictions on transfers and encumbrances set forth herein, all of the
terms, provisions. covenants and conditions of this Agreement and the Transaction Documents shall inure to the benefit of
and be binding upon and be enforceable by the undersigned parties and their respective heirs, executors, administrators,
representatives, successors and permitted assigns. NOTWITHSTANDiNG ANY CONTRARY PROVISION OF THIS
AGREEMENT OR ANY OTHER CLOSING DOCUMENT, IT IS EXPRESSLY INTENDED AND AGREED THAT
THE SELLER'S SALE TO THE PURCHASER OF THE PERIODiC PAYMENT RIGHTS SHALL BE BINDiNG ON
THE SELLER'S ESTATE AND THE SELLER'S HEIRS. EXECUTORS, BENEFICIARIES, REPRESENTATIVES AND
ADMlNISTRATORS, IRRESPECTIVE OF ANY DESIGNATION OF THE SELLER'S ESTATE AS THE
BENEFICIARY UNDER THE SEITLEMENT DOCUMENTS.
8. I 1 Purchaser's Rieht to Assil!D. The Purchaser (and each and any assignee of the Purchaser) may assign all
or any portion of its right, title, and interest in and to this Agreement, the other Transaction Documents, the Annuity, the
Settlement Documents. and/or the Periodic Payments either before or after the Closing and without any requirement of
prior consent from or notice to the Seller. Upon any such assignment. Purchaser shall be released from any liability
hereunder and thereunder without any requirement of further documentation and Transferor shall look solely to such
assignee for any payment (e.g., the Transfer Price, the servicing of non-Transferred Payments) and any other performance
hereunder and thereunder. Without limiting the generality of the foregoing, the Seller shall upon request of the Purchaser
or any assignee of the Purchaser execute and deliver any such documents as the Purchaser or any such assignee may require
to effectuate and consummate the transactions contemplated hereby. If Purchaser does make an assignment as contemplated
hereby, any such reference in this Agreement and its related documenl' shall mean Purchaser's assignee.
8.12 Recitals Incorporated. Each of the recitals to this Agreement is hereby incorporated and included in this
Agreement by this reference, as if fully set forth at length.
8.13 Holdback. In the event that the Closing occurs within sixty (60) days of the first scheduled monthly
payment of the Periodic Payments, Purchaser may, in its discretion at the Closing, hold in Purchaser's bank account and
deduct from the Purchase Price, an amount equal to no more than the first two (2) monthly payments to be received by
Purchaser hereunder. Upon the receipt by Purchaser of the first montWy payment from the Annuity Ovmer (thereby
insuring the effective change of Payment address), Purchaser shall immediately release such funds withheld from the
Purchase Price to the Seller. Purcha.<er shall have the right to retain funds sufficient to cover any payments not received by
Purchaser.
PURCHASE AND ASSIGNMENT AGREEMENT -- Page 12 of 16
6Li(
Seller'. Initials
8.14 MultiDle Ori~inals. This Agreement shall be fully executed in two (2) multiple originals. each of which
shall be deemed an original Agreement.
8.15 Usury Savin~s Clause. THIS IS NOT A LOAN. It IS the intention of Purchaser and Seller thaI the
provisions of this Agreement constitute a purchasc and sale of all of Seller's right. title and interest in and 10 Ihe Periodic
Payment~ and it is nol. nor should it be construed as. a loan. Nonetheless. in order to protect against any conceivable
detennination that the conveyance was not effective. it is the intent of Purchaser and Seller to conform to and contract in
strict compliance with applicable usury law from time to time in effect. All agreement'i between Purchaser and Seller are
hereby limited by the provisions of this paragraph whicli shall override and control all such agreements. whether now
existing or hereafter arising and whether written or oral. In no way. nor in any event or contingency (including but not
limited to prepayment. default, demand for payment, or acceleration of the maturity of any obligation) shall the rate of
mterest taken. reserved. contracted for. charged or received under thi.~ Agreement or othern'ise. exceed the Maximum
Lawful Rate (defined below). If. from any possible construCl1on of any document. mterest would otherwise be payahle in
excess of the Maximum Lawful Rate. any such construction shall be autontatically reformed and the inrere.,t payable shall
be automatically reduced to the Maximum Lawful Rate. without the necessity of execution of any amendment of new
document. As used herein. the term "Maximum Lawful Rate" means the maximum nonusurious rate ofintereSl per annum
permitted by whichever of applicable United States federal law or applicable state law permits the higher interest rate.
8.16 Ri~ht of First Refusal. Seller agrees that during the Tenn, Seller will not sell. assign. borrow against,
pledge, or otherwise encumber anyone or more of the Settlement Payments not included in the Periodic Payments assigned
to Purchaser without first giving Purchaser written nOlice of the terms of any such proposed loan or sale. whether such
proposal was made orally or in writing. If, within ten (10) business days of receiving such notice. Purchaser informs Seller
that it elects to match the terms of any such proposed loan or sale, then Seller shall execute all documenls necessary to
consummate such transaction with Purchaser on those terms. The foregoing right of first refusal shall survive the exercise
of any right of cancellation or rescission that Seller or Purchaser may have under this Agreement, or applicable law. This
right of first refusal is assignable by Purchaser, however Purchaser may elect, at its sole option. not to permit the
assignment of this right of first refusal upon the assignment of this Agreement. in which event this right of first refusal shall
remain the property of Purchaser.
[REMAINDER OF THIS PAGE IS INTENTIONALLY BLANK]
PURCHASE AND ASSIGNMENT AGREEMENT -- Page 13 of 16
bt",
Seller's Initials
IN WITNESS WHEREOF. the parties have caused this Agreemenl 10 be executed by their duly authorized
representatives effective as of the date first set forth above.
SELLER:
{'!f,. 'v 17r:n't;rn4. '1
Glei-. Montgomery vi' I
J -; it -( ')~
Dale
Commonwealth of Pennsylvania
r-:: .
County oft ~fh1i!.);A!'
Acknowledgment for Glenn L. Monlgomery
S5:
I. a Notary Public of the County and State aforesaid. do hereby certify thaI Glenn L. Montgomery whose name is signed 10
the foregoing Structured Settlement Paymenl Right Purchase and Assignment Agreement. has this day acknowledged the
same before me and that said signatory has signed said Structured Settlement Payment R. Purchase and Assignment
Agreement as said signatory's free act and deed. Given under my hand this /7 day of 2005.
~yJ:<#Ik/
Cm"';"'w~ m~'~"" f
Print Name Here: J A . '
My Commission EXPire~~ ~l' ;~~
I
COMM'JNV>,tt"t..>.~.l:~-..~~W'NIA.
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PURCHASER: STRUCTURED ASSET FUNDING, LLC
By:
.2-z.>,c>~
Date
PURCHASE AND ASSIGNMENT AGREEMENT -- Page 14 of 16
.1Ut
Seller's Initials
EXHIBIT A TO STRUCTURED SETTLEMENT
PAYMENT RIGHT PURCHASE AGREEMENT
I. DATE OF AGREEMENT:
o PARTIES TO AGREEMENT:
A. Seller--
B. Purchaser--
Thi~ Agreemenl is dated and effective as of Purchaser's execution of the
Agreement (or the date that is otherwise required by applicable law).
Glenn L. Montgomery
110 S. Queen Street
Shippensburg. Pennsylvania 17257
(717) 530-9056
SS*: 184-42-094]
DOB: December 9,1951
Structured Asset Funding. LLC
1250 East Hallandale Beach Blvd.. Penthouse A
Hallandale. FL 33009
(866) 876-3863
3. SEITLEMEI\'T AND ANNUITY DOCUMENTS
A. Settlement Agreement --
B. Annuity Contract Number--
C. Qualified Assignment --
D. Annuity Issuer --
E. Settlement Obligor--
Release of Claim executed on or about April 27, 1987, by and between Glenn
L. Montgomery, ("Plaintiff"): Kuhlman Corporation, ("Defendant"); and The
Hartford Insurance Company, ("Insurer") settling and discontinuing the action
entitled Glenn L. Montgomery and Cassandra Montgomery, Plaintiffs, vs.
Kuhlman Corporation, Defendant, filed in the United States District Court for
the Western District of Pennsylvania. under Civil Action No. 85-2678.
4.027,722-0
Not available
The Manufacturers Life Insurance Company, USA
Hartford Casualty Insurance Company
4. SEITLEMEI\'T PAYMENTS -- Four Hundred Twenty (420) monthly payments, each in the amount of One
Thousand Three Hundred Ninety Five 00/100 Dollars ($1.395.00), beginning
with the payment on May 1, 1987 through and including the final payment on
April I, 2022. and for life thereafter.
5. PERIODIC PAYMENTS --
Two Hundred Eight (208) monthly payments. each in the amount of One
Thousand Three Hundred Ninety Five and 00/100 Dollars ($1.395.00).
beginning with the payment on January 1. 2005 through to and including April
1,2022.
6. PURCHASE PRICE -- One Hundred Thirteen Thousand Five Hundred Fifty Six and 22/100 Dollars
($113,556.22) One Hundred Three Thousand Seven Hundred Fifty One and
22/100 Dollars ($103,751.22) ("Payoff Amount") will be paid by the
Purchaser to Stone Street Services. Inc. on or before December 30, 2004 to
satisfy other obligations of Seller to Stone Street Services, Inc., as more
particularly set forth and described in the Disclosure Statement. The exact
PURCHASE AND ASSIGNMENT AGREEMENT -- Page 15 of 16 ~--r.
Seller's Imtials
Payoff Amount to be paid and remitted to Stone Street by Purchaser on
Seller's behalf will be detennined when the closing date for this transaction is
determined. I understand that at Purchaser's sole discretion. Purchaser
reserves the right to convey an interest in the Periodic Payments to any third
pany in order to satisfy Seller's obligations to said third pany.
This Exhibit A is incorporated into and made a pan of the Periodic Payment Right Purchase and Assignment
Agreement (the "Purchase Agreement"). to which thIS Exhibit A is attached. and the other Transaction Documen!.' as if
fully set forth and Incorporated into said agreements. contracts. and documents. at length. Seller acknowledges that it is
his'her intent to assign. sell. transfer. and convey to Purchaser the Periodic Payments described above. Seller
acknowledges that the closing and funding of the Transaction described herein and m the Transaction Documents IS
expressly contingent upon entry of a final Court Order. as described in section 5.5 of the Purchase Agreement.
/--
C
- i...- -I /J
i ; lIe I.. I . /nTi, 0':. ';
GJ<tn L Montgomery tJ I
I
Acknowledgment for Glenn L Montgomerv
Conunonwealth of Pennsylvania
County of ..rill-/2.../(/; tV
)
)
)
SS:
I, a Notary Public of the County and State aforesaid. do hereby cenify that Glenn L. Montgomery whose name is signed to
the foregoing Strucrured Settlement Payment Right Purchase and Assignment Agreement. has this day acknowledged the
same before me and that said signatory has signed said Structured Settlement Payment R. urchase and Assignment
Agreement as said signatory's free act and deed. Given under my hand this /9 day of .2005.
)
~
COMI\t.q'''iJ::.:~~~-~'- "'t","'NSl~_ p.,
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Notary Publi
Conunonwe th of Pennsylvania
Print Name He~ [fL[ JII/..Mt{/
My Commission Expires: tl'~ $/ ;Z~
/
PURCHASE AND ASSIGNMENT AGREEMENT -- Page 16 of 16
LJ(/v(
Seller's Initials
STATEMENT OF DEPENDENTS
I, Glenn L. Montgomery, ("I", "Me", "Seller", "Payee"), being duly sworn upon
my oath depose and say:
I. I understand that the applicable state transfer statute defines "dependents" to
include "payee's spouse and minor children and all other family members and
other persons for whom the payee is legally obligated to provide support,
including alimony."
2. I am married to Cassandra Phillips Montgomery (d.o.b.) January 29,1957.
3. I have no minor children.
4. I am not legally obligated to provide support, including alimony, to any other
family members and/or other persons.
.;:.. JJ,~
(1X"H .. J\. /1'/ C]~Tj rY>-JLj
GlennJ. Montgomery (j t1
d -I/" -c.j-
Date
Acknowledgment of Glenn L. Montgomery
Commonwealth of Pennsylvania
County of (jC{l2lt I,;J
)
)
)
On this, the -H- day of , 2005, before me a Notary Public,
personally appeared Glenn 1. Montgome , known to me (or satisfactorily proven) to be
the person whose name is subscribed to the within instrument, signed the same before me
as said signatory's free act and deed. /"1 (
/ ~~~aJWL ~kN
L. Notary Pu c
---r;;,,:r ,\u[ fi3fM,,/ .
Print Nam /VI / J ~
My Commission Expires:UI 'T1JOJi MI .:z a:JS..
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Statement of Dependents
Glenn L. Montgomery
Gl~Al~~t"'!\L"N ur- ,..tit"U''C~ll..W'NlA.
r-- NCTAAJAL SF.AL
I TAMMY flUE HE,MAN, Now). Public
I Boro of Ch.;"~",,,).!r~. Frn'lklm County
My C,:ti~lrr)~:~," ~x;}:~,:~_0ct. ~1. ~wo
Spousal Consent, Approval and Waiver of
CASSANDRA PHILLIPS MONTGOMERY,
wife of GLENN L. MONTGOMERY
I, Cassandra Phillips Montgomery, currently residing at 110 S. Queen Street,
Shippensburg, Pennsylvania 17257, am married to Glenn L. Montgomery (the "Seller"). The
Seller is entitled to receive certain payments (the "Settlement Payments") in connection with the
settlement of a personal injury claim which Seller settled by way of a settlement, release or similar
agreement and/or a court order or judgment (the "Settlement Agreement"). The obligation to make
the Settlement Payments mayor may not have been assigned to a third party pursuant to a qualified
assignment (the "Qualified Assignment") in accordance with the Settlement Agreement and may
or may not have been funded by an annuity (the "Annuity"). The Seller has entered into a
Structured Settlement Payment Right Purchase and Assignment Agreement on or about February,
2005 (the "Purchase Agreement") with Structured Asset Funding, LLC ("Purchaser") whereby
Seller has agreed to sell, assign, transfer, and convey to Seller all of Seller's right, title, and interest
in and to all or a portion of the Settlement Payments and/or payments due and payable under the
Qualified Assignment and related Annuity (hereafter the "Periodic Payments"). The transaction
reflected and described in the Purchase Agreement and the Closing Documents, as described
therein, shall hereafter be referred to as the "Transaction." The Settlement Agreement, Qualified
Assignment, Annuity, Purchase Agreement, Settlement Payments, Periodic Payments, and the
Transaction are further described in Exhibit A attached to this Spousal Consent and in the Purchase
Agreement and Closing Documents.
I have been asked to consent to and approve the Transaction and the Purchase Agreement
and the related Closing Documents by and between the Seller and Purchaser. I hereby voluntarily
and knowingly consent to and approve the Purchase Agreement. I hereby waive and convey to the
Purchaser any and all rights that I may now have or claim, or which I may hereafter acquire or
claim, to or in the Periodic Payments, whether such rights or claims are vested or contingent, and
whether they arise directly or indirectly through the Seller, as a result of being married to Seller, as
a payee, an heir, contingent payee or beneficiary under the Settlement Documents, or otherwise in
any capacity whatsoever.
I understand, acknowledge, and agree that upon closing of the Transaction I shall have no
further right or claim to the Periodic Payments and I shall not make or assert any claim to said
payments or to the proceeds of the Transaction until said proceeds are paid and remitted to the
Seller and then I shall make any such claim, if any, to the proceeds only against the Seller and shall
not make any such claims against the Purchaser or its assigns.
I understand that Purchaser is relying upon my promises, agreements, covenants, approvals,
waivers, and consents set forth herein in entering into the Purchase Agreement and concluding the
Transaction. As the Seller's spouse, I desire that Purchaser complete the Transaction with Seller
and I agree to be legally bound by this Spousal Consent. I understand that the Transaction may be
submitted for court approval in accordance with applicable laws and I will cooperate in connection
Spousal Consent of Cassandra Phillips Montgomery, wife of Glenn L. Montgomery
("Seller")
Page 1 of2
with such court approval process in any way requested by Seller or Purchaser in order to complete
the Transaction.
This Spousal Consent shall be attached to, and form a part of, the Purchase Agreement. In
the event of any conflict or inconsistency between the provisions of this Spousal Consent and the
provisions of the Purchase Agreement, the provisions of this Spousal Consent shall govern and
control.
AGREED, ACKNOWLEDGE, AND APPROVED, THIS
/1
DAY OF
,)L{r~I..-'-{ t(. L '-i
I
,2005.
/l.
I/r.k-
sandra Phillips Montgo
Acknowledgment for Cassandra Phillips Montgomery
commonw~p~Vania
County of JLI
,
)
)
I, a Notary Public of the County and State aforesaid, do hereby certify that Cassandra
Phillips Montgomery , whose name is signed to the foregoing Spousal Consent has this day
acknowledged the same before me and that said signatory has signed said ~al Consent as said__
signatory's free act and deed. Given under my hand this /1 day of J2td-t larA
2005.
GGMM;.I!:lWl",~" 1.''''~''''''lI- ..
r- NOTARIA'_ ,,':Ai.
I TAMMY PJ~: hElMAl\, Not:!.')' Public
i Bore o[ C:1'i1;i~f.mrJ1ar; Fralktin County
, ~y ~'._~~_:'?r:.f:,:":'r}l!~~ f,..lct. 31, ~J:'
/'I! ~~
U?:f:t
Commonwealth of Pennsylvania
.~ ~--;/d<-Ati
Print ~ere:
My Commission EXPires:~ 3/ ;l()os.---
Spousal Consent of Cassandra Phillips Montgomery, wife of Glenn L. Montgomery
("Seller")
Page 2 of2
AFFIDAVIT OF GLENN L. MONTGOMERY IN SUPPORT OF HIS TRANSFER OF
STRUCTURED SETTLEMENT PAYMENT RIGHTS
TO STRUCTURED ASSET FUNDING, LLC
I, Glenn L. Montgomery, ("I", "Me", "We", "Seller"), being duly sworn upon my oath
deposes and says:
I. I am Fifty Three (53) years old, of sound mind and fully and personally cognizant of all
facts and matters stated in this Affidavit. I have never been adjudged incompetent by any
court.
2. I reside at 110 S. Queen Street, Shippensburg, Pennsylvania 17257.
3. My social security number is 184-42-0941 and my date of birth is December 9, 1951.
4. I have never been convicted of a felony.
5. I am married to Cassandra Phillips Montgomery, (d.o.b.) January 29,1957.
6. I am signing and submitting this affidavit in connection with that certain Structured
Settlement Periodic Payment Right Purchase and Assignment Agreement (the "Purchase
Agreement") executed by and between myself as the Seller and Structured Asset
Funding, L.L.C. ("SAF") as the Purchaser. Capitalized terms not otherwise defined in
this Affidavit shall have the meanings given to them in the Purchase Agreement. The
"Transaction" shall hereafter refer to the transaction set forth and described in the
Purchase Agreement and the Closing Documents, involving the sale and assignment of
my right to receive certain future payments to the Purchaser.
7. I have read and understand the Purchase Agreement and the other Closing Documents
and understand the Transaction. I am fully aware of the economic consequences of this
Transaction and am fully capable of managing my financial, personal and business
affairs.
8. I was advised by SAF that I should talk and consult with my own independent
professional advisors regarding the Purchase Agreement, the Closing Documents, and the
Transaction. I have been provided ample opportunity to talk with others regarding the
Transaction and have relied solely upon myself and/or upon the advice of my own
accounting, tax, legal, and other advisors. SAF has not made any representations or
assurances and has not provided me any advice regarding the legal, tax or other financial
consequences of the Transaction.
9. I have agreed to sell, convey, assign, transfer and deliver to SAF or its designated
assignee(s) certain structured settlement payment rights as set forth in Exhibit A to the
Purchase Agreement (the "Transferred Payments").
Affidavit of Glenn L. Montgomery
Page I 00
I
Exhibit D
I
10. I understand that I have previously sold some of the Transferred Payments as listed in
Exhibit A of the Purchase Agreement to Stone Street Services, Inc. as successor to Stone
Street Capital, Inc. ("Stone Street") prior to the effective date of an applicable structured
settlement transfer act. Accordingly. I have asked SAF to deduct a certain amount (the
"Payoff Amount") from the net amount payable to me. The Payoff Amount will be paid
to Stone Street to enable me to obtain Stone Street's release of its encumbrance on a
portion of the previously sold payments so that such previously sold payments may be
transferred to SAF. The exact Payoff Amount to be paid and remitted to Stone Street by
SAF on my behalf will be determined on the closing date for this transaction
I I. I understand that I shall not be entitled to receive any of the Transferred Payments. I
understand that I, and my beneficiaries/heirs. will no longer receive any of the
Transferred Payments or any portion of the Transferred Payments. I understand that the
Transferred Payments will go to SAF or its assign(s).
12. I intend to use the proceeds] receive from SAF under the Purchase Agreement to make
some much needed repairs to my home. My home is over twenty years old and it is now
in need of major repairs to the garage as well as much needed remodeling of both
bathrooms. The repairs and remodeling work will help me maintain and/or add to the
value of my home without having to borrow from any outside sources and incurring any
additional debts. This way. I will be able to increase my home's value without increasing
my monthly obligation. I have determined that the sale of the Transferred Payments to
SAF is fair and reasonable, will improve the quality of my life and is in my best interests,
taking into account the welfare and support of my dependents. The transfer will not
subject me or my dependents to economic hardship now or in the future.
13. I understand that the Settlement Agreement and/or other Settlement Documents may
contain provisions that restrict or prohibit the assignment or sale of the Transferred
Payments. I waive all such restrictions and prohibitions and desire to complete the
Transaction notwithstanding such restrictions and prohibitions.
14. I understand and acknowledge that each of the representations, warranties, covenants,
agreements, obligations, and duties I made under the Purchase Agreement and the other
Closing Documents are being relied upon by SAF. I understand that if! breach or violate
any of the terms of the Purchase Agreement or the other Closing Documents, SAF will
suffer substantial damages as a result.
15. I will not, and will not permit anyone claiming by or through me (other than SAF), to do
anything which would divert any Transferred Payments from SAF.
16. I recognize and accept the continuing and irrevocable duty and obligation under the
Purchase Agreement to cooperate with SAF to make sure that SAF receives all of the
Transferred Payments, including the duty to immediately deliver to SAF any checks,
funds or other form of payment received by me which constitute any of the Transferred
Payments. I understand that this duty exists regardless of whether the Transferred
Affidavit of Glenn L. Montgomery
Page 2 of3
Payments are received by mistake Of as a result of any action or omission on the part of
SAF.
17.1 have not previously pledged, promised, assigned, sold, or encumbered any of my rights
in or to the Transferred Payments or any of the Settlement Payments or any other
payments or payment rights or benefits due under the Settlement Documents or the
Annuity (except as may be set forth and fully disclosed in writing in the Disclosure
Statement and/or made part of the Closing Documents in this Transaction), nor have any
such Transferred Payments ever been attached, levied, foreclosed upon, seized, restricted,
or subjected to garnishment or other legal process or proceeding.
18. The transfer, assignment, and conveyance of the Transferred Payments to SAF under the
Purchase Agreement shall constitute an absolute assigrunent and conveyance to SAF of
the Transferred Payments. Said assignment, transfer and conveyance is not intended to,
nor shall it ever be construed as, a loan from SAF to me nor shall it create any type of
partnership or other joint ownership arrangement between myself and SAF.
19. I hereby acknowledge that my execution and delivery of this sworn Affidavit is being
made as a material inducement in SAF's decision and willingness to accept the Purchase
Agreement and pay the Purchase Price and that BUT FOR MY EXECUTION AND
DELIVERY OF THIS SWORN AFFIDAVIT, SAP WOULD NOT PAY THE
PURCHASE PRICE OR PURCHASE OR ACCEPT THE TRANSFERRED
PAYMENTS, BUT RATHER WOULD TERMINATE THE PURCHASE
AGREEMENT.
SUBSCRIBED TO AND SWORN TO BEFORE ME on this the ~ day of ~y
,2005. ~
if."' /.1J1r1-:i""'" 'i
G nn L. Montgom / I
Acknowledgment for Glenn L. Montgomery
Commonwealth ofPeIYlsylvania )
County of f1; 4.1? 11/,1; )
I, a Notary Public of the County and State aforesaid, do hereby certify that Glenn L.
Montgomery, whose name is signed to the foregoing Affidavit has this day acknowledged the
same before me and that said signatory has signed ,jilip Affidavit as said signatory's free act and
deed. Given under my hand this /? day of kJ;~/11 / ,2005.
&M~: LLdod~
- Notary Pu ic
COnmlonwealth of Pennsylvania
Print Name Here: - !ll;t:i;~ 1f:1.--rufd
My Commission Expires: _ c__ _
/
Affidavit of Glenn L. Montgomery
Page 3 of3
COMMONWt '.l.'" \J~ ,.,,"N"'VcVAHIA
N0TiiRiALSE.h S
TAMMY SUc.H E.M. M.; Not1f\.: P.UlJIic
I 80m of Ctwr.o""",ury Fm' lkli~ County
~~m;'~<1',r~ ~l('"'>.'rQ<: "'t. .:n. 4'UO
PENNSYL VANIA DISCLOSURE STATEMENT
Payee: Glenn L. Montgomery - Resident of: Pennsylvania
A. The amounts and due dates of the structured settlement payments
to be transferred: Two Hundred Eil!ht (208) monthlv pavments,
each in the amount of One Thousand Three Hundred Ninety Five
and 00/100 Dollars ($1,395.00), bel!inninl! with the payment on
January 1. 2005 throue:h to and includine: April 1. 2022.
B. The aggregate amount of the payments: $290,160.00.
C. The discounted present value of the payments, together with the
discount rate used in determining the discounted present value:
$207,775.35. This amount is determined by applying the
applicable federal rate of 4.2% as of December, 2004.
D. The gross amount payable to the payee in exchange for the
structured settlement payments: $116,056.22.
E. The following is an itemized listing of all brokers' commissions,
service charges, application or processing fees, closing costs, filing
or administrative fees, 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: Good faith estimate of $2,500.00 for transaction/legal
costs.
F. Independent Professional Advice. Payee will be solely responsible
for any independent professional advice or advisor's fees related
to the rendering of any advice regarding Payee's transfer of
structured settlement payments. These fees are in addition to any
legal or other fees estimated above.
(1..#
Payee's Initials
Pennsylvania Disclosure Statement
Page 1 of 4
I Exhibit E
I
padsvtt3
G. The net amount payable to the Payee after deducting all
commissions, fees, costs, expenses, and charges described in sub-
paragraph E: $113,556.221.
H. The net amount that you will receive from us in exchange for your
future structured settlement payments represent 54.65% of the
estimated current value of the payments based upon the
discounted value using the applicable federal rate. This
percentage is the "quotient" and it is obtained by dividing the net
payment amount by the discounted present value of the payments.
I. The amount of any penalty and the aggregate amount of any
liquidated damages, including penalties, payable by the Payee in
the event of a breach of the transfer agreement by the Payee:
$0.00.
By signing below, I am confirming that I received a copy of this
disclosure statement at least ten (10) days prior to the date on which I
first incurred an obligation with respect to the transfer agreement with
Structured Asset Funding, LLC, pursuant to Pennsylvania's Structured
Settlement Protection Act.
Except $103,751.22 (the "Payoff Amount" effective on or before
December 30, 2004) will be deducted from the net amount payable and
will be paid to Stone Street Services, Inc. ("Stone Street"), to enable
Payee to obtain Stone Street's release of its encumbrance on a portion of
the payments set forth in section A above relating to a prior transfer
transaction that was consummated prior to the effective date of
Pennsylvania's Structured Settlement Protection Act. The exact Payoff
Amount to be paid and remitted to Stone Street by Transferee on
Payee's behalf will be determined on the closing date for this
transaction.
t,UJ/I
Payee's lnitials
Pennsylvania Disclosure Statement
Pagel of 4
pads\:C'f)
By my signature, I am also confirming that I received a written notice
on a separate sheet that contains the following statement:
"IMPORTANT NOTICE: You are strongly urged to consult with an
attorney who can advise you of the potential tax consequences of this
transaction."
/ -;J(; -(l~
DATED
afll%I7Jj~
9LENN L. MOf4TG ERY
tl.M
Payee's Imtials
Pennsylvama Disclosure Statement
Page3 of 4
pads.ver3
IMPORTANT NOTICE: You are strongly urged to consult with an
attorney who can advise you of the potential tax consequences of this
transaction.
ktt
Payee's. Initials
Pennsylvania Disclosure Statement
Page 4 0[4
padsw:tJ
CONNECTICUT DISCLOSURE STATEMENT
Payee: Glenn L. Montgomery - Resident of: Pennsylvania
A. The amounts and due dates of the structured settlement payments to be
transferred: Two Hundred Eie:ht (208) monthlv pavments, each in the
amount of One Thousand Three Hundred Ninety Five and 001100
Dollars ($1,395.00), beginnine: with the Davment on Januarv 1. 2005
through to and includine: April 1, 2022.
B. The aggregate amount ofthe payments to be transferred: $290,160.00.
C. The discounted present value of the payments to be transferred which is
the calculation of current value of the transferred structured settlement
payments under federal standards for valuing annuities: $207,775.35.
This amount is determined by applying the applicable federal discount
rate of 4.2% as of December, 2004.
D. The gross amount payable to the payee in exchange for the structured
settlement payments: $116,056.22.
E. The following is an 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: Good faith estimate of $2,500.00 for transaction/legal costs.
F. The following is the transferee's best estimate of the amount of
attorneys' fees and related disbursements payable in connection with
the transferee's application for approval of the transfer: See Paragraph
E above.
G. The amount payable to the Payee, net of all expenses, in exchange for
the payments to be transferred: $113,556.22. I
I Except $103,751.22 (the "Payoff Amount" effective on or before December
30, 2004) will be deducted from the net amount payable and will be paid to
Stone Street Services, Inc. ("Stone Street"), to enable Payee to obtain Stone
Street's release of its encumbrance on a portion of the payments set forth in
section A above relating to a prior transfer transaction that was consummated
prior to the effective date of the Connecticut Transfer of Structured
Connecticut Disclosure Statement
Page I of 2 cwsv....2
tit(
Payee's Initials
H. The amount of any penalties or liquidated damages payable by the
Payee in the event of a breach of the transfer agreement by the Payee:
$0.00.
I. The Payee has the right to cancel the transfer agreement, without
penalty or further obligation, not later than the third (3rd) business day
after the date the agreement is signed by the Payee.
J. Independent Professional Advice. Payee will be solely responsible for
any independent professional advice or advisor's fees related to the
rendering of any advice regarding Payee's transfer of structured
settlement payments. These fees are in addition to any legal or other
fees estimated above.
YOU ARE ADVISED TO SEEK INDEPENDENT PROFESSIONAL
ADVICE. "INDEPENDENT PROFESSIONAL ADVICE" IS TYPICALLY
DEFINED AS "ADVICE OF AN ATTORNEY, CERTIFIED PUBLIC
ACCOUNTANT, ACTUARY OR OTHER LICENSED PROFESSIONAL
ADVISER," WHO CAN ADVISE YOU REGARDING THE TRANSFER OF
YOUR STRUCTURED SETTLEMENT PAYMENT RIGHTS.
By signing below, I am confirming that I received a copy of this disclosure
statement at least three (3) days prior to the date on which I will enter into a
transfer agreement with Structured Asset Funding, pursuant to Connecticut's
Transfer of Structured Settlement Payment Rights Act. By my signature, I
am also confirming that I have read and understood this disclosure statement.
. 1 ....--
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DATED
Settlement Payment Rights Act. The exact Payoff Amount to be paid and
remitted to Stone Street by Transferee on Payee's behalf will be determined
on the closing date for this transaction.
Connecticut Disclosure Statement
Page 2 of 2 C1dsver.2
~01
P3Yec's Initials
IMPORTANT NOTICE (PA)
Payee: Glenn L. Montgomery
IMPORTANT NOTICE: You are strongly urged to consult with an
attorney who can advise you of the potential tax consequences of this
transaction.
I Exhibit F I
I, Glenn L. Montl!omerv, hereby affirm that prior to entering into a
Structured Settlement Payment Right Purchase and Assignment
Agreement for the transfer of my structured settlement payment rights,
I received an Important Notice from Structured Asset Funding, LLC on
a separate sheet. In the Important Notice, Structured Asset Funding,
LLC strongly urged me to consult with an attorney who can advise me
of the potential tax consequences of this Transaction. The Important
Notice was in bold print and at least 12-point type on a separate sheet of
paper.
/-,;1605
Date
*
*
*
*
*
*
A copy of the Important Notice that I,
Glenn L. Montgomery, received appears below:
IMPORTANT NOTICE: You are strongly urged to consult with an attorney who
can advise you of the potential tax consequences of this transaction.
AFFIDAVIT OF
INDEPENDENT PROFESSIONAL ADVICE
1, Glenn L. Montgomery, ("1", "Me", "Seller"), being duly sworn upon my oath
depose and say:
I. 1 am of sound mind and fully and personally cognizant of all facts and matters
stated in this Affidavit. 1 have never been adjudged incompetent by any court.
, On or about February, 2005, 1 entered into a Structured Settlement Payment Right
Purchase and Assignment Agreement with Structured Asset Funding, LLC (the
"Agreement") to transfer certain structured settlement payment rights.
3. With regard to said Agreement, I received a Disclosure Statement from Structured
Asset Funding, LLC in which I was strongly urged to seek advice from an
attorney who can advise me of the potential tax consequences of this transaction.
4. Accordingly,
a. I have received independent professional advice regarding the transfer
of my structured settlement payment rights from (provide name, firm,
address and telephone number):
Signature
OR
b. I understand the potential tax consequences of this transaction and
hereby expressly waive my right to seek advice regarding the transfer
of my structured settlement ~cm~nt ri.ghts. . .
C~rhn [-Jrin.J1.hU./
ygnature (/
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Date
Affidavit of Independent Professional Advice
Glenn L. Montgomery
Page 1 of2
I
Exhibit G
I
Commonwealth of Pennsylvania
County of 0Hil.10 II.!
)
)
)
On this, the /9 day of b 4{#.. tv , 2005, before me a Notary Public,
the undersigned officer, personally ap ared Glenn L Montgomery, known to me (or
satisfactorily proven) to be the person whose name is subscribed to the within instrument,
and acknowledged that said signatory executed the same for the purposes therein
contained.
In witness whereof, I hereunto set my hand and official seal.
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COMMQNWt:AUt1 Or h::rlI'lST
NOTARIAL SEAL
T/\MMY SU::: HEI.M~N, Not3ry Public
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Affidavit oflndependent Professional Advice
Glenn L. Montgomery
Page 2 of2
26 USCA S 5891
26 U.S.C.A. S 5891
Page 1
J.R.C. S 5891
UNITED STATES CODE ANNOTATED
TITLE 26. INTERNAL REVENUE CODE
SUBTITLE E--ALCOHOL, TOBACCO, AND CERTAIN OTHER EXCISE TAXES
CHAPTER 55--STRUCTURED SETTLEMENT FACTORING TRANSACTIONS
Copr. (t'J West Group 2002. No claim to Orig. U.S. Govt. Works.
Current through P.L. 107-136, approved 1-24-02
~ 5891. Stl1lctured settlement factoring transactions
(a) Imposition of tax.--There is hereby imposed on any person who acquires directly or indirectly structured
settlement payment rights in a structured settlement factoring transaction a tax equal to 40 percent of the
factoring discount as determined under subsection (c)(4) with respect to such factoring transaction.
(b) Exception for certain approved transactions.--
(I) In general.--The tax under subsection (a) shall not apply in the case of a structured settlement factoring
transaction in which the transfer of structured settlement payment rights is approved in advance in a qualified
order.
(2) Qualified order.--For purposes of this section, the term "qualified order" means a final order, judgment, or
decree which--
(A) finds that the transfer described in paragraph (I )--
(0 does not contravene any Federal or State statute or the order of any court Of responsible administrative
authority, and
(ii) is in the best ll1terest of the payee. taking mto account the welfare and support of the payee's dependents. and
(B) is issued--
0) under the authority of an applicable State statute by an applicable State court, or
(ii) by the responsible administrative authority (if any) which has exclusive jurisdiction over the underlying action
or proceeding which was resolved by means of the structured settlement.
(3) Applicable State statute.--For purposes of this section, the term "applicable State statute" means a statute
providing for the entry of an order, judgment, or decree described in paragraph (2)(A) which is enacted by--
(A) the State in which the payee of the structured settlement is domiciled, or
(B) if there is no statute described in subparagraph (A), the State in which either the party to the structured
settlement (including an assignee under a qualified assignment under section 130) or the person issuing the funding
asset for the structured settlement is domiciled or has its principal place of business.
(4) Applicable State court.--For purposes of this section--
(A) Iu general.--The term "applicable State court" means, with respect to any applicable State statute, a court of
Copr.!!;) West 2002 No Clairn to Orig. U.S. Govt. Works
I Exhibit H I
26 USCA!l 5891
26 U.S.CA.!l 5891
Page 2
the State which enacted such statute.
(B) Speeial rule.--In the case of an applicable State statute described in paragraph (3 )(B), such term also includes
a court of the State in which the payee of the structured settlement is domiciled.
(5) Qualified order dispositive.--A qualified order shall be treated as dispositive for purposes of the exception
under this subsection.
(c) Definitions.--For purposes of this section--
(1) Structured settJement.--The term "structured settlement" means an arrangement--
(A) which is established by--
(i) suit or agreement for tbe periodic payment of damages excludable from the gross income of the recipient
under section 104(a)(2). or
(ii) agreement for the periodic payment of compensation under any workers' compensation law excludable from
the gross income of the reciplent under section 104(a)(l), and
(H) under which the periodic payments are--
(i) of the character described in subparagraphs (A) and (B) of section 130(c)(2), and
(H) payable by a person who is a party to the suit or agreement or to the workers' compensation claim or by a
person who has assumed the liability for such periodic payments under a qualified assignment in accordance with
section 130.
(2) Structured settlement payment rights.--1l1e term "structured settlement paymeut rights" means rights to
receive payments under a slrudun:u sdllement.
(3) Structured setiiement factoring transaciion.~-
(A) In general.--The term "structured settlement factoring transaction" means a transfer of structured
settlement payment rights (including portions of structured settlement payments) made for consideration by means
of sate, assignment, pledge, or other form of encumbrance or alienation for considerahon.
(B) Exception.--Such term shall not include--
(i) the creation or perfection of a security interest in structured settlement payment rights under a blanket security
agreement entered into with an insured depository institution in the absence of any action to redirect the structured
settlement payments to such institution (or agent or successor thereof) or otherwise to enforce such blanket security
interest as against the structured settlement payment rights, or
(H) a subsequent transfer of structured settlement payment rights acquired in a structured settlement factoring
transaction.
(4) Factoring discount.-- The term "factoring discount" means an amount equal to the excess of--
(A) the aggregate undiscounted amount of structured settlement payments being acquired in the structured
settlement factoring transaction. over
(B) the total amount actually paid by the acquirer to the person from whom such structured settlement payments
are acquired.
(5) Responsible administrative authority.--The term "responsible administrative authority" means the
Copr. ~ West 2002 No Claim to Orig. U.S. Govt. Works
26 USCA Ii 5891
26 D.S.C.A. Ii 5891
Page 3
administrative authority which had jurisdiction over the underlying action or proceeding which was resolved by
means of the structured settlement.
(6) State.--The term "State" includes the Cornnlonwealth of Puerto Rico and any possession of the United States.
(d) Coordination with other provisions.--
(1) 1n general.--lf theapplicable requirements of sections 72, 104(a)( I), 104(a)(2), 130, and 461(h) were satisfied
at the time the structured settlement involving structured settlement payment rights was entered into, the subsequent
occurrence of a structured settlement factoring transaction shall not affect the application of the provisions of
such sections to the parties to the structured settlement (including an assignee under a qualified assignment under
section 130) in any taxable year.
(2) No withholding of tax.-- The provisions of section 3405 regarding withholding of tax shall not apply to the
person making the payments in the event of a structured settlement factoring transaction.
CREDlT(S)
2002 Pocket Part
(Added Puh.L. 107-1,4. Tirle l. ~ 1151 a), Jan. 23,2002, 115 Stat. 2436.)
<General Marerials (GM) - References, Annotations, or Tables>
HISTORICAL AND STATUTORY NOTES
ReviSIOn Notes and Legislative Reports
2002 Acts. Statement of President, see 2001 U.S. Code Congo and Adm. News, p. 1812.
Effective and Applicability ProviSIOns
2002 Acts. Pub./.. 107-134. Tille I. ~ I 15(c), Jan. 23, 2002. 115 Stat. 2438, provided that:
"(1) In general.--The amendments made by this section [enacting this chapter] (other than the provisions of
section 5891(d) of the Internal Revenue Code of 1986, as added by this section [26 U.S.C.A. Ii 5891(d)]) shall apply
to structured settlement factoring transactions (as defined in section 5891(c) of such Code (as so added) [26
U.S.C.A. Ii 5891(c)]) entered into on or after the 30th day following the date of the enacttnent of this Act [Jan. 23,
2002].
"(2) Clarification of existing law.--Section 5891(d) of such Code (as so added) [26 U.S.C.A. S 5891(d)] shall
apply to struetured settlement factoring transactions (as defined in section 5891(c) of such Code (as so added)
[26 U.S.C.A. Ii 5891(c)]) entered into before, on, or after such 30th day.
"(3) Transition rule.--In the case of a structured settlement factoring transaction entered into during the period
beginning on the 30th day following the date of the .enacttnent of this Act [Jan. 23, 2002] and ending on July I,
Copr. rQ West 2002 No Claim to Orig. U.S. Govt. Works
26 USCA ~ 5891
26 U.S.C.A. ~ 589l
Page 4
2002, no tax shall be imposed under section 5891(a) of such Code [26 U.S.C.A. ~ 5891(a)] if--
"(A) The structured settlement payee is domiciled in a State (or possession of the United States) which has not
enacted a statute providing that the structured settlement factoring transaction is ineffective unless the
transaction has been approved by an order, judgment, or decree of a court (or where applicable, a responsible
administrative authority) which finds that sucb transaction--
"(i) does not contravene any Federal or State statute or the order of any court (or responsible administrative
authority); and
"(ii) is in the best interest of the structured settlement payee or is appropriate in light of a hardship faced by the
payee; and
"(B) the person acquiring the structured settlement payment rights discloses to the structured settlement payee in
advance of the structured settlement factoring transaction the amounts and due dates of the payments to be
transferred, the aggregate amount to be transferred, the consideration to be received by the structured sertlement
payee for the transferred payments, the discounted present value of the transferred payments (including the present
value as determined in the manner described in section 7520 of such Code [26 U.S.C.A. ~ 75201), and the expenses
required under the tem15 of the structured settlement factoring transaction to be paid by the stmctured settlement
payee or deducted from the proceeds of such transaction."
26 U.S.c.A. ~ 5891
26 USCA ~ 5891
END OF DOCUMENT
Copr. @ West 2002 No Claim to Orig. U.S. Gov!. Works
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSYLVANIA
CIVIL DIVISION
INRE:
PETITION OF GLENN L. MONTGOMERY
TO TRANSFER STRUCTURED
SETTLEMENT PAYMENT RIGHTS
No.
FINAL ORDER OF COURT
AND NOW, this
day of
, 2005, upon presentation of
the Petition of Glenn L. Montgomery ("Montgomery") to Transfer Structured Settlement
Payment Rights pursuant to the Structured Settlement Protection Act, 40 P.S. 99 4001-4009, it
appearing to this Court that proper notice of the filing and presentation of this Petition was given
to the Settlement Obligor, Hartford Casualty Insurance Company, and to the Annuity Issuer, The
Manufacturer's Life Insurance Company, USA; and it further appearing that Hartford Casualty
Insurance Company and The Manufacturer's Life Insurance Company, USA, have not opposed
the Petition; after due consideration, this Court finds as follows:
I. This Court has subject matter and personal jurisdiction.
2. The transfer complies with the requirements of the Structured Settlement
Protection Act, 40 P.S. 994001-4009, and will not contravene other applicable Federal or State
statutes or regulations or any applicable law limiting the transfer of workers' compensation
claims.
3. Not less than ten (10) days prior to the date upon which the Petitioner first
incurred any obligation with respect to the transfer, the Transferee, Structured Asset Funding,
LLC provided the Petitioner a disclosure statement setting forth in boldface, minimum 12-point
size type all ofthe following:
a. The amounts and due dates of the structured settlement payments to be
transferred.
b. The aggregate amount of such payments.
c. The discounted present value of such payments, together with the discount
rate or rates used in determining such discounted present value.
d. The gross amount payable to the Petitioner in exchange for such
payments.
e. An 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 Petitioner or deductible from the
gross amount otherwise payable to the Petitioner.
f. The net amount payable to the Petitioner after deduction of all
commissions, fees, costs, expenses, and charges described above.
g. The quotient, expressed as a percentage, obtained by dividing the net
payment amount by the discounted present value of the payments.
h. The amount of any penalty and the aggregate of any liquidated damages,
inclusive of penalties, payable by the Petitioner in the event of any breach
of the Purchase Agreement by the Petitioner.
4. The Petitioner has established that the transfer is in his best interests, taking into
account the welfare and support of the Petitioner's dependents, if any, at time of entry of this
Order of Court.
5. The Petitioner has expressly waived independent legal advice regarding the
implications of the transfer, including consideration of the tax ramifications ofthe transfer.
2
'.
6. The transfer has been expressly approved in writing by the Petitioner, and at the
time the Petitioner and the Transferee proposed to enter into the Purchase Agreement, a
favorable tax result was in effect. The approvals of the Annuity Issuer and Settlement Obligor
are not required.
7. The Petitioner has given written notice pursuant to 40 P.S. S 4003 (a)(6) of the
Transferee's name, address, and taxpayer identification number to the Annuity Issuer, and the
Structured Settlement Obligor, and a copy of the written notice has been filed with the Court.
8. Prior to entering into the Purchase Agreement the Petitioner was provided with a
written notice on a separate sheet that contains the following, in boldface, minimum 12-point
size type required by 40 P.S. SS 4003 (b):
"IMPORTANT NOTICE: You are strongly urged to consult wjth an attorney
who can advise you of the potential tax consequences of this transaction."
9. Not less than 20 days prior to the scheduled hearing on the petition for
authorization of a transfer of structured settlement payment rights under 40 P.S. S 4003, the
Petitioner filed with the Court and served on the Transferee a notice of the proposed transfer and
the application for its authorization, including in the notice a copy of the Petitioner's Petition to
the Court, a copy of the Purchase Agreement, a copy of the disclosure statement required under
40 P.S. S 4003, notification that the Transferee, the structured settlement obligor or the annuity
issuer is entitled to support, oppose or otherwise respond to the Petition, either in person or by
counsel, by submitting written comments to the Court or by participating in the hearing and
notification of the time and place of the hearing and notification of the manner in which and the
time by which written responses to the Petition must be filed.
10. The Purchase Agreement does not authorize Transferee or any other party to
confess judgment or consent to entry of judgment against Petitioner.
3
NOW THEREFORE, in consideration ofthe foregoing findings, it is hereby ORDERED,
ADJUDGED and DECREED that the Petition to Transfer Structured Settlement Payment Rights
pursuant to the Structured Settlement Protection Act, 40 P.S. 99 4001-4009 be and is hereby
GRANTED as follows:
A. The transfer by Petitioner Montgomery, to Transferee, Structured Asset Funding,
LLC and its successors and assigns, of the Transferred Payments (consisting of: two hundred
eight (208) monthly payments, beginning with the payment on January I, 2005, each in the
amount of $1 ,395.00, through to and including April I ,2022) is hereby APPROVED.
B. The Settlement Obligor, Hartford Casualty Insurance Company, shall direct the
Annuity Issuer, The Manufacturer's Life Insurance Company, USA, to send the Transferred
Payments to Structured Asset Funding, LLC and its successors and/or assigns care of the
following address:
Structured Asset Funding, LLC
757 SE 17th Street, #360
Fort Lauderdale, FL 33316
or such other address as Structured Asset Funding, LLC and its successors and/or assigns may
designate upon written notice to Settlement Obligor, Hartford Casualty Insurance Company and
the Annuity Issuer, The Manufacturer's Life Insurance Company, USA. Settlement Obligor,
Hartford Casualty Insurance Company and the Annuity Issuer, The Manufacturer's Life
Insurance Company, USA, shall not be required to change the address for the Transferred
Payment absent payment of a reasonable administrative fee, which shall not be charged to or
paid by the Payee. Nothing in this Final Order shall prevent Structured Asset, its successors or
assigns, from assigning its right, title or interest in the right to receive the Transferred Payments
to any other entity. In the event that Structured Asset assigns the Transferred Payments to
4
another person or entity, neither the Settlement Obligor, Hartford Casualty Insurance Company
nor the Annuity Issuer, The Manufacturer's Life Insurance Company, USA, shall be obligated to
re-direct the Transferred Payments to any such person or entity.
C. The death of Petitioner Montgomery prior to the due date of the last Transferred
Payment shall not adversely affect the transfer of the Transferred Payments from Petitioner
Montgomery to Structured Asset Funding, LLC. Petitioner Montgomery acknowledges that he is
transferring all of his right, title and interest to the Transferred Payments on behalf of himself
and his estate to Structured Asset, its successors and assigns.
D. Structured Asset Funding, LLC and its successors and/or assigns shall defend,
indemnify and hold hanuless (collectively, the "Indemnity") the Settlement Obligor, Hartford
Casualty Insurance Company and the Annuity Issuer, The Manufacturer's Life Insurance
Company, USA, from any claims, liability or damages, including, but not limited to, reasonable
costs and attorneys' fees arising from or in connection with (a) any disclosures made in or related
to this Order of Court; (b) compliance by the Settlement Obligor, Hartford Casualty Insurance
Company and the Annuity Issuer, The Manufacturer's Life Insurance Company, USA, with this
Order of Court; and (c) the Transferee's failure to comply with the Act.
E. Structured Asset Funding, LLC and Petitioner Montgomery agree that the tenus
of this Order of Court are based exclusively upon the facts, representations and circumstances of
this particular case. Nothing in this Order of Court shall preclude Settlement Obligor, Hartford
Casualty Insurance Company and the Annuity Issuer, The Manufacturer's Life Insurance
Company, USA, from contesting any other proposed transfer of structured settlement payment
rights, whether on the basis of applicable law. This Order of Court is entered without prejudice
to the rights of Settlement Obligor, Hartford Casualty Insurance Company and the Annuity
5
Issuer, The Manufacturer's Life Insurance Company, USA, and the Court makes no findings
regarding the enforceability of any non-assignment provision( s) contained in the structured
settlement agreement or related documents; provided, however, that the transfer of the
Transferred Payments, as provided in this Order of Court shall be valid and enforceable against
Settlement Obligor, Hartford Casualty Insurance Company and the Annuity Issuer, The
Manufacturer's Life Insurance Company, USA, in accordance with its terms. This Order of
Court shall not serve as precedent in any way nor be cited in any matter. Nothing contained in
this Order of Court shall be deemed to afford Petitioner Montgomery and Structured Asset
Funding, LLC any rights of ownership or control of the annuity or shall otherwise affect the
exclusive ownership and control of the annuity by Settlement Obligor, Hartford Casualty
Insurance Company.
F. Pursuant to the Act, this Court orders that Settlement Obligor, Hartford Casualty
Insurance Company and the Annuity Issuer, The Manufacturer's Life Insurance Company, USA,
are hereby discharged and immune from all liability to the Petitioner, anyone claiming through
the Petitioner, or to any other person or entity (except Structured Asset Funding, LLC, per the
terms of this Order) for the Transferred Payments or for disclosures made in or related to this
Order.
G. Compliance with the requirements and fulfillment of the conditions set forth in
the Act shall be solely the responsibility of the Transferee in the transfer of the Transferred
Payments, and neither Settlement Obligor, Hartford Casualty Insurance Company nor the
Annuity Issuer, The Manufacturer's Life Insurance Company, USA, shall bear any responsibility
for, or any liability arising from, noncompliance with those requirements or failure to fulfill
those conditions.
6
.
H. All interested parties, including Petitioner, the Transferee, the Structured
Settlement Obligor, and the Annuity Issuer shall abide by the terms of the Purchase Agreement
in all respects. This Order shall be considered a "qualified order" for purposes of 26 U.S.C.A. 9
5891. Notice of the entry of this Order shall be served by Petitioner on all parties and Proof of
Service shall be filed with the Court. Jurisdiction shall remain with this Court.
BY THE COURT:
J.
7
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSYL VANIA
CIVIL DIVISION
MAR 0 8 2005 f'"
P
INRE:
PETlTION OF GLENN L. MONTGOMERY
TO TRANSFER STRUCTURED
SETTLEMENT PAYMENT RIGHTS
No. OS- - /ft?J.... /}. . cc...-..,..--
C {uc 1 tiL'l
ORDER OF COURT
SCHEDULING HEARING DATE
AND NOW, this '-L- ~ay or /Y)/ille-h
, cOOS, upon the filing 'lIld
prescntation of the Petition to Transfer Structured Settlement Payment Rights pursuunt to the
Structured Settlement Protcction Act, 40 P.S. SS 400]-4009, it is hereby ORDERED that a
hearing thereon is set for the l.,ytAday of API?/L , 2005 at
S
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Eel c....... dd .
/
A.m.
III
Courtroom
before
the
Honorable
VK. '" G t:. .
Pctitioner shall provide notice of the time and date set for hearing, a copy orthe Petition
filed, and the Transfer Disclosure, to the Settlement Obligor, and the Annuity Issuer, as set forth
in the Petition, and shall in all other respects comply with the terms of the aforementioned
statute.
J.
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSYLVANIA
CIVIL DIVISION
PETITION OF GLENN L. MONTGOMERY
TO TRANSFER STRUCTURED
SETTLEMENT PAYMENT RIGHTS
INRE:
No. 05 - 1192 Civil Term
NOTICE OF PROPOSED TRANSFER OF
STRUCTURED SETTLEMENT PAYMENT RIGHTS
Hartford Casualty Insurance Company
4040 Vincennes Circle, Suite 100
Indianapolis, IN 46268
(Settlement Obligor)
Structured Asset Funding, LLC
1250 East Hallandale Beach Blvd.
Penthouse A
Hallandale, FL 33009
Attn: C. Duane West, Esquire
(Transferee)
The Manufacturer's Life Insurance Company, USA
500 Boylston Street
Boston, MA 02116-3739
(Annuity Issuer)
Glenn L. Montgomery
110 South Queen Street
Shippensburg, P A 17257
(Payee)
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 for April 18,2005, at II :00 a.m. before the Honorable Edward Guido. (A copy
of the Scheduling Order dated March 1],2005, is included with this notice).
.
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. S 4003 (2).
Pursuant to 40 P.S. S 4003 (6), notice of the transferee's name, address and taxpayer
identification number are as follows:
Structured Asset Funding, LLC
757 SE 17th Street, # 362
Fort Lauderdale, FL 33316
(TIN: 82-0561706)
Respectfully submitted,
Jones, Gregg, Creehan & Gerace, LLP
~
By: /;f~ X~~
t' Robert L. Monks
P A II> No. 52760
411 Seventh Avenue, Suite 1200
Pittsburgh, PA 15219
412-261-6400
Counsel for Petitioner, Glenn L.
Montgomery
2
..
CERTIFICATE OF SERVICE
I 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 Scheduling a Hearing Date have
been served via certified mail, return-receipt requested upon the persons and entities, and at the
addresses listed above, this 16th day of March, 2005.
Respectfully submitted,
Jones, Gregg, Creehan & Gerace, LLP
By:
'7~ 74z.-P---;?~
I Robert L. Monks
P A II> No. 52760
411 Seventh Avenue, Suite 1200
Pittsburgh, PA 15219
412-261-6400
Counsel for Petitioner,
Montgomery
Glenn
L.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNT'
PENNSYLVANIA
CIVIL DIVISION
INRE:
PETITION OF GLENN L. MONTGOMERY
TO TRANSFER STRUCTURED
SETTLEMENT PAYMENT RIGHTS
No. 0~-1192 C vi1 Term
AFFIDAVIT OF SERVICE OF NOTICE OF
FILING OF PETITION AND NOTICE OF HEARI~G
Before me, the undersigned authority, personally appeared, RobertiL. Monk, who, after
being first duly sworn according to law, deposes and says that on March 16,2005, h served true
and correct copies of the Petition of Glenn L. Montgomery to Transfer Structure Settlement
Payment Rights including a copy of the Transfer Disclosure, a copy of the Notice of Proposed
Transfer of Structured Settlement Payment Rights, and a copy of the Order,of Court cheduling a
hearing for April 18, 2005, at 11 :00 a.m., via certified mail, return-recei>>t request d, upon the
following:
Hartford Casualty Insurance Company
4040 Vincennes Circle, Suite 100
Indianapolis, IN 46268
(Settlement Obligor)
The Manufacturer's Life Insurance Company, USA
601 Congress Street, 2nd Floor
Boston, MA 02210
(Annuity Issuer)
and
Structured Asset Funding, LLC
1250 East Hallandale Beach Blvd.
Penthouse A
Hallandale, FL 33009
Attn: C. Duane West, Esquire
(Transferee)
Copies of the certitled mail return-receipts are attached hereto as Exhibit "A."
Respectfully submitted,
Jones, Gregg, Creehan & Gerace, LLP
By:
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-7.04" . ..
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obert L. Monks
PA ID No. 52760
411 Seventh Avenue, Suite' 1200
Pittsburgh, PA 15219
412-261-6400
Counsel for Petitioner, GleIjn L. Mo tgomery
Sworn to and sUD3cribed before me
this A'A t&day of /l)/1PCh
,2005.
tf~fh, 0fbt(JY?ir)
N TARY Ie
My Commission Expires:
Nolarial Seal
KimlJel1y A. Slavonic, NoIary PUblic
City Of Pittsburgh, Ailegheny CoW1ly
My C<Jmmission Expres May 13, 2006
Member, Pennsylvanra Association Of Notaries
2
. . .
.
..
. Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
. Print your name and address on the reverse
so that we can return the card to you.
. Attach this card to the back of the mailpiece,
or on the front if space permits.
1. . Article Addressed to:
Hartford Casualty Insurance Company
4040 Vincennes Circle, Suite 100
Indianapolis, IN 46268
2. ArtICle Number
(7;ansfer from_
PS Form 3811, February 2004
COIV1PLETE THIS SECTION ON DELIVERY
/1.' /~
</'01. ..;,;::: 0 Agent
/1 / !It( I. "'7 0 Addressee
B. Receive by (Printed Name)
D. Is delivery address different from item 1?
If YES, enter delivery address below:
3. Service Type
1/1 certified Mail _ [] ExpAlSS Mail
o Registered 4!1 Retum Receipt. . .
o Insured Mall- D C.O.D.
4. Restricted Delivery? (Extra Fee) 0 Yes
e
7004 2510 0005 6868 0745
Domestic Return Receipt
. Complete items 1, 2, and 3. Also complete
nom 4 n Restricted Delivery Is desired.
. Print your name and address on the reverse
so that we can return the card to you.
. Attach this card to the back of the mail piece,
or on the front n space permits.
1. Article Addressed to:
Manufacturer's Life Insurance
Company, USA
585 buybluH .3lu;:a;l
~.,tvu, !.L\. 92116: J7J3
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2. Article Number
(Transfer from S6f,
x
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If YES, enter delivery address b~: . 0 No
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3. Service Type
If certified Mall [] Express Mail
[] Registered [] Retum Receipt
o Insured Mall 0 C.O.D.
4. Restncted Delivery? (Extra Fee) [] Yes
7004 2510 0005 6868 0738
PS Form 3811, February 2004
DOmestic Return Receipt
. Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
. Print your name and address on the reverse
so that we can return the card to you.
. Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Structured Asset Funding, LLC
1250 East Hallandale Beach Boulevard
Penthouse A
Hallandale, FL 33009
Article Number
(Transfer from se"
3. Service Type
ttIICertifled Mail
, 0 Registered
o Insured Mail
o Express Mail
fI/I Return Receip
o C.O.D.
4. RestrIcted Delivery? (Extra Fee)
DYes
7004 1350 0000 5502 6721
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I PS Form 3811, February 2004 i
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Exhibit A
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSYL VANIA
CIVIL DIVISION
INRE:
PETITION OF GLENN L. MONTGOMERY
TO TRANSFER STRUCTURED
SETTLEMENT PAYMENT RIGHTS
No. 05-1192 Civil Term
FINAL ORDER OF COURT
AND NOW, this
ICf^day of April, 2005, upon presentation
of the unopposed
Petition of Glenn L. Montgomery ("Montgomery") to Transfer Structured Settlement Payment
Rights pursuant to the Structured Settlement Protection Act, 40 P.S. 994001-4009, it appearing
to this Court that proper notice of the filing and presentation of this Petition was given to the
Settlement Obligor, Hartford Casualty Insurance Company, and to the Annuity Issuer, The
Manufacturer's Life Insurance Company, USA; and it further appearing that Hartford Casualty
Insurance Company and The Manufacturer's Life Insurance Company, USA, have not opposed
the Petition; after due consideration, this Court finds as follows:
I. This Court has subject matter and personal jurisdiction.
2. The transfer complies with the requirements of the Structured Settlement
Protection Act, 40 P.S. 994001-4009, and will not contravene other applicable Federal or State
statutes or regulations or any applicable law limiting the transfer of workers' compensation
claims.
"
.
3. Not less than ten (10) days prior to the date upon which the Petitioner first
incurred any obligation with respect to the transfer, the Transferee, Structured Asset Funding,
LLC provided the Petitioner a disclosure statement setting forth in boldface, minimum 12-point
size type all of the following:
a. The amounts and due dates of the structured settlement payments to be
transferred.
b. The aggregate amount of such payments.
c. The discounted present value of such payments, together with the discount
rate or rates used in determining such discounted present value.
d. The gross amount payable to the Petitioner in exchange for such
payments.
e. An 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 Petitioner or deductible from the
gross amount otherwise payable to the Petitioner.
f. The net amount payable to the Petitioner after deduction of all
commissions, fees, costs, expenses, and charges described above.
g. The quotient, expressed as a percentage, obtained by dividing the net
payment amount by the discounted present value ofthe payments.
h. The amount of any penalty and the aggregate of any liquidated damages,
inclusive of penalties, payable by the Petitioner in the event of any breach
of the Purchase Agreement by the Petitioner.
4. The Petitioner has established that the transfer is in his best interests, taking into
account the welfare and support of the Petitioner's dependents, if any, at time of entry of this
Order of Court.
5. The Petitioner has expressly waived independent legal advice regarding the
implications of the transfer, including consideration of the tax ramifications ofthe transfer.
2
6. The transfer has been expressly approved in writing by the Petitioner, and at the
time the Petitioner and the Transferee proposed to enter into the Purchase Agreement, a
favorable tax result was in effect. The approvals of the Annuity Issuer and Settlement Obligor
are not required.
7. The Petitioner has given written notice pursuant to 40 P.S. 9 4003 (a)(6) of the
Transferee's name, address, and taxpayer identification number to the Annuity Issuer, and the
Structured Settlement Obligor, and a copy of the written notice has been filed with the Court.
8. Prior to entering into the Purchase Agreement the Petitioner was provided with a
written notice on a separate sheet that contains the following, in boldface, minimum 12-point
size type required by 40 P.S. 994003 (b):
"IMPORTANT NOTICE: You are strongly urged to consult with an attorney
who can advise you of the potential tax consequences of this transaction."
9. Not less than 20 days prior to the scheduled hearing on the petition for
authorization of a transfer of stmctured settlement payment rights under 40 P.S. Ii 4003, the
Petitioner filed with the Court and served on the Transferee a notice of the proposed transfer and
the application for its authorization, including in the notice a copy of the Petitioner's Petition to
the Court, a copy of the Purchase Agreement, a copy of the disclosure statement required under
40 P.S. Ii 4003, notification that the Transferee, the structured settlement obligor or the annuity
issuer is entitled to support, oppose or otherwise respond to the Petition, either in person or by
counsel, by submitting written comments to the Court or by participating in the hearing and
notification of the time and place of the hearing and notification of the manner in which and the
time by which written responses to the Petition must be filed.
10. The Purchase Agreement does not authorize Transferee or any other party to
confess judgment or consent to entry of judgment against Petitioner.
3
NOW THEREFORE, in consideration of the foregoing findings, it is hereby ORDERED,
ADJUDGED and DECREED that the Petition to Transfer Structured Settlement Payment Rights
pursuant to the Structured Settlement Protection Act, 40 P.S. SS 4001-4009 be and is hereby
GRANTED as follows:
A. The transfer by Petitioner Montgomery, to Transferee, Structured Asset Funding,
LLC and its successors and assigns, of the Transferred Payments (consisting of: two hundred
eight (208) monthly payments, beginning with the payment on January I, 2005, each in the
amount of$1 ,395.00, through to and including April I ,2022) is hereby APPROVED.
B. The Settlement Obligor, Hartford Casualty Insurance Company, shall direct the
Annuity Issuer, The Manufacturer's Life Insurance Company, USA, to send the Transferred
Payments to Structured Asset Funding, LLC and its successors and/or assigns care of the
following address:
Structured Asset Funding, LLC
757 SE 17th Street, #360
Fort Lauderdale, FL 33316
or such other address as Structured Asset Funding, LLC and its successors and/or assigns may
designate upon written notice to Settlement Obligor, Hartford Casualty Insurance Company and
the Annuity Issuer, The Manufacturer's Life Insurance Company, USA. Settlement Obligor,
Hartford Casualty Insurance Company and the Annuity Issuer, The Manufacturer's Life
Insurance Company, USA, shall not be required to change the address for the Transferred
Payment absent payment of a reasonable administrative fee, which shall not be charged to or
paid by the Payee. Nothing in this Final Order shall prevent Structured Asset, its successors or
assigns, from assigning its right, title or interest in the right to receive the Transferred Payments
to any other entity. In the event that Structured Asset assigns the Transferred Payments to
4
another person or entity, neither the Settlement Obligor, Hartford Casualty Insurance Company
nor the Annuity Issuer, The Manufacturer's Life Insurance Company, USA, shall be obligated to
re-direct the Transferred Payments to any such person or entity.
C. The death of Petitioner Montgomery prior to the due date of the last Transferred
Payment shall not adversely affect the transfer of the Transferred Payments from Petitioner
Montgomery to Structured Asset Funding, LLC. Petitioner Montgomery acknowledges that he is
transferring all of his right, title and interest to the Transferred Payments on behalf of himself
and his estate to Structured Asset, its successors and assigns.
D. Structured Asset Funding, LLC and its successors and/or assigns shall defend,
indemnify and hold harmless (collectively, the "Indemnity") the Settlement Obligor, Hartford
Casualty Insurance Company and the Annuity Issuer, The Manufacturer's Life Insurance
Company, USA, from any claims, liability or damages, including, but not limited to, reasonable
costs and attorneys' fees arising from or in connection with (a) any disclosures made in or related
to this Order of Court; (b) compliance by the Settlement Obligor, Hartford Casualty Insurance
Company and the Annuity Issuer, The Manufacturer's Life Insurance Company, USA, with this
Order of Court; and (c) the Transferee's failure to comply with the Act.
E. Structured Asset Funding, LLC and Petitioner Montgomery agree that the terms
of this Order of Court are based exclusively upon the facts, representations and circumstances of
this particular case. Nothing in this Order of Court shall preclude Settlement Obligor, Hartford
Casualty Insurance Company and the Annuity Issuer, The Manufacturer's Life Insurance
Company, USA, from contesting any other proposed transfer of structured settlement payment
rights, whether on the basis of applicable law. This Order of Court is entered without prejudice
to the rights of Settlement Obligor, Hartford Casualty Insurance Company and the Annuity
5
\
Issuer, The Manufacturer's Life Insurance Company, USA, and the Court makes no findings
regarding the enforceability of any non-assignment provision(s) contained in the structured
settlement agreement or related documents; provided, however, that the transfer of the
Transferred Payments, as provided in this Order of Court shall be valid and enforceable against
Settlement Obligor, Hartford Casualty Insurance Company and the Annuity Issuer, The
Manufacturer's Life Insurance Company, USA, in accordance with its terms. This Order of
Court shall not serve as precedent in any way nor be cited in any matter. Nothing contained in
this Order of Court shall be deemed to affofd Petitioner Montgomery and Structured Asset
Funding, LLC any rights of ownership or control of the annuity or shalI otherwise affect the
exclusive ownership and control of the annuity by Settlement Obligor, Hartford Casualty
Insurance Company.
F. Pursuant to the Act, this Court orders that Settlement Obligor, Hartford Casualty
Insurance Company and the Annuity Issuer, The Manufacturer's Life Insurance Compimy, USA,
are hereby discharged and immune from alI liability to the Petitioner, anyone claiming through
the Petitioner, Of to any other person or entity (except Structured Asset Funding, LLC, per the
terms of this Order) for the Transferred Payments or for disclosures made in or related to this
Order.
G. Compliance with the requirements and fulfillment of the conditions set forth in
the Act shalI be solely the responsibility of the Transferee in the transfer of the Translimed
Payments, and neither Settlement Obligor, Hartford Casualty Insurance Company nor the
Annuity Issuer, The Manufacturer's Life Insurance Company, USA, shall bear any responsibility
for, or any liability arising from, noncompliance with those requirements or failure to fulfilI
those conditions.
6
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\
H. All interested parties, including Petitioner, the Transferee, the Structured
Settlement Obligor, and the Annuity Issuer shall abide by the terms of the Purchase Agreement
in all respects. This Order shall be considered a "qualified order" for purposes of 26 lJ.S.C.A. 9
5891. Notice of the entry of this Order shall be served by Petitioner on all parties and Proof of
Jurisdict~all remain with this Courtil~ rt-- "")1'"0 s-: ~
W; 1~..'" -rrr hi' ",..,-~..
Service shall be filed with the Court.
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSYLVANIA
CIVIL DIVISION
INRE:
PETITION OF GLENN L. MONTGOMERY
TO TRANSFER STRUCTURED
SETTLEMENT PAYMENT RIGHTS
No. 05-1192 Civil Term
AFFIDAVIT OF SERVICE
OF FINAL ORDER OF COURT
Before me, the undersigned authority, personally appeared, Robert L. Monks, who, after
being first duly sworn according to law, deposes and says that on April 21, 2005, he served true
and correct copies of the Final Order of Court dated April 18, 2005, approving the Petition of
Glenn L. Montgomery to Transfer Structured Settlement Payment Rights via regular mail,
postage pre-paid, upon the following:
Hartford Casualty Insurance Company
4040 Vincennes Circle, Suite 100
Indianapolis, IN 46268
(Settlement Obligor)
The Manufacturer's Life Imurance Company, USA
601 Congress Street, 2nd Floor
Boston, MA 02210
(Annuity Issuer)
Structured Asset Funding, LLC
1250 East Hallandale Beach Blvd.
Penthouse A
Hallandale, FL 33009
Attn: C. Duane West, Esquire
(Transferee)
and
Glenn L. Montgomery
110 South Queen Street
Shippensburg, P A 17257
(Payee)
Respectfully submitted,
Jones, Gregg, Creehan & Gerace, LLP
'// L/ ~ "--;lA:, rl--7
By: ;:1A!~ ~ , <.. -~ --
nobert L. Monks
P A II> No. 52760
411 Seventh Avenue, Suite 1200
Pittsburgh, P A 15219
412-261-6400
Counsel for Petitioner, Glenn L. Montgomery
Sworn to apd subscribed before me
this .QI ,':, day of I9p{li / ,2005.
~~r~gJ' ~~km;r)
My Commission Expires:
Notarial Seal
Kimberly A. Slavonic, Notary Public
City Of Pittsburgh, Allegheny County
My Commission Expires May 13, 2006
Member. Pennsylvania Association Of Notaries
2
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