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HomeMy WebLinkAbout05-5916 RE: CHRISTOPHER WEEMS :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA NO: 05: - S9Lb c.; u 'Ll /82--",,- PETITION FOR PARTIAL TRANSFER OF STRUCTURED SETTLEMENT PURSUANT TO STRUCTURED SETTLEMENT PROTECTION ACT 40 P.S. 4000 ET. SEO. TO THE HONORABLE JUDGES OF SAID COURT: AND NOW comes Petitioner, Christopher Weems, by and through counsel, Lawrence J. Rosen, Esquire, and respectfully represents as follows: 1. Petitioner is and adult individual residing at 15 Burgandy Circle, Boiling Springs, P A. 17001 2. Petitioner is the beneficiary of an annuity contract issued by Erie Family Life Insurance Company. The structured settlement provides payments to the Petitioner as follows: A. A one time lump sum payment of $5,000.00.....................................04/24/2002 B. A one time lump swn payment of $5,000.00.....................................04/24/2003 C. A one time Iwnp sum payment of $5,000.00.....................................04/24/2004 D. A one time lump sum payment of$15,000.00...................................04/24/2005 E. A one time Iwnp sum payment of $46,350.00...................................04/24/2009 F. A one time lump sum payment of $60,585.00....................................04/24/2014 3. The structured settlement payment schedule is more fully set forth on the General Release as Settlement Agreement between Petitioner and Erie Insurance Company and/or Erie Insurance Exchange, dated December 20,1999. A true and correct copy of said General Release is attached hereto as "Exhibit A" 4. Petitioner proposes to enter into a purchase agreement with 321 Henderson Receivables Limited Partnership ("Buyer" or "Transferee"), its nominees, successors, or assigns, whose address is 40 Morris avenue, Bryn Mawr, P A 19010 who will purchase a portion of whose address is 40 Morris avenue, Bryn Mawr, P A 190 I 0 who will purchase a portion of Petitioner's structured settlement (One payment of $46,350 due on 04/24/2009) owned by Erie Insurance Exchange and issued by Erie Family Life Insurance Company for twenty eight thousand dollars ($28,000.00). A copy of the Purchase Agreement is attached hereto, made a part hereof, and designated as "Exhibit B". 5. The Buyer/Purchaser has furnished Petitioner with a Disclosure Statement pursuant to 40 P.c. Section 4003 (See Exhibit C) at least 10 days prior to the date on which Petitioner first incurred any obligation to the Buyer. The Statute also requires a Petition and court Order, authorizing the sale and a finding the sale is in the best interest of the Petitioner or the Petitioner's dependents. 6. The buyer/purchaser has served written notice, including its name, address and tax identification number, to the structured settlement obligor and has served written notice as required by Pennsylvania Statute 40 P.S. Section 4004 upon all interested parties, none of whom have objected to the transfer. True and correct copies of said notices are attached hereto made a part hereof and designated as "Exhibit D". 7. Petitioner's best interest would be served by granting the relief requested herein so that Petitioner can payoff personal debts, acquire a home and invest in a business venture. THEREFORE, Petitioner respectfully requests this Honorable Court to enter a rule upon Erie Family Life Insurance Company and Erie Family Exchange to show cause why the sale of a portion of the structured settlement payments stream between Erie Insurance Exchange (issued by Erie Family Life Insurance Company) and Christopher Weems to be sold and transferred to 321 Henderson receivable Limited Partnership, its nominees, successors or assigns should not be approved. Date: /lh/Ol~ , , Respectfully submitted: KREVSKY & ROSEN, P.c. By: awrence . Rosen, Esquire 1101 North Front Street Harrisburg, PA 17102 10# 10625 (717) 234-4583 Exhibit "A" 10/24/2005 10:42 FAX 81487041r EFL ANNllITIES - TEAM A I4J 003 "1\'",-'" ~ GENERAL RELEASE AND SETrLEMENT AGREEMENT RECEiVED DEe 2 7 1999 ~ ". E.F.1- UWe elller into this agreement as of !he M day of December 1m, betweeD myseIfIClUrselves. <..hristopher Weems. a minor, and the releasee(s). Albert Jack Crowl, Jr. and Joan L. Crowl and Michael 1.. Richie and together with their illSUIer, Erie Insurance Companyand/or Erie Insurance Excl1ange. Por the consideration as outlined below which is hereby acknowledged and also fur futnre ac:knowledgement, I/we release and discharge, and for IlI)'llOlfIourselves and for myfour hllirs, representatives, =tors. adminisuaJots, $UCCeSsors and assigns, do hereby remise, release and forever discharge. Alben Jack Crowl. JI. and Joan L. Crowl and Michael L. Richie, hereinafter relerred to as the releasee(s), hisfherltheWlts heirs, elIeculors, adqUnistrators. insuters, suea:ssurs and assigns, and any and all other pel'S0IIS, finns. c:orporntions. associations, of and from any and aU QUIles of actiOll, suits. rigbts judgmeDlS, claim!; and ri.....smri. of whatsoever kind, in law or in equity, known and unknown, which Ifwe now have Or may heleaf'teI: have, especially the claimed leglllliability of releasee(s) arising from or by n:sson of any and aU bodily or persoual injurlos known and 1IIIknown, foxeseen and unforeseen which heretofore haslhave been or which beMafter may be suscained by meIus arising out of the accident on or about Au,gmt 19, 1998, at or neat SouthMidd1esex Road, carlisle, in the County of Cumberland, in the State of PennsylvaDla. which liability releasee{s) expressly deniell. It is understood that tlds :l.s " full settlement of the 3"d party case only. It is not a !leIea.e of any further under:f.neured UWe agree that the consideration set faith below i9 specifitaUy applicable to and paid to m""'" with respect"18~& ~ personal or bodily itijnlY of mine/ours. whether pIeSeDtly known or unknown, foreseen or unforeoeen or which may SUbs~lIent1y develop aDd the conseqllences dlereOf, all arising ont of the aforementioned llCcident. UWe furtber agzee that the CODSiderallon set 101'lll bel.ow is specifically appfu:abJe to and paid to mefas with respect 10 any right of contribution tbat J/we lI1llY have against the re1easee(s), hislherJtheirlits heirs, execntors, admi.Di8Irators, insurers, Sllcc:essom and assigns relative to claims of othml that may be brollgbt against mefus by reason of said accident. UWe f'nrlher agree that the (:OII$i~l'r2lioD set forth below is speeifically applicable to myfOUT ~ent tbat J/we wID not jOin nor ottempt to join the. releasee(s), hiBJhcrltheirrllS exeentOrS, admi11istrotoIS. iDsurers, sncccssors and assigns in any lllIplICity, in lIlIY action ~ may be brought agaWst mefus arising out of S1lid a.ccldent. lIWe watt2llt for myselffOU1'Selves ond my/our heiIs, upr-.uti_, executoa;. ~n;_rs, sw:i(~~ "'. and llSIligns that J/we have received no monq or other VlI1uable wll5ideration from any olber pemon or persons by RaSOIl of lIIIY ~ of action, suits, covenants, agreemems. judglllelll$, claims and dem:mr\. of whalSoever kind, which J/we now have or may heleaf'teI: have, for Dguries to myfonr penot1 or property or lOr the olber IlUUletll for which this release is given. It- J/We understand tbat in COIllrideration iQr this telease and the execution of a Di=lion of Paym/lll1lJ !0lIll for Erie Family Life. Erie hIsurance Company lU1JjJor Erie 1Ils~ ~ agrees to waklo the 1Ollowing paymems: a. cash paymant of $19,632.60; b. prior payments tolDling $367.40; Co gIIar.lnleed futnte pa}'lllClllS beginning4124/02 at age 18-$5,000.00. 4124/03 at age 19-$5,000.00, 4/24/04 at age 20-$5,000.00; 4124/05 at age 21...$15,000.00; 41241O!l at age 25-$46.350::00;, : ' . - , 4124114 at age 3Q..$60,S8S.oo. UWe understaDd tbat in the event of death of Christopher Weems. a minor, prior to the date opeeified lOr the 1aBt guaIlllIteed payment, the bala'lcc of any gu.arameed payments shait. continue to be paid on the same basis lIS outlinecI above, to the EstaI40 of Christopher Weems, .. minor. UWe furthcr understand aIJd agtec !bat, with the =>:plion of any consideration that may be payable upon approval of lhis Agreel1l8lllll8 provided above, all future paymenlS herenndcr wiD be funded by the purchase of an annuity from Erie FamIly Ufe Insurance Company. whicl!, by its lenns will provide for the payment of the above lImOntIts. The Releasing Party hereto shall have no legal interest vesll:d or contingent in such Contract. J/We also understand that notWithstanding any oW provision of the Agreement. the Insurer shall at all times remain directly responsible fo< the payment of all 8UIIlS and obligations contained in this agreement, in the event of insolvency or any oth...: default of the Brie Pamily Life Insurance Cmnplmj. , ST5 L. 785776 Page 1 EFL ANNUITIES - TEAM A I4i 004 10/24/2005 10:42 FAX 8148704]' -A!: ~.~ ..._.1, -.;>>...... . GE:'IlERAL RELEASE AND SETTLEMENT AGREEMENT I !We el<prell$1y ackoowledge and represout that: (1) My/C1D! righa; against lilsurer, Et:ie IllSllrance Company' and/or Erie Insurance Ellchange, are no greater than those of a gencnl c:reditot. (2) Iasurer, Erie InsuJ;allCC COJnPany and/or Erie Insorance Ihchangc, has llOt made, nor are they nader a duty to tlIlllre funds available to melus except as provided within lhis settlement agreement and set forth above. . (3) Insurer, Erie Insurance Company and/or Erie Insunmce Bxc:hange, is not required to set aside funds for melus or to otherwise _ theiJ." obligation 10 melUS. All payments made under and In accordanl:e with this.Release and Agreement are being made OIl aC::Ol1llt of bodily injuries sustained by Christopher Weems, a minor. The Releasor.; or payees under this Release and Agreement sball have no rigbls of contml over the perloclic payments BI1d !bey shall not be able to accelerate, defer, increase or decrease the periodic p..yme:nts. N"elther the p~ to be made in accordance wilh this ReI_e and Agreemeut, nor my of the 0$Cfll of the de!endaIIt anIlIor ERIE are subject to execution or my legal process. - . Specifically, the RcIca50r aeknowIOdges that be or Iihe is the c:ertiflcale bolder of the Annuity Contract refelenccd her;:in. BlUE is the cwuer oime llIIlNity. The petl.odie payments to be made under this Release and AgreMlCnt cannot he ac:celmted, deferred. increased or decreased by the plaintiff or any payee. NeitM the ReleasOr nor my payee bas the power to sell, assign, mortgage, encumber 01' am.icipate me periodic payments at any part thereof in any lIIlIIWer whatsoever. Any attempt bY the Releasors or any payee to sell, assign, anticipate, morlgllge Or enetIlIlher any of the ~ hereunder Or allY part thereof sbaIl DOt be recognized by ERIE. (4) (5) IIWe ate DOt entitled to cootrollhe investment of any Iimds which Insurer, Erie Insurance CompllllY and/or Erie IDsunmce ExcbaDgC, may set aside for its own benefit to fimd the payments tequUed to be D1llc1a pIlmWlt to this ~ that any llDlllIil:y Or other COIItIact which may be requind by \be ~, Erie Insurance Compaa.y andIor Erie Insurance Eli:dllUIge, shall be and remain the sole property of the lnsarel-, Brie Insurance Company and/or ErIe Insurance Ill<cbange, and that lIwe abaIl have no ownership rights wbalsoever, either attual or constrUCtive, in any such ammity, incIudiDg no right to change the benaficiary or other CODl1'OI. t:hmof, Or any rights of 11 sec=d party berein. I further certify, stat", acltIlowledge, warrant and declare that each and every person, attorney, carrier, entity ot association, including any underil!sured motorist carrier, any ERISA entity or Workers' Compeusation carrier, bealth care cmier and any welfare at govemmeDllll entity, inclnding but nOt limitl:d TO Mediw'e, which claims to have a lien on the proceeds of tbis settlement arising out of this incide:nt or a ti'u.'eatCIlod litigation, is aware of this :ReI_ and Sett\emellt Agreement aIid its t=, and has consented and authorized me 10 =te this Release 8< Agreement, waiving any and all subrogation, and I lIIldemaIld that said payers and releaso parties hereunder Ilre relying expressly upon this unconditional expres~ wammty and making payment hereunder. Int9{lding to bo legally bound thoreby, WITN1lSS my/our band(s) ana seaI(s) this -~..~ . yqqq . .,. ..l c; 11- ~_ of f!.~),d/ ub~ (f'ather-Guanlian) RECEiVED DEe 2 7 1999 E.F.L. z:;s {lI~~ ST5 (Seal) . 7.~n~ Page 2 10/24/2005 10:44 FAX 81487041 ...1 . - . EFL ANNUITIES - TEAM A I4i 005 GENERAL RELEASE AND SETTLEMENT AGREEMENT C\: (O/ W f1.fUyts.~ (Seal) If (Mother) ~ W~ (Seal) (Minor) NOTICE; AIr! !'<<""" who kn~ ancl willlllllcllt 10 olofml<l..y i"",,,,,,,,,, company or ob.cr pemn liles an appliclllian far losu...ce or Sll\leI11eIIt of claim c:ontaining lII\l' lII3lorially fall. ilIlbrmali.. or co_ for III. putpose ~f misleading. iofonnaIian _iog llIrJ t'al:t motorial theceCo commils a. fmuIhit= ~ ..... wbith is :l crime 1IIld subjctla thto pemon to mlDinallad c;ivD penalties." STS , 'fIECEI\1EI) aJEC 2 7 If/W c.F.!.. 788775 l?age 3 10/24/2005 10:41 FAX 8148704'~' EFL ANNUITIES - TEAM A I4J 002 ERIE FAMILY LIFE INSURANCE COMPANY 100 ERIE INSURANCE PLACE ERIE, PA 16530 CERTIFICATE ERIE FAMILY LIFE INSURANCE COMPANY certifies. that the purchase payment for the following st~ctured settlement has been paid ~n full, as evidenced by the issuance of this certificate. The specifics of the settlement are: Certificate#: 605-744 Payee's Name: CHRISTOPHER WEEMS 15 BURGUNDY CIRCI..JO BOILING SPRINGS, PA 17007 Effective Date: 12(15(199S Birth Date: 04(24(1984 Schedule of Payment,. Lump Sums Paym~t Date Age Amount -~--------~------- -----_...------- --------......---, Guaranteed 04(24/2002 18 $5,000 Guaranteed 04(24(2003 .19. $5,000 Guaranteed 04(24/2004 20 .$5,000 Guaranteed 04/24(?005 21 $15,000 Guaranteed 04/24/2009 25 $46,350 Guaranteed 04(24/2014 30 $60,585 Guaranteed Payout , $136.:935 Expected payout : . $136,935 * upon the death of the payee, any unpaid guaranteed payments will be paid in accordance to tbe attached beneficiary designation. This certificate outlines t~. structured settlement payments. It is not a contract. The actual contract provisions will control. SENIOR VI ERIE FAM COMPANY Exhibit "B" PURCHASE AGREEMENT This is a Purchase Agreement. The date of this Agreement is ,200_. Christopher Weems is the Seller. 321 Henderson Receivables Limited Partnership, a Nevada Limited Partnership, its successors and/or assigns is the Buyer. In this Agreement, Christopher Weems is referred to as ny ou" or "Your" and 321 Henderson Receivables Limited Partnership or its nominee, is referred to as "We", "Us" or "Our". BACKGROUND OF THIS AGREEMENT I. Your or someone on your behalf signed a Settlement Agreement (the "Release" or the "Settlement Agreement"). in connection with the resolution of a personal injury claim. 2. The insurer funded the Payments by buying an annuity contract (the "Annuity") issued by Erie Family Life Insurance Company (the "Annuity Company"). 3. A list of the Payments being sold under this Agreement is attached to this Agreement as Exhibit llA". 4. You desire to sell and assign to Us all of Your rights to receive all or a portion of the Payments under the Release, as described on Exhibit "A", all of the other rights You have under the Release and the other rights as described in Section I(a) below. We desire to purchase all of Your rights and benefits, on the terms and under the conditions described in this Agreement. You and We agree as follows: 1. Purchase and Sale. a. You now sell, transfer and assign to Us all of Your rights in the "Assigned Assets" as listed in Exhibit "A". By Our signing this Agreement, We are hereby purchasing and accepting the sale and assignment of all of the Assigned Assets described above. b. The Gross Purchase Price is Twenty-Eight Thousand Dollars and 00/1 00 Cents ($28,000.00). The Net Purchase Price payable to You is $27,500.00 (the "Purchase Price"). The Net Purchase Price will be paid to You when both You and We sign this Agreement and We have completed Our internal process. 2. Acknowledement. a. You will agree after Your signing of this Agreement to deliver to Us, addressed as We may require, other notices, instructions or documents, and copies of them, as We think are necessary or proper to carry out this Agreement. b. When You and We sign this Agreement, You will also deliver to Us: (1) a letter addressed to the Annuity Company directing that all payments of the Assigned Assets after Your death shall be sent directly to Us, and (2) a Change of Beneficiary Form changing the beneficiary of the Assigned Assets, after Your death, to "321 Henderson Receivables Limited Partnership", as sole beneficiary [(I) and (2) above are referred to as the Change of Beneficiary Form]. The Change of Beneficiary Form will state that the instructions may never be revoked and that no change may be made in the instructions or "'" Q;J; . .. @2005 321 Henderson Receivables Limited Partnership in the payments (including as to the payee or the manner or place of making such payments) without OUT prior written consent. You will also, when this Agreement is signed by You and Us, deliver to Us, addressed as We may require, such other notices, instructions or documents, and copies of them, as We think are necessary or proper to carry out this Agreement. c. Before You and We sign this Agreement, You will deliver to Us an acknowledgment of the Estate of Christopher Weems, as primary beneficiary of the Assigned Assets, of the terms of this Agreement. the Estate of Christopher Weems will agree that they are not entitled to any rights to any of the Assigned Assets. d. You agree to sign all other documents which We may request forever naming Us as the only beneficiary of the Assigned Assets, including but not limited to an agreement to provide in Your Last Will and Testament that all of Your rights to the Assigned Assets were sold to Us (a "Testamentary Agreement"). e. You acknowledge that We advised You to obtain independent professional tax advice to determine whether this transaction will result in any adverse federal and/or state tax consequences. f. You acknowledge that We advised You must obtain independent legal representation prior to executing this Agreement and that We have advised you that We may not refer You to any specific attorney for such purpose. 3. Your Representations and Warranties. You now represent and warrant to Us that: a. You own (and are selling and assigning to Us under this Agreement) all of the Assigned Assets, free and clear of all claims, liens, charges, security interests, encumbrances, and agreements of any nature (other than this Agreement), and when You and We sign this Agreement, no one other than Us shall have any present or future right to the Assigned Assets. b. This Agreement and all of the other documents signed in connection with this Agreement have been properly signed by You, and they represent Your legal, valid and binding obligation, enforceable against You in accordance with their teons. c. The signing and performance of this Agreement by You and the transactions described in this Agreement: I. do not contlict with any other obligations of Yours; ii. will not cause a violation under (or create any right of termination, cancellation or acceleration or similar right under) any contract or agreement by which You or Your assets, including the Release, are bound or may be affected; Ill. will not create, or give any party (other than Us) the right to create, any lien, charge, security interest or encumbrance in, to or on any of the Assigned Assets; and iv. will not create a present or future right in any other party to make any claim against You or Your assets, or any of the Assigned Assets. Initial JiIJL '" 2 @2005 321 Henderson Receivables Limited Partnership - Initia! [I w d. You understand the tenus and provisions of this Agreement and You have been represented by tax and accounting advisors and a lawyer in the signing of this Agreement. e. Neither You nor anyone else have to do anything else for (I) the proper signing and performance by You of this Agreement and any transactions intended to be done in this Agreement, or (2) the carrying out by Us of any of Our rights and remedies under this Agreement. No other person has made a claim in any rights in or to the Assigned Assets. f. You have valid reasons for selling Your interest in the Assigned Assets rather than obtaining a loan with the Assigned Assets as collateral, and You agree that the transaction set forth in this Agreement is not a loan or other financing transaction. g. This Agreement is a valid sale, transfer and assignment to Us of the Assigned Assets. h. Your residence and legal address is as described in Paragraph 1] of this Agreement. During the last years, You have lived at such address. I. No representation or warranty of Yours in this Agreement or in any of the documents delivered in connection with this Agreement or in any agreement required by this Agreement, is inaccurate or contains any untrue or misleading statement. j. The signing by You of this Agreement will not violate any other promise or agreement you have made with anyone else, You understand that any and all restrictions on the assignability of the Scheduled Payments were included in the Release andlor Annuity at Your request, for Your benefit and not for the benefit of any other person, These restrictions, if any, were included by You as a precautionary measure to make sure You were allowed favorable tax treatment under the Internal Revenue Code, You understand that by entering into this Agreement, you may be giving up this favorable tax treatment. You understand that any income earned by You on any investment or use of the Purchase Price may be taxable to You. You may have to pay more in taxes as a result of this Agreement. For Our benefit and the benefit of Our assigns or successors, You agree to WAIVE AND RELEASE all of Your rights in, to, or under, such restrictions on assignability, if any. k, You have not before the date of this Agreement, sold or assigned Your right to the Assigned Assets or any part of the Assigned Assets. You do not owe any money to Your present or former spouse for support maintenance or similar obligations, nor do You owe any money to any of Your children or guardians of Your children, The Assigned Assets are not subject to any community property or similar marital rights of any person. ., 3 @2005321 Henderson Receivables Limited Partnership I. Your right to the Assigned Assets is not affected by any mortgage, pledge, lien, charge, security interest, encumbrance, restriction or adverse claim of any nature. You understand that any violation of any of Your representations in this agreement will result in an act of fraud by You which could result in Yon being held responsible for damages in favor of Us, with money to be paid by Yon to Us. ffi. You are not in violation of any obligations concerning child-care, alimony or support. n. You now give up forever all Your rights in any agreement that says that You cannot assign or sell Your rights in the Assigned Assets to Us. You have not requested and You do not expect to receive from Us, a Fonn 1099 or any other documentation which could make the transaction described by this Agreement taxable to You in any way. You further understand that We have not given to You any advice about any of Your taxes in this transaction. You have relied on Your own professional advisors concerning taxes. o. As of the date of this Agreement, You are of legal age in the state noted as Your address in Section II of this Agreement, mentally sane, and of a sound mind. You have never been convicted of a felony or any other crime involving dishonesty. p. You are very familiar with Your financial affairs and condition. With that full understanding, You certify that (I) on the date We pay You the Purchase Price and You sell to Us the Assigned Assets, the fair value of Your assets are and will be greater than all of Your debts; (2) You presently intend to pay all of Your creditors when such payments are due; and (3) You have not intentionally hidden the fact from any creditor of Yours that You have entered into this Agreement ani! the other documents referred to in this Agreement. q. You do not intend to file for bankruptcy and there are no lawsuits or other efforts by any of Your creditors to put You into bankruptcy or to take the Assigned Assets. r. The Purchase Price is not Your only or most important source of income and You do not have any mental or physical problems that would prevent You from having a paying job. s. You promise to us that no broker, finder, or other person other than those persons named in the broker statement signed by you in connection with this Agreement was involved in or important in arranging the purchase transaction in this Agreement. No other person has a right to any fee, payment, commission, or other compensation because of this Agreement. t. You agree that We have not forced You to give to Us copies of any confidential documents. You agree that We told You that We only needed to see those documents which described the Assigned Assets so we could buy from You the Assigned Assets. You agree that We do not intend to tell any other party about what is included in those documents. You understand that if We do so, it will only be for the sole purpose of buying the Assigned Assets. Initial d11L __ 4 @2005 321 Henderson Receivables Limited Partnership Initial: u. You understand that it usually takes six to eight weeks to complete this process, but that it could take longer. You understand that we have to obtain court approval of this transfer. YOU UNDERSTAND THAT, DUE TO OCCASIONAL DELAYS, WE WILL ESCROW THE AMOUNT EQUAL TO THE NEXT TWO MONTHLY PAYMENTS DUE TO YOU FROM THE ANNUITY COMPANY TO INSURE THAT WE RECEIVE ALL OF THE PAYMENTS THAT WE PURCHASE. YOU UNDERSTAND THAT WE MAY EITHER PAYOR ESCROW FUNDS TO SATISFY ANY JUDGMENTS, TAX LIENS OR CHILD SUPPORT AGAINST YOU OR THE ASSIGNED ASSETS AND DEDUCT THOSE AMOUNTS FROM THE PURCHASE PRICE. YOU UNDERSTAND THAT WE WILL DEDUCT FROM THE PURCHASE PRICE ANY AMOUNTS OF PAYMENTS RECEIVED BY YOU PRIOR TO FUNDING, IF SUCH AMOUNTS ARE NOT COVERED BY THE ESCROWED FUNDS. 4. You promise Us that: a. You will not, and will not allow any other party (except Us or Our assignee, if applicable) to take funds away from the Assigned Assets. You will not do anything else to affect the Assigned Assets. You will not say You still own the Assigned Assets. You will not do anything or allow anyone else to do anything that could in any way interfere with Or lessen Our rights in the Assigned Assets. b. You will not do anything that will, or could in the future, violate the Release, or any of the agreements required to be executed by this Agreement. You also agree to cooperate with Us to help Us to obtain all of the rights that We are buying from You in this Agreement and in the Release. c. You will give to Us at least thirty (30) days written notice of Your intention to move Your residence or change Your legal address from the address in Paragraph II of this Agreement. d. You will not make any change in Your instructions to the Annuity Company regarding payments to be made to You. {luJ ." 5 @200S 321 Henderson Receivables Limited Partnership e. You understand that the Annuity and the Release may say that You agree not to sell Your rights to the Assigned Assets. f. You agree to continue to cooperate with Us. This includes Your obligation to immediately deliver to Us any checks, funds or other form of Payment received after the date of this Agreement by You or anyone other than Us. If any Payment is ever denied, delayed, or withheld from Us, as determined by Us in our reasonable discretion, directly or indirectly on account of any act or omission by You or any person acting for You, then You shall be in default under this Agreement (and an Event of Default under 98 shall be deemed to have occurred). Immediately upon such default, and without any further notice to You, You will pay to Us the following amounts: (i) the full, dollar value of all remaining Assigned Assets as they become due after the date of the default; All of the remedies specified under this section shall be cumulative with all of the remedies for default pursuant to 58. g. If You leam before or after the signing of this Agreement of the threat or actual beginning of any lawsuit or proceeding that has anything to do with Our rights under this Agreement or the Assigned Assets, then You will immediately notifY Us of that and You will give Us copies of all notices and other writings relating to it promptly after You receive them. h. If You receive any notice relating to any supposedly unpaid claim affecting the Annuity or the Assigned Assets or to any other claim against the Annuity or the Assigned Assets, then You will promptly notifY Us and will promptly give Us copies of all notices and other writings relating to it received by You promptly after You receive them. 5. RIGHT TO CANCELLATION. YOU MAY CANCEL THIS CONTRACT WITHOUT PENALTY OR FURTHER OBLIGATION WITHIN TWENTY-ONE DAYS FROM THE DATE YOU RECEIVE PAYMENT FROM 321 HENDERSON. In order for the cancellation to be effective, You must mail a notice of cancellation by registered or certified U.S. mail, postmarked within twenty-one (21) days ofreceipt of the Purchase Price to Us, c/o Vice President of Operations at 2215-B, Suite 5, Renaissance Drive, Las Vegas, NV 89119. Furthermore, in order for Your notice of cancellation to be effective, Your registered or certified U.S. mail package to us must include a bank or certified check for the full Purchase Price that We paid You under this Purchase Agreement. Any failure to comply with the above procedure shall be a waiver of Your right to cancel this transaction. 6. Your Further Promises. You agree that, from time to time, at Your expense, You will promptly sign and give to Us any and all documents to help Us realize our rights and benefits under this Agreement. This promise includes signing, filing or allowing Us to file financing or continuation statements, or amendments or assignments of those documents. You permit Us or others acting for Us to sign our name and/or your name and file without Your signature such financing statements, if that is permitted in Your state of residence. When You sign this Agreement, You will also sign and deliver to Us a "Special Irrevocable Power of Attorney" You must retain the services of an attorney and deliver an opinion of Your attorney about the sale of Assigned Assets to Us, in a form acceptable to Us. Initial: {M ." 6 @200S 321 Henderson Receivables Limited Partnership 7. Continuation of Reoresentations. Warranties and Covenants. All of Your representations, warranties and promises made in this Agreement will continue to be relied on by Us after this Agreement is signed. 8. Event of Default. Your failure to comply with any term of this Agreement or Your breach of any of Your representations in this Agreement will mean that You will be in default. We refer to this as an "Event of Default. " If there is an Event of Default, We have the right to sue You in court to make You perform Your promises or to get money from You. Your failure to comply with any material terms of this Agreement will be a default. In Paragraph 4 (c) You agree to give US at least thirty (30) days written notice after Your move to a new residence or change of Your legal address from the address in Paragraph I I of this Agreement. If we are purchasing from You certain lump sum payments, We will contact you at least 3 months before the scheduled payment is due to determine if the address change We have effected with the annuity company is in place and to determine if Your legal address has remained the same. If We cannot contact you because You have changed Your legal address or moved Your residence and failed to notify Us, We will consider such failure to notify Us to be an EVENT OF DEFAULT and We will exercise all of our legal rights under this Agreement. OUR RIGHT TO PROCEED AGAINST YOU UNDER THIS AGREEMENT SHALL BE SOLELY LIMITED TO WHEN YOU HAVE COMMITTED AN EVENT OF DEFAULT. WE SHALL NOT HAVE THE RIGHT TO SUE YOU IF OR BECAUSE THE ANNUITY COMPANY IS NOT ABLE TO MAKE PAYMENTS BECAUSE IT IS NOT FINANCIALLY ABLE TO DO SO. 9. Controlling Law. This Agreement shall be governed, construed and enforced in accordance with the internal laws of the State of Pennsylvania without regard for the conflicts of law rules thereof or elsewhere. (For Court Orders or Notice Transfers obtained in the following jurisdictions: AK, ~~~~~~~~~m~~un~~~~~~~~~ ~~m~~OO~~~~~m~~~~~~~~~~ jurisdictions shall be applied in the event of a dispute regarding the transfer.) Your domicile is the proper place of venue to bring any action arising out of a breach of this Agreement. 10. Responsibility for this Agreement. Tbis Agreement will hold responsible Your heirs, executors, successors and assigns and will benefit Our representatives, successors, beneficiaries and permitted assigns. Nothing in this Agreement is intended to give anyone other than You or Us or each of Our successors or assigns any benefits. II. Notices. All notices and other communications under this Agreement will be in writing and will be made by delivery by means by which the sender obtains a receipt of delivery from the carrier (including without limitation, certified mail return receipt requested or overnight courier services), addressed to the party to whom a request or demand is to be made. Such demand or notice or request shall be deemed given on the date which is one business day after the date sent by overnight mail or three days after the date sent by certified mail. The addresses of the parties are as follows: If to You: Christopher Weems 15 Burgundy Circle Boiling Springs, P A 17007 Initial: {fh -- 7 @2005321 Henderson Receivables Limited Partnership Ifto Us: 321 Henderson Receivables Limited Partnership 2215-B Renaissance Drive Suite 5 Las Vegas, NV 89119 Attention: Vice President - Operations 12. Past Actions. Anything either You or We did or said before this Agreement was signed will not affect Your or Our rights under this Agreement in any way. 13. Exoenses. Except as otherwise affirmatively set forth in this Agreement, You and We agree that we will each pay our respective costs and expenses in connection with the carrying out of this Agreement. 14. Headin!!s. The section and subsection headings contained in this Agreement are for reference purposes only and will not affect in any way the meaning or interpretation of this Agreement. 15. Counteroarts. One or more originals of this Agreement may be signed with Your or Our signature. When put together they will make one agreement and the Agreement will be considered signed by all parties that need to sign. A facsimile signature will be considered an original. 16. Assi!!nment. We and anyone to whom We assign this Agreement may assign Our right, title and interest in and to this Agreement, the Annuity and the Assigned Assets without Your approval. You and We agree that if there is an assignment by Us to someone else, We shall not be responsible to You. You must look only to the person or company that We assign this Agreement to for any payment (for example, of the Purchase Price) and performance of this Agreement. When asked by Us or any assignee, You will sign and deliver any such documents as We may require to perform this transaction, as assigned. Initial: t:Il/I -- 8 @l005 321 Henderson Receivables Limited Partnership 17. Your soouse. You and Your spouse are fully aware of Your rights in the Assigned Assets. You and Your spouse fully give up those rights. You and Your spouse understand that by selling the Assigned Assets to Us, You and Your spouse are not receiving the same amount of money as You would if You waited for all of the scheduled Payments of the Assigned Assets but, rather, are receiving a discounted value in return for receipt of the Purchase Price immediately. You and Your spouse have valid reasons for selling the Assigned Assets. You and Your spouse fully understand the terms of the Purchase Agreement and understand that the sale of the Assigned Assets is final. You also understand that Your spouse gives up any property right he or she may have in the Assigned Assets that Your spouse could claim because of Your marriage. 18. Entire Al!reement. This Agreement and the Exhibits and other documents You signed make up the entire understanding and agreement between You and Us about this Agreement. This Agreement replaces all prior agreements, whether written or oral, about this Agreement. This Agreement may not be changed unless in a writing signed by You and Us. 19. Limitation of Liabilitv of Buver. You understand that Our liability to You under this Agreement is strictly limited to the requirement to pay the Purchase Price and under no circumstances will We be responsible for consequential damages. 20. Court Aooroval. You understand that court approval is required for this transfer. You agree to cooperate with us to obtain such court approval. 21. Exhibits. Attached to this Purchase Agreement are the following Exhibits: Exhibit "A" List of What Payments We are Buying. Intending to be legally bound, You and We have signed this Agreement as of the date at the top of the first page of this Agreement. 321 HENDERSON RECEIVABLES LIMITED PARTNERSHIP <:3IGN HERE I Spouse Sworn to and s.,\~s~ed () :hJrr before me this ~~y of Y.300S QU1\O~I~~~\tlH~ Notary COMMONWEALTH OF PENNSYLvANIA Notarial Seal Public Alrnee L. PaukoVlts, NO~~ CountY City of Harrisburg, ?aup 17 2007 My Commission Expires Apr. . 9 @2005 321 Henderson Receivables Limited Partnership Exhibit A We are hereby purchasing from You under the Annuity: A) 1 payment of$46,350.00 on 4/24/2009 ~~-/ Christopher eems ~IGN HERE I STATE OFPP<; ~ . ',_ : COUNTY OF lX::Lu.f11...-U" ') : On this ~ay of())rJb V, 206 before me, the above signed personally appeared before me, personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed it. (W1w~~.\l~~ Notary COMMONWEALTH OF PENNSYLVANIA 'i~t~)1"la; Seal i~lmt:; , Notary Public City of li;;-,l.;;>.','g Dauphin COlUlty My Commlsslor, L.9ircs Apr. 17,2007 EXHIBIT "C" EXHIBIT "D" SCHEDULE 1 DISCLOSURE STATEMENT PLEASE BE ADVISED THAT THE PROPOSED TRANSACTION IS A SALE, NOT A LOAN, AND THAT YOU WILL BE SELLING ALL RIGHTS AND TITLE TO THE ASSIGNED ASSETS ONCE THIS TRANSACTION IS CONSUMMATED. PLEASE BE ADVISED THAT YOU MAY BE SUBJECT TO ADVERSE FEDERAL AND STATE INCOME TAX CONSEQUENCES AS A RESULT OF THE PROPOSED TRANSACTION. YOU SHOULD CONSULT YOUR OWN COUNSEL, ACCOUNTANT, OR FINANCIAL ADVISOR REGARDING ANY FEDERAL OR STATE INCOME TAX CONSEQUENCES ARISING FROM THE PROPOSED TRANSFER. YOUR PURCHASE PRICE WAS DERIVED ASSUMING A DISCOUNT RATE SIGNIFICANTLY HIGHER THAN THE PRIME INTEREST RATES CHARGED BY COMMERCIAL BANKS, THEREFORE, WE URGE YOU TO EXPLORE ALL FINANCIAL OPTIONS. WE WILL PURCHASE FROM YOU A) 1 payment of $46,350.00 on 4/24/2009 THE AGGREGATE AMOUNT OF THE PURCHASED PAYMENTS IS $46,350.00. THE DISCOUNTED PRESENT VALUE OF THE AGGREGATE PAYMENTS AT 5.00% IS $39,073.94. THE DISCOUNTED PRESENT VALUE IS THE CALCULATION OF THE CURRENT VALUE OF THE TRANSFERRED STRUCTURED SETTLEMENT PAYMENTS UNDER FEDERAL STANDARDS FOR VALUING ANNUITIES. THE GROSS AMOUNT PAYABLE TO SELLER IS $28,000.00. THE FOLLOWING EXPENSES ARE INCURRED BY THE SELLER (YOU) AND WILL BE DEDUCTED FROM THE PURCHASE PRICE: COMPLIANCE AND ADMINISTRATIVE FEE: $500.00 THE NET AMOUNT PAYABLE TO THE SELLER(YOU) IS $27,500.00. NO OTHER EXPENSES ARE INCURRED BY YOU. SCHEDULE 1. PAGE 2 THE DISCOUNTED PRESENT VALUE OF PAYMENTS SHALL BE CALCULATED AS FOLLOWS: THE APPLICABLE FEDERAL RATE USED IN CALCULATING THE DISCOUNTED PRESENT VALUE IS 5.00%. THE EFFECTIVE ANNUAL DISCOUNT RATE FOR THIS TRANSACTION IS 16.09%. THE CASH PAYMENT YOU RECEIVE IN THIS TRANSACTION FROM US WAS DETERMINED BY APPLYING THE SPECIFIED EFFECTIVE ANNUAL DISCOUNT RATE, COMPOUNDED MONTHLY, TO THE TOTAL AMOUNT OF FUTURE PAYMENTS TO BE RECEIVED BY US, LESS THE TOTAL AMOUNT OF COMMISSIONS, FEES, COSTS, EXPENSES AND CHARGES PAYABLE BY YOU. THE NET AMOUNT THAT YOU WILL RECEIVE FROM US IN EXCHANGE FOR YOUR FUTURE STRUCTURED SETTLEMENT PAYMENTS REPRESENTS 70.40% OF THE ESTIMATED CURRENT VALUE OF THE PAYMENTS BASED UPON THE DISCOUNTED VALUE USING THE APPLICABLE FEDERAL RATE. THE QUOTIENT OBTAINED BY DIVIDING THE NET PAYMENT BY THE DISCOUNTED PRESENT VALUE IS 70.40%. BASED ON THE NET AMOUNT THAT YOU WILL RECEIVE FROM US AND THE AMOUNTS AND TIMING OF THE STRUCTURED- SETTLEMENT PAYMENTS THAT YOU ARE TURNING OVER TO US, YOU WILL, IN EFFECT, BE PAYING INTEREST TO US AT A RATE OF 16.09% PER YEAR. THE NET AMOUNT PAID TO YOU (THE PAYEE) BY US (THE TRANSFEREE) REPRESENTS AN ESTIMATE OF THE FAIR MARKET VALUE OF THE FUTURE PERIODIC PAYMENTS TRANSFERRED UNDER THE STRUCUTRED SETTLEMENT AGREEMENT. SCHEDULE 1. PAGE 3 NOTICE OF CANCELLATION RIGHTS: YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO 5:00 P.M. OF THE TWENTY-FIRST DAY FOLLOWING THE LATER OF THE EXECUTION OF THE PURCHASE AGREEMENT, OR THE DATE THE PAYEE BECOMES OBLIGATED UNDER THE PURCHASE AGREEMENT WITHOUT PENALTY OR FURTHER OBLIGATION. THIS CANCELLATION RIGHT CANNOT BE WAIVED IN ANY MANNER. TO CANCEL, YOU MUST PROVIDE WRITTEN NOTICE TO THE TRANSFEREE. WRITTEN NOTICE SHOULD BE MAILED OR DELIVERED TO THE ADDRESS BELOW BY 5:00 P.M. OF (THE TWENTY-FIRST DAY FOLLOWING THE TRANSACTION). IT IS BEST TO MAIL IT BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED, AND TO KEEP A PHOTOCOPY OF THE SIGNED FORM AND YOUR POST OFFICE RECEIPT. ADDRESS TO WHICH CANCELLATION IS TO BE RETURNED: 321 HENDERSON RECEIVABLES LIMITED PARTNERSHIP 2215-B RENAISSANCE DRIVE SUITE 5 LAS VEGAS, NV 89119 ATTENTION: VICE PRESIDENT - OPERATIONS IMPORTANT NOTICE: YOU ARE STRONGLY URGED TO CONSULT WITH AN ATTORNEY WHO CAN ADVISE YOU OF THE POTENTIAL TAX CONSEQUENCES OF THIS TRANSACTION. SCHEDULE 1. PAGE 4 PLEASE BE ADVISED THERE ARE NO PENAL TIES OR LIQUIDATED DAMAGES PAY ABLE BY YOU IN THE EVENT OF ANY BREACH OF THE TRANSFER AGREEMENT BY YOU. THERE ARE NO BROKERS COMMISSIONS, SERVICE CHARGES, APPLICATION FEES, PROCESSING FEES, CLOSING COSTS, FILING FEES, ADMINISTRATIVE FEES, LEGAL FEES, NOTARY FEES AND OTHER COMMISSIONS, FEES, COSTS, EXPENSES AND CHARGES PAYABLE BY YOU OR DEDUCTED FROM GROSS AMOUNT OTHERWISE PAYABLE TO YOU OTHER THAN THE COMPLIANCE AND ADMINISTRATIVE FEE. IF YOU BELIEVE YOU WERE TREATED UNFAIRLY OR WERE MISLED AS TO THE NATURE OF THE OBLIGATIONS YOU ASSUMED UPON ENTERING INTO THIS AGREEMENT, YOU SHOULD REPORT THOSE CIRCUMSTANCES TO YOU LOCAL DISTRICT ATTORNEY OR THE OFFICE OF THE ATTORNEY GENERAL. THE EFFECTIVE DATE OF THE TRANSFER AGREEMENT SHALL BE DEEMED TO BE THE DATE THAT THE AGREEMENT WAS SIGNED BY THE YOU (PAYEE). PLEASE BE ADVISED THAT PAYMENT TO YOU PURSUANT TO THE TRANSFER AGREEMENT IS CONTINGENT UPON COURT APPROVAL OF THE TRANSFER AGREEMENT. PLEASE BE ADVISED THAT PAYMENT TO YOU WILL BE DELAYED UP TO 30 DAYS OR MORE IN ORDER FOR THE COURT TO REVIEW AND APPROVE THE TRANSFER AGREEMENT. BY SIGNING BELOW YOU ARE CONFIRMING RECEIPT OF THIS DISCLOSURE AT LEAST 10 DAYS PRIOR TO RECEIPT OF THIS CONTRACT. /Iu,k;J;V~ Christop:W~ems ~IGN HERE I EXHIBIT "D" 321 HENDERSON RECEIVABLES LIMITED PARTNERSHIP October 28, 2005 Erie Family Life Insurance Company 100 Erie Insurance Place Erie, PA 16530 Attn: Legal Department/Structured Settlements Erie Insurance Exchange Erie Insurance Exchange 100 Erie Insurance Place Erie, PA 16530 Attn: Legal Department/Structured Settlements RE: Notice of Sale/Assignment of Payment Rights Your Contract #: 605-744 Payee: Christopher Weems SS #: 194-66-1382 Dear Insurer: Please be advised that 321 Henderson Receivables Limited Partnership and/or its successors and assigns, have entered into a transaction with the above-referenced annuitant who is seeking to transfer certain of his/her rights to the payments scheduled to be received under the above- referenced annuity policy. We are currently seeking court approval pursuant to the applicable structured settlement transfer statute. Pursuant to the statute, please note the following information about the Purchaser: 321 Henderson Receivables Limited Partnership 40 Morris Ave Bryn MawrPA 19010 Tax ID #88-0513 I 64 PLEASE NOTE: No payments under this annuity should be held until the courts have entered a final order and we have forwarded this order to you. Very truly yours, By: President 2215-B RENAISSANCE DRIVE. suite 5. LAS VEGAS, NV 89119 PHONE: 800-454-9368. FAX: (215) 567-7525' E-MAIL: JGW@IGWFUNDING.COM WEB SITE: WWW.JGWFUNDlNG.COM IN RE: CHRISTOPHER WEEMS :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :NO: VERIFICATION I, LAWRENCE J. ROSEN on behalfofCHRlSTOPHER WEEMS, hereby verify that the information contained in the foregoing Complaint is true and correct to the best of my knowledge, information and belief. I also understand that false statements made herein are subject to the penalties of 18 Pa. C.S. S 4904, relating to unsworn falsification to authorities. DATE: / / / 7 /0 1- / / ~C2 , re e J. Rosen IN RE: CHRISTOPHER WEEMS :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :NO: CERTIFICATE OF SERVICE ~ , , AND NOW, this 2- day of II! C ' ,2005, I, Lawrence 1. Rosen, on behalf of Krevsky & Rosen, P.c. for Plaintiff, Christopher Weems, hereby certify that I have this day served a copy of this Complaint in the above-captioned matter, by First Class U.S. Mail, on the following: Erie Family Life Insurance Company 100 Erie Place Erie, PA 16530 Attention: Legal Department/Structured Settlements Erie Insurance Exchange 100 Erie Insurance Place Erie, PA 16530 32 I Henderson Receivables 40 Morris A venue Bryn Mawr, PAl 901 0 /2 a e e J. Rosen 1 101 North Front Street Harrisburg, P A 17102 (717) 234-4583 0 -k::t ~ 7J 'i 0 it Cr( ...... \i"- CY r--,_"l ~ -!:::: -cJ C~.;l 0 ,~'::~j -n -.'t 01 --l ...() ---.{ P- ::r.:,., rT1r::~ ~ -r-d21 ~ TI~_' C.;"; :-:~!S .. .,t.- --~~~ '---Z ;" ~--. .. ill . :IN THE COURT OF COM :CUMBERLAND COUNTY, PENNSYLVANIA REC EI vY:T) .Ay i ! J NOV ] 6 L005 !lA IN RE: CHRISTOPHER WEEMS :NO: O~ - .{qlfo C;oJ/~ RULE AND NOW, this ;l.htday of~, 2005, upon consideration ofthe within Petition for Partial Transfer of Structured Settlement Pursuant to Structured Settlement Protection Act, 40 P.S. 4000, Et. Sec., a Rule is hereby issued upon Erie Family Life Insurance Company, Erie Insurance Exchange and 321 Henderson Receivables, L.P. to show cause why said Petition should not be granted. RULE RETURNABLE FOR HEARING the f67L day of Z:Jt-,~ ~ 0:>(" 2.oo? at 3~30 p, M. in Courtroom No. i in the Cumberland County Court House, Carlisle, Pennsylvania. BY THE COURT: 1. Distribution: Lawrence J. Rosen, Esquire, 1101 North Front Street, Hbg, PA 17102 Christopher Weems, 15 Burgandy Circle, Boiling Springs, P A 17007 Erie Family Life Insurance Company, 100 Erie Insurance Place, Erie, Legal Department/Structured Settlements Erie Insurance Exchange, 100 Erie Insurance Place, Erie, PA 16530 321 Henderson Receivables, 40 Morris Avenue, Bryn Mawr, PA 19010 A 16530; Attention: /('J~f{)) (lA ,,~./\ ~ JUs' II n.:. i"; :S lid zz .~ (jIJ ('nn7 ""n; JIJeJ", ;JO IN RE: CHRISTOPHER WEEMS : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 05-5916 CIVIL TERM ORDER OF COURT AND NOW, this 2th day of December, 2005, due to a conflict in the court's schedule, the hearing on the Petition for Partial Transfer of Structured Settlement Pursuant To Structured Settlement Protection Act, 40 P.S. 4000, et seq., previously scheduled for Wednesday, January 18, 2006, at 3:30 p.m., in Courtroom No.1, is transferred to Courtroom No.5, Cumberland County Courthouse, Carlisle, Pennsylvania, before the Honorable M.L. Ebert, Jr. BY THE COURT, 011, J. es ey Oler, Jr., J. Lawrence J. Rosen, Esq. Christopher Weems Erie Family Life Insurance Company Erie Insurance Exchange 321 Henderson Receivables r:rJf- 65 (( . -. '..1 ,,-. ~ ~ . Y~e,L ~ :rc i,! ""~or):] ;, I :rj!. '1 oel ~I:iil "107 r I -' i"- w0 ........,:u:J'-' u i 10... IN RE: CHRISTOPHER WEEMS :IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA :NO: 05-5916 ORDER AND NOW, this I ~i~ day of ::S.." 0Q {'~ ' 2006, the Court having considered the Petition of Christopher Weems for the transfer of st ctured settlement payment nghts pursuant to Act 200-1 (40 P.S. 4001, et seq.): And the interested.parties to this action as defined by 40 P.S. 4002 being: I. The Payee: Christopher Weems 15 Burgundy Circle Boiling Springs, P A 17007 2. Annuity Policy Owner: Erie Insurance Exchange 100 Erie Insurance Place Erie, PA 16530 3. Annuity Policy Issuer: Erie Family Life Insurance Company 100 Erie Insurance Place Erie, PA 16530 4. Transferee: 321 Henderson Receivables 40 Morris A venue Bryn Mawr, PA 19010 The Court, upon such Petition hereby makes the following findings: I. The transfer sought to be approved complies with the requirements of the Structured Settlement Protection Act, 40 P.S 4000, et seq. And will not contravene any other applicable law; 2. Not less than ten (10) days prior to the date on which Petitioner first incurred any obligation with respect to the transferee, 321 Henderson Receivables has provided to Christopher Weems a disclosure statement as required by Pennsylvania Statute 40 P.S. 4003(a)(2); 3. The transfer does not contravene any Federal or State statute or the Order of any court or responsible administrative authority. , .."... 4. The best interests of Christopher Weems, taking into account his welfare and support renders the transfer appropriate; 5. 321 Henderson Receivables has served written notice, including its name, address, and tax identification number, to the structured settlement obligor and has served written notice a required by Pennsylvania Statute 40 P .S. 4004 upon all interested parties, none of whom have objected to the transfer. Based on the foregoing findings, it is hereby ORDERED AND DECREED that the transfer of structured settlement payments rights, as described in the purchase agreement filed with the Petition in this matter, is hereby APPROVED, and no party to this proceeding shall hereafter refuse to honor this approved transfer. Erie Family Life Insurance Company and Erie Insurance Exchange are hereby AUTHORIZED to remit the assigned payments payable to Christopher Weems: One (1) payment of forty six thousand three hundred and fifty dollars ($46,350.00) on April 24, 2009 to the following address: 321 Henderson Receivables Limited Partnership P.O. Box 7780-4244 Philadelphia, P A 19182-4244 This Order is entered without prejudice to Erie Family Life Insurance Company and Erie Insurance Exchange and the Court makes no finding regarding the enforcability of any non-assignment provision(s) contained in the original settlement agreement or related documents. This Order in no way modifies or negates the ownership or control of the underlying contract inuring to Erie Family Life Insurance Company and Erie Insurance Exchange. BY THE COURT: ~ J. Distribution: Law.rence J. Rosen, Esquire, 1101 North Fro?t Street,Harrisburg, PA 1710i>cc I~~ 9,~,n Chnstopher Weems, 15 Burgundy CIrcle, BOIlmg Spnngs, PA 17007 j '. f Erie Family Life Insurance Company, 100 Erie Insurance Place, Erie, PA 16530,' Attention].' ( _, CUf'l! "'''U '''' Legal Department/Structured Settlements / Erie Insurance Exchange, 100 Erie Insurance Place, Erie, PA 16530 321 Henderson Receivables, 40 Morris A venue, Bryn Ma"T, P A 19010 CDff mallet:!