HomeMy WebLinkAbout06-0473
c: (
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
IN RE: PETITION OF JEROMEY
TASKER A/K/A JEREMY MICHAEL
TASKER, FOR APPROVAL OF
TRANSFER OF STRUCTURED
SElTLEMENT PAYMENT RIGHTS
CIVIL DIVISION
NO. 0 fs,- If 1 ~I (~'"J, --r;:....
PETITION FOR APPROVAL OF
TRANSFER OF STRUCTURED
SETTLEMENT PAYMENT
RIGHTS
Filed on behalf of:
Petitioners, Jeromey Tasker and :
Novation Capital, LLC
Counsel of Record
Allen D. Moyer
8150 Derry Street
Harrisburg, PA 17111
717.909.5858
717.909.7788 (facsimile)
(Counsel for Jeromey Tasker)
r
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL DIVISION
IN RE: PETmON OF JEROMEY
TASKER A/K/A JEREMY MICHAEL
TASKER FOR APPROVAL OF
TRANSFER OF STRUcrURED
SETILEMENT PAYMENT RIGHTS
NO. tJ/,- '17.3 ~,':J 'T~
PETITION FOR APPROVAL OF
TRANSFER OF STRUCTURED
SETTLEMENT PAYMENT
RIGHTS
PETITION FOR APPROVAL OF TRANSFER OF
STRUCTURED SETTLEMENT PAYMENT RIGHTS
Pursuant to 40 SS 4001-4009 (the "Act"), the Pennsylvania Rules of Civil
Procedure, and the Cumberland County Local Rules, Petitioners, Jeromey Tasker
a/k/a Jeremy Michael Tasker ['Payee") and Novation Capital, LLC ("Novation"),
respectfully submit this Petition for Approval of Transfer of Structured Settlement
Payment Rights (this "Petition"):
A. Factual Backaround
1. Pursuant to a Settlement Agreement and Release, Payee became
entitled to receive monthly payments of $496.00 commencing August 15, 2007
guaranteed through and including July 15, 2027 and life thereafter. See true and
correct copy of the Settlement Agreement and Release ("Settlement
Agreement"), attached as Exhibit "A" and incorporated by reference.
2. In order to fund its obligation to pay the aforementioned payments,
Allstate Settlement Corporation ("Owner"), purchased an annuity policy from
Allstate Life Insurance Company ("Issuer"). See exhibit "A".
I
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL DIVISION
IN RE: PETITION OF JEROMEY
TASKER AIK/ A JEREMY MICHAEL
TASKER FOR APPROVAL OF
TRANSFER OF STRUCTURED
SETTLEMENT PAYMENT RIGHTS
NO. 06-473 CIVIL TERM
PETITION FOR APPROVAL OF
TRANSFER OF STRUCTURED
SETTLEMENT PAYMENT
RIGHTS
PRAECIPE TO ADD
To the Prothonotary:
Please add the attached Certificate of Service to the above captioned case. Thank
you.
LAW OFFICES OF LESLIE D. JACOBSON
Date: January 26,2006
By:
Allen D. Moyer
10 # 81846
Attorney for Mark Scone
8150 Derry Street
Harrisburg, P A 17111.5260
717.909.5858
717.909.7788 [fax]
.,
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL DIVISION
IN RE: PETITION OF JEROMEY
TASKER A/K/A JEREMY MICHAEL
TASKER FOR APPROVAL OF
TRANSFER OF STRUcrURED
SETTLEMENT PAYMENT RIGHTS
NO. 06-473 CIVIL TERM
PETITION FOR APPROVAL 0'
TRANSFER OF STRUCTURED'-
SETTLEMENT PAYMENT
RIGHTS
r--<'1
\.J
"
r :~_~
'"
\,-,)
c' ,
CERTIFICATE OF SERVICE
-,
,,)
{.:"l
The foregoing Petition for Approval of Transfer of Structured Settlement
Payments Rights has been served upon the following interested parties, via certified
mail, return receipt requested, and regular first-class mail, postage prepaid, this 26th
day of January, 2006, addressed as follows:
Allstate Settlement Corporation
544 Lakeview Pkwy, L3F
Vernon Hills, Illinois 60051
Allstate Life Insurance Company
544 Lakeview Pkwy, L3F
Vernon Hills, Illinois 60051
Courtesy Copies to:
Lisa Stern
Allstate Life Insurance Company
Drinker, Biddle, & Reath LLP
1000 Westlakes Drive
Suite 300
BeIWyn, PA 19312-2409
Lisa Sterner
Allstate Life Insurance Company
3100 Sanders Road
Suite M3B
Northbrook, IL 60062
,:~
.
3. On or about September 1, 2005 Payee entered into an Agreement
for Sale of Structured Settlement Payments (the "Sale Agreement") with
Novation. See true and correct copy of the Sale Agreement, attached as Exhibit
"B" and incorporated by reference.
4. Pursuant to the Sale Agreement, Payee agreed to transfer/sell to
Novation some of the payments due under the Settlement Agreement. See
Exhibit "B".
5. Specifically, Payee agreed to transfer, in consideration of payment
to him by Novation of twenty six thousand four hundred and ninety dollars and
no cents ($26,490.00), monthly payments of $496.00 commencing July 15, 2007
through and including June 15,2017.
B. Petitioner Has Met the StatutOry Conditions of
Transfer of the Structured Settlement Payment Riahts
Under pennsylyania Law.
6. By this Petition, Payee and Novation seek this Honorable Court's
approval of the aforementioned transfer of structured settlement payment rights.
7. The transfer complies with each of the requirements of the Act,
and does not contravene any federal or state statutes or regulations, or any
other applicable law. See 40 P.s. 94003(a)(1).
8. Pursuant to the Act, Novation provided Payee with a Disclosure
Statement on August 29, 2005, Le., more than ten days prior to the time Payee
incurred an obligation with respect to the Sale Agreement. See true and correct
copies of August 29, 2005 letter and the Disclosure Statement attached as
Exhibit "C" and "0" respectively and incorporated by reference.
9. The Disclosure Statement sets forth all of the information required
by the Act.
10. The transfer contemplated by the Sale Agreement is in Payee's best
interests. See also, Affidavit of Jeromey Tasker in Support of his Petition to
Transfer Structured Settlement Payment Rights attached as Exhibit "E" and
incorporated by reference at ~ 15.
11. Payee is single with no children.
12. Payee intends to use the money to payoff some of his debts. See
Exhibit "E" ~ 11.
13. Pursuant to 40 P. S. 9 4003(b), Payee was advised in writing by
Novation to seek independent professional advice regarding the legal and tax
implications of the transfer.
14. Payee has waived his right to seek independent professional
advice. See Waiver of Independent Professional Advice attached as Exhibit "F".
15. Novation has transferred its rights under the Sale Agreement to
Novation Holdings, LLC ("Novation Holdings")
16. Pursuant to the Act, Novation has given written notice of Novation
Holdings' address and taxpayer identification number to Allstate Settlement
Corporation and Allstate Life Insurance Company.
17. Specifically, Novation Holdings' address and taxpayer identification
number is:
Novation Holdings, LLC #520661
P.O. Box 102265
Atlanta, GA 30368-2265
Tax 10: 20-1861007
WHEREFORE, Payee and Novation have met all of the conditions to
transfer Payee's structured settlement payment rights, as set forth in the Act,
and respectfully request this Honorable Court enter the attached Order of Court,
thereby approving the transfer/sale of the structured settlement payment rights
outlined infra.
Respectfully submitted,
Date: ,:..; - :JC
,200~
Allen D. oyer
10# 81846
8150 Derry Street
Harrisburg, PA 17111
Phone: 717.909.5858
FAX: 717.909.7788
Counsel for Jeromey Tasker
-1 \\,~
.....C ',;) ,.
^".,'J
j.>:. ,"
-,
!.(- ~
\-j
1
,,"..I
-:,\\.
\:\
NOV-18-2005 02:47PM FROM-WILSON COLLEri
+1"'641578
7-474 POOl
H20
SETTLEMENT AGREEMENT AND RELEASE
THIS SETtLEMENT AGREEMENT !\ND IU::LEASE (Settlement
Agreement) is made and entered into th1s --3~b___ day of
19 b d Shori TilSki'>t' and .TCl"allV Tasker
-1L'IDJ,lst 'J1!L.' y iln among Gera.rd 'j'askm- , 7\ M1nOr
(Releasing I?arties), and EIlr.l rtc.iU..!sLDutch Wonderland
(Released Parties).
1. Fat' and in consiJeraUon or those paymcI'ILs provideu for
herein, the sufficiency of which is hereby acknewledged, the
Releasing Parties, being of lawful ago, do hereby, anu for
their heirs, executors, administrators, successors anu assigns,
release, acquit and forever discharge the Released Parties as
~ell ~s its o(fice~s, directors, attorneys, represontatives,
employees, associates, pn~lncrs, agents, sa~vants, l~sure~s,
successors, heirs, exocuto"r-!J, administrotot's and all other
persons, fitms, corporations, associations or partnerships or any
other el'ltity connected therewith or and from any .Jnel all _cr..ims,
actioMs, causes of action, dem~nds, obligations, lie~s, rights,
damag~s, costs, loss of scr-viee, expense a~d/or compensation, oE
any nature .wh~tsoever which I:he Releasing Parties now have or
which may hereaftor accrue to the Releasing Parties on account
of, or i~ any way growi~g out of, any and all known or unknown,
foreseen and unforeseen, injuries and/or damages ~nd the
consequences thereof, il'lcludi~g wro~yful death, resulting from, or to
result from, l:.he i~cide~t, casualty or event which occurleed on or
about l\uaust 15 19.JlL' in J,ancllstar. Pl\ ,and which has
resulted in a claim and/or lawsuit for physical injuries and damages
being brought by the Releasing l'a.rties against the Released Parties..
.,;
..
Exhibit "A"
NOV-19-2005 02:A7PU FROM-WILSON COLLEGE
+11 126AI578
7-m P 002
H20
2. Payments
In cOnsideration of the Release set forth above, th.. Insurer on
behalf of the Released Parties hereby agrees to pay the following sums
in the following manner:
(a). Immediate Payment:
The sum of Thirt~ saven t~ousand five hundred dollars
Sha,rJ. 'H\SkW;c:er;a,J. 'n\S"d~' I 11 d
($37.500.00 ) to...:r~ 1n lVHua 'I, an
Dennis L. Plank his/her attorney(sl.
(b) Future Periodic Payments, $37,5~0.00 'f'? Purchase an
. - AnnUl. ty PayJ.1lg:
The sum of: $500 per month Commencing on
August ]5, 2000 and monthly thcroafter for (4S1
months certain.
The sum of: $6000 per year Commencing on
August IS, 2000 and annually thereafter for (4)
years certain.
The sum of: $496 per month Commencing on
August 15, 2007 and mOnthly thereafter for (20)
twenty years or life, whichever is greater.
Payable to Jeremv Tasker
Any and all payments to be made are not compensation but
are on account of physical injuries.
Primary Bcnc[;iciary
In the event of the death of JERBM~ TASKER
any remaining payments will be paid when due to
Shari Tusker and Geruld Tasker
NOV-18-2005 02:48PM FROM-WILSON COLL~G;.
+7172641518
H14 P 003
H20
(c). Fun(~ ing OCV L_,J
It is understood and aurced that Allstate Insur~nce
Company will pay the neccss~ry money to Allstate Settlomont
Corporation in order to tran5fer. its obligatio~ to make the
future periodic payments stated herein to Allstate Settlement
Co rpoTa t ion .
Shari.T[\sk~l:, Gerald'i'ilsker, and hcr.eby agree to look solely to
J=emy Tasker
Allstate Settlement Cor.poration for. these future payments.
It is understood and agroed that the obligation to make
future periOdic payments will be transfer.red to Allstate
:3etlloment Corporation and Albtate Settlement corporation
will fund its obligations with an annuity contract purchased
from Allstate Life Insurance company. Allstate Settlement
Corporation will be the owner of such annuity contract and
shall retain all r.ights of owner.ship ther.ein.
Cd). Contr.ol of Payments:
The Releasing Parties shall have no r.ight to the
discounted present value of the payments and no right to
control the investment of that amount, and no r.ight to
anticipate said payments in advance of the aforementioned
SChedule.
"
J. Releasing rartier.' Rights to Payments
The Rolei15e<l Parties and/or tho Insurer. shall not oer)r:"egatc
or. set aside ilny of its ass.:>ts to fLlnd tha pilymants to RalaasinrJ
Parties r:'oquired herein, it baing under:'sl:ood Re1easino Parties
are and shall be a general creditor to the Released Parties, the
In5urer, or. thoir assignee. Saiei payments cannot be accel'jratcd,
deferred, increased or. decreased by tho neleasing Parties and no
part of the payments called for. herein or. any assets of the.
Released parties, Insurer, or tho ^osi\Jnee aro to bo subject to
execution or any legal proees5 Eor any obligation in any manner,
nor. shall the Releasing Parties hava the power. to sell or.
mortgage or encumber same. or. any pal-I: thereof, nor. anticipate
the same, or any part thereof, by assignment or otherwise.
NOV-li-2005 02:4iP~ FROM-WILSON COLL~G~
+717264\Sli
T-474 P004/0\2 F-120
4. Qualified Assiqnment
Th", Purties he...cto 1lcknowl..dge 1lnd agree that the lteleased
Parties undlor the Insure... will make a "qualified assignment"
within the meaning of Section 130 [0). of the Inter-nal Revenue
Code of 1954, as amended. oC the Released parties' and/or the
Insurer's liability to make the pe...iodio payments required
her-ein. Said assignment shall be accepted by the Releasing
Pilrtics without right of rejection and shall completely release
and discharge the Released Parties and the Insurer from such
obligations hereunder as arc ussigned to the assignee. The
Releasing Par-ties recoqnize that. the assiqnec shall be their
sole obligor wi th .espoct to the obUga tions ilSS igned, ilnd tha t
all olhe... releases that pertain to the liability of the Releused
Parties and the Insu~e... shall thereupon become final. irrevocable
and absolute.
It the liability to makc the periodic payments is assigned
by way of a "qualified assignment",
1. That periodic payments from the assignee cannot be
Acccler-ated. dofel'r-ed. increased 011 decreased by the
neleasing Parties
2. The assignee does not pro~ide to the Releusing Parties
rights against the assignee that are 9~eater than those of a
general creditor; and
J, The assignee's obligation for payment of the poriodic
pAyments is no greater than tho obligation of the person
or-iginally liable (whether by suit Ot" agreement) fot" p~yment
and (r-om whom the obligation was assigned.
NOV-18-2005 02:~8PM FROM-WilSON COll;GE
+7172S~I5T8
T-~7~ P005/012 F-920
.:..~.~...-'''-':~~'''::':-~'
\.III '11111\.1 l....r
The Assignee w.II fund i~s liabiti~y tu make pe~iodic
payments through the purchase oE an annuity policy [rom Allstate
Life Insur.ancQ Company. The Assignee sh<lll be the OWntH' of the
annuity policy, and shall have all rights oE ownership. The
Assi~nee may have the annuity c<lrl'ie~, Allstat,~ LiCe InSUrance
Camp"ny, mail piJyments directly to tho Releasing partias
receiving per.iodic payments. The said Releasing Parties shall be
responsible Eor maintilining the cLlrrency of the proper maili'lg
address and mortality InEOl'mation to Allstate Life Insu~ance
Comp"ny.
6. Attorney's Fees
Each party hereto shall bear all attorney's (eas and cost
arising (~um the actions of its own ceunsel in connection with
tho Complaint. this Settlement Agreument and the matter.s "nd
documents referred to herein, the Eiling oE a Dismissal of the
Complaint. and all related matters.
7. Releasing Pa~tics' Beneficiar.ies
Any payment~ to be made aEter the death of the Releasing
Parti~s receiving periodic payments pursuant to the terms oE this
Settlement Agreement shall be milde to such person or entity as
shall be designated in writing by said Releasing Parties to the
Insurer or the Insurer's assignee. If no person or entity is so
designated by said nele~sing Parties, such payments shall be made
to the cstat. of the said Releasing Pilt'ties. No such designation
nor any revocation thereof shall be eEfective unless it is in
writing and delivered to the Insurer. or. the Insurer's assignee.
8. Tax Disclaimer Clause
Relcilsing Parties agree and wa!:'rant th"t they (Lilly
understand that the Released Parties and ~ssignee have no cont~ol
or responsibility and shall have no liability fo!:' any changes in
the law or by virtue o( any rLlling of the Internal Revenue
Se.vice (" IRS") which might result in a change in the talC-free
status of any portion of the benefits herein described. Any
chango, modification, or. alteration in tax rulings, regulations
or 13WS dealing with the talCability oE said payments as those
pr.ovided Eo.r herein shall have nO efEect upon this Settlement
Agr.ceme'lt and Release of all Claims which is full and Einal upon
execution and pe~Eor.mance.
(5 )
NOV-19-2005 02:49PM FROM-WILSON COLLEGE
+7112641579
T-474 P006/012 F-920
'9. Disch~e of Obligation
The obligations of the Assignees to make oach monthly
payment pu~suant to the terms of the Agreement shall be
discharged upon the mailing of a valid check in the amount of
~ueh payments to the addross designated by the party to whom the
payment is required to be made under the terms of the Settlement
^grcemeYlt anel the Insurer shall not be liable for the failure of
the appropriate persons to receive any such check if said check
is so ma lIed. In the event of non-I."eeeipt of said mailed check
the Releasing Party shall notify the assignee. 'The assignee will
upon propel." notiCication taka the necessary steps to issue a stop
payment on said missing cheCk and replace it as is proper.
10. General Release
The Releasing Parties hercby acknowledgo and agree that
the Re10nse set Corth het"ein is a gonera1 release and further
expt"essly waive and assume the risk of any and all claims
for damages which exist as of this date but which do not know of
or suspect to exist, whether through ignorance, oversight, error,
negligence. or otherwise, and Wll ieh. if known, would materially
affect their decision to enter into this Settlement Agreement.
The Reto.1sin9 Parties further agree they have accepted payment
o~ the sums specified herein as a complete compromise and
satisfaction of the Final Judgement involving disputed issues of
law and [act .and they fully aSSUme the risk that facts or.' taw
may be otherwise than they believe.
11. Warra~ of Capacity to Execute~reement
The Relea$ing Parties represent and warrant that no
other person or entity has or has. had any interest in the claims.
demnnds, Obligations. or causes oE action referred to in this
Se t t leme n t Ag reemen t, tha t they have the sole ri9h t and
exclusive authority to execute this Settlement Agreement and
rece i ve the sums spec ified in it; and that they have not sold.
assigned, transferred, conveyed, or otherwise disposed of any of
the claims, demands, obligations, 01." causes oE action referred to
in this Settlement Agreement.
(6 )
NOV-IS-2005 02:49PM FROM-WILSON COLLEGE
+7171641578
T-474 P.007/012 F-920
l~. Disclaimer of Liability
The Releasing Pilrties ilgroll and ilcknowledge that they
accept payment of the sums specified in this Settlement
Agreement as a full and complete compromise of matters involving
d ispu ted issues; that neither paymen t of the sums by the Released
Parties, Insurers, their assignees, nor the negotiations of this
settlement by the Insurers, thoir Released Parties. or their
attorneys shall be considerod admissions by any of said parties;
that nO past or present negligenco on the part of the Released
Parties be implied by such payment or negotiations.
13. Delivery of Dismissal with Prejudice
Concurrently with the execution of this Settlement Agreement.
coun:<;ol (or the Releasing Parties has delivered to counsel fat'
the Released Parties, or counsel for the Insurer an executed
Dismissal with prejudice of the civil action described in
paragraph 1 above. The Releasing Pat'ti~s have authocized their
Attorney to execute this Di.smissal on their behalf and hereby
authorize counsel for the Released Parties or counsel Eor the
Insurer to file said Oismissal with the court and enter it as a
mattec of rocord.
14. Construction b~n~svlvania Law.
This Settlement ^gceement is
and shall be construed and
entered into in the CO!'1monwealth
interpreted in accordance
of PA'..' '.
with its
laws.
(7)
NOV-19-2005 02:4IP~ FROM-WILSON COLL;GE
+1172641519
1-414 P"009/012 F-IIO
15. ~re5cntlltionn of Comprehen"ion of DoCUIh"...S
In entering into this Settlement Agreement the
Rclc~sin9 Parties represent that they have celied upon the legal
advice of their attorneys, who arc the attorneys of their own
choice and that the terms of this Settlement Agreement have been
completely read and eltplained to them by their attorneys. and
thot those terms are fully understood and VOluntarily accepted by
them.
16. ~ntire Aqreemcnt and Successor" in Interest
This settlement Agre~menl:. contains the entire agreement
between the Releasing Parties. the Released Parties and the
Insurer with regard to the matters set forth herein and shall be
binding upon and enure to the benefit of the eltecutors,
admin iSl:.rators. personal representatives. heirs, successors and
assigns of each.
It to; specifically understood and agreed
Agr.eement and Release of All Claims is not
any of the Defendants named in the pending
subject matter of the .Complaint. other
Parties. "..
that this Settlelllent
intended to release
action which is the
than the . Re leased
17. ^dditional Documents
All parties agree to cooperate fully and execute any and
all supplementary documents and to take all additional actions
which may be necessary or appropriate to give full force and
eEEect to the basic terms and in~ent of this Settlement
Agreement.
(a)
[
NOV-19-1005 01:41PM FROM-WILSON COLLEGE
+7111641578
T-474 P 001/012 F-IlO
17. Effectiveness
This Settlement Agreement and Release shall become effective
immediately following execution by all of the parties.
Datel
<;/15!D
By"" 0,:, _
RcYeasing arty: A. TASKE ,
individually, and as parent and
guardian of the property of JEREMY
TASKER, a minor.
Date:
By: ,C6~e abo've)
Releasing l'arty:GERALD A. TASKER, SR.
.individu~lly, and as parent and
guardian 'of the property of JEREMY
TASKER, a minor.
Date:
3/df?
l3y: {l~~:~ j.' ft,1.,k
Rclcaslng Parties' 'Attorney:
DENNIS L. PLANK of the law firm of
GOING '" PLANK
T.H.E. INSURANCE CO.,
(Insurance carrier)
Date:
By:
Name:
Title:
N/A
NOV-I8-2005 02:49PM FROM-WILSON COLLEGe +T1TZ6415T8 T-474 P.OIO/OI2 H20
Allstate:life Insurance/Company
A stock Company - Home Office: Northbrook, Illinois 60062
This contract is issued to the Owner (called "you") in consideration of the application, a copy 01 which is
attached, and your payment of the single premium. This contract and the. application are the entire con.
tracl. All statements made in the application are representations and not warranties. No statement will be
used by us in defense of a claim or to void this contract unless It Is in the signed application. Only our
officers may ohange this contract or waive a right or requirement. No agent may do this.
Allstate Life Insurance Company (called "we" or "us") will pay the Annuitant or the Owner's designee the
Payments shown on Page 3 as long as the Annuitant shall live. In addition, lIthe Annuitant is not living, any
Payments shown as Certain Payments on Page 3 will be made to the Beneficiary.
This contract terminates on the later of the payment 01 the last Certain Payment or the death of the Annui-
tant.
If you are not satisfied with this contract, you may void it b~Bit to us or our agent within 10 days
after you receive It. We will give you all of your money back.. ) 'iRPOLICY CAREFULLY.
~k
&?~~.s$-~
Secretary
President
Page 1
(1-90)
LU970
~. ;:
NAME
SEX
DATE OF BIRTH
. '
ANNUITANT: JEREMY MICHAEL
TASKER
MALE
OCT 30. 1't80
CONTRACT NUMBER: 9070<370
ISSUE DATE: AUG 23, 1990
OWNER: ALLSTATE SETTLEMENT CORP
PAGE 3
POLICY DATA PAGE FOR LU970
....
NOV-18-2005 02:'9P~ FROM-WILSON COLLEGE
+11728.1518
T-.1. P 011/012 F-920
..._....I......&.,U.f.Jo-_......,....":("......_1Q.7<:'>
.-
'-"01
";:"1<~~
--.-._i'"
. ,.)~
SCHEDULE OF PAYMENTS
DATE
AMOUNT
AUG IS. 2007
AND
THEREAFTER
$
496.00 MONTHLY
CERTAIN PAYMENTS, THE FIRST 240 PAYMENTS SHOWN ABOVE. THE LAST ONE
SCHEDULED FOR JUL 15. 2027.
NAME
SEX
DATE OF BIRTH
ANNUITANT, JEREMY MICHAEL
,
TASKER
MALE
OCT 30. 1980
CONTRACT NUMBER. 90702370
ISSUE DATE: AUG 23. 1990
OWNER. ALLSTATE SETTLEMENT CORP
PAGE :3
POLICY DATA PAGE FOR LU970
I
.'1
,
I
I
I
,
..j
I
. ,
,
,
,
,
.
NOV-I8-IOOS OI:SOPM
FROll-WllSON COllEGE +71TIS41S78
A.....:STATEt'I'A: lM:iUHArcwc u\,l~ .....
Application for Single Premium Annuity
H/O
H74
P 01//011
,
I
j
!
,
I
.,
,
I
!
)
1. Annuitant
a. Full Name
(PRIN'O
c. Address
d. Pllone (
2, Owner
TASKER JEREMY Michael b.SoClaISecurllyNo. 199-68-4771
Last First Middle
9~ l.ocu..t Street, ShiDPensoou. PennsYlvania 17257
No. and Sueet City,. County
Unkt10wn e. Blrthdate(M/D/Y)~~J..{L I. Age 9
State
Zip
g.Se)(~
^
i
,
,~
!
a. Name Allstate Settlement Corporation b. Relation 10 Annultanl None
AddressOne Penn Square W2St,Ste. 1504 Philadelphia. ~9102d.None
No. and Streel City State Zip Phone
3. Single Premium Valuable Consideration (must be submllled wllh application)
4. Type 01 Annuity
f]: a. Cenaln Payments only (Annuitant's survival not required)
fi b. Single life Annuity (submit proof of age, e.g. birth certlflcale) C"mmencil.:' 08-15-2007
o c. Joinl and Survivor Lile Annully (submit proof 01 ages, 8.g. birth cerllneales: also submit LR5'2)
5. Number of Cenaln Payments 240 (Enter "0" if none desired)
6. Payment Informallon
a. First pa.yment date (M/DIY) ~-.-lli~O
$500 per month for 48 months.
o Annually 0 Irregular tJ Other__S6.000 per )1"81:' (4) vear~
Commencing: 08-15-2000
b. Frequency: 0 Monthly
c. AmOunl(S) 01 Payments
a I. Level payments 01 $
o Ii. Slart payments at $
(percant or amount)
G Iii. Irregular Payments
Dale --' . , Amount
-.1-:.-
496.00
Commencing: 08-15-2007 L/20yrs
. Increase payments_
(Irequency and duration).
Dale
Date
Amollnt
Amount
..' <-.;'
7. Make payments'to {jj Annuitant
o Other designee (give name, address, relallon, etc.)
. ,
5. Benellciery (will be the Annuitant's eSlate illefl blank)
GERALD TASKER
Father
IN EQUi
SHAREs
a. Primary: Name
Relallon to Annuitant
b. ~Name SHARI TASKER
Mother
Aelalion to Annuifant
The Applicanl represents that all statements and answers on this Application are true 10 lhe best of his or h.
knowledge and belief and completely recorded herein.
Applicant: Allgtar.. S..rtlpClll'nt Corp by ciI-f" .....-/:'9/1.1. Date: -----1-------1_
Agen t: GERALD D. GREGER Signature < - Mo. Day Y,
LRS".'
NOVATION CAPITALt LLC
Agreement for Sale of Structured Settlement Payments c
Jeromey Tasker
This is on Agreement between Jeromey Tasker (referred to as "you" in this Agreement) and
Novation Capital, LLC ("Novation"). This Agreement sets forth the terms of a legally binding
contract in which you agree to sell structured settlement payments to Novation. This Agreement
and all its terms are subject to the approval of a court, which. by law, must approve the
Agreement before it is carried out.
Background
A. Some time ago, you (or someone acting for you) entered into a Settlement Agreement.
You have told Novation that you have the right to receive certain payments due under
that Settlement Agreement.
B. In connection with that Settlement Agreement. an insurance company agreed to make
the settlement payments now due to you. In turn, that insurance company arranged for
the purchase of an Annuity Policy so that those settlement payments would be made
on an agreed schedule.
C. Because the settlement payments are funded by an annuity, your risk of not getting
paid by the insurance company is low. However, those settlement payments will be
made in the future, on a schedule that may no longer meet your needs.
D. Accordingly, and after considering other ways of raisin!~ current cash, you have
decided that you want to sell some (or all) of your settlement payments. Simply stated,
you now want to give up the right to receive certain future settlement payments in a
trade for a lump-sum cash payment from Novation.
THEREFORE:
1. The Sale: You agree to sell and Novation agrees to buy the settlement payments
identified as the "Assigned Payments" at the very end of this Agreement. In exchange,
Novation agrees to pay you (and you agree to accept) cash in the amount of the
Purchase Price stated at the very end of this Agreement.
2. Paymenllo You: You can choose to be paid by wire transfer or by check. If you elect to
be paid by some other means. (for example, by "money order") any Charges imposed
by the bank or money transfer service will be deducted from your purchase price.
3. Court Approval: A court must approve your sale of payments before the Assigned
Payments can be transferred and monies will be paid to you. You understand and
agree that you will not be paid by Novation until the company that is making the
settlement payments has acknowledged receipt of a final court order that: (a) cannot
be appealed; (b) directs the Annuity Owner and Issuer to m:Jke the Assigned Payments
to Novation (or to an entity named by Novation); and (c) makes 011 findings required by
applicable state and federal law.
Page I
Copyright Novation Capital, L1,C (2002~2004). All Rights Reserved
Exhibit "B"
NOVATION CAPITAL, LLC::
4. Best Efforts and Working Together: Novation agrees to use ,"s best efforts to obtain the
required court approval in an uncontested court proceeding. You agree to cooperate
with Novation in that effort and to do all things reasonably necessary to cooperate with
Novation in its effort to complete this transaction. Among other things, you agree to
promptly provide Novation with complete and legible copies of the Settlement
Agreement and the Annuity, as amended and now in effect, and execute such
documents which may be necessary to obtain court approvol of your sale to Novation.
5. We Rely Upon What You Tell Us: All facts or statements in this Agreement (including any
attachments to this Agreement) regarding you, your situation, the payments you are
receiving, and the payments you are now selling are based upon documents and
information that you have provided to Novation. In entering into this Agreement.
Novation is relying upon the truth of the statements you have made and the documents
you have provided.
6. Your Money, Your Decision: You have told us that you are 18 years of age or older, are
of sound mind, not under the influence of drugs or alcohol. and understand and agree
fo the terms of this Agreement. Further, you agree that no one has forced you to sign this
Agreement nor has anyone promised you anything other than what is stated in this
Agreement in an effort to persuade you to sign it.
7. Facts About Your Payments: Novation must determine whether anyone other than you
is claiming an interest in the structured settlement payments you are selling us. Unless
you tell us in writing otherwise, we will assume:
(a) You alone have the right to receive the Structured Settlement payments that
you are now selling;
(b) Neither you nor anyone else has sold or pledged or otherwise transferred the
Assigned Payments nor attempted to do so;
(c) No other person (or business) claims a lien, right, title, or interest of any kind in
the Assigned Payments:
(d) You are not in bankruptcy;
(e) You are "up to date" in your child support (if any), alimony (if any), and tax
payments;
(f) There are no unsatisfied judgments or liens against you;
[g) No lawsuit has been filed or threatened against you or your assets; and
(h) As far as you know, there is no dispute about your right to receive the
payments under the Settlement Agreement and no one has challenged or
threatened to challenge your right to receive those payments.
If one or more of these statements becomes untrue before the Purchase Price is paid to
you, you agree to notify Novation in writing. In all events, you authorize Novation to
Page 2
Copyright, Novation Capital. LLC (2002-2004). All Rights Reserved
NOVATION CAPITAL, lLC
conduct credit checks and judgment and lien searches to confirm that there are no
claims against the Assigned Payments.
8. Facts About Your Life Situation: You have told us that neither you nor those who depend
on you rely upon the payments you are now selling for food, shelter, medical care, or
the other necessities of life. You understand that you may be asked to set forth
additional facts about your circumstances and life situation so that the court can better
understand your reasons for wanting to sell some or all ot your structured settlement
payments. Your name, date of birth, marital status, current and former addresses. social
security number. and other personal information is fully and truthfully set forth on the
application you provided to Novation. Your social security number will not be revealed
by us In any public filings.
9. Certain Debts Paid: Many people choose to sell future settlement payments because
they want to clear up their debts, payoff liens, and bring their past due obligations
current. If you owe back taxes, past due child support, or have judgments or liens
recorded against you or your assets, Novation will review any such obligations with you
and determine which debts, claims. or liabilities must be paid at the closing. If it is
necessary to pay certain debts before funds are released to you, Novation will pay
lhose debts for your account and deduct the payment from your Purchase Price.
10. other Possible Deductions from the Purchase Price: If some of the payments being sold
to Novation under this contract are paid over to you (and not Novation) before the
Purchase Price is paid to you, the payments received by you (rather than Novation) will
be deducted "dollar for dollar" from the Purchase Price.
11. "Holdbacks" While Address Change Is Processed: The insurer making payments may
take several months to process the change. Accordingly, Novation may withhold from
the Purchase Price: (a) the sum of assigned payments, if any, due to be received within
three to six months following the closing; or (b) 10% of the Purchase Price; or (c)
$1,000.00, whichever is greater, until the insurer begins to re-direct payments fo Novation
(or other parties) pursuant to the court's order or the insurer making the payments
confirms in writing the change of payee for the Assigned Payments. When the Assigned
Payments begin to be received by Novation [or other third party designated in the
order} or the insurer confirms in writing the change of payee, any amounts withheld will
be paid over to you, less any monies paid to you in error while the insurance company
was processing the address change.
12. Misrouted Payments: On rare occasions, even after a court has approved a sale, an
Assigned Payment may be misrouted or mislabeled by the insurance company. In the
event that payments you have sold to Novation are instead sent to you, you agree to
hold those payments in trust and immediately tum them over to Novation. Similarly, in
the event that payments you have sold to Novation are sent to Novation but made
payable to you, you hereby grant Novation an irrevocable limited "power of attorney"
authorizing Novation to cash any such checks and deposit them to Novation's
collection account. In some cases, if the Assigned Payments only constitute a portion of
your structured settlement payments, the court or your insurance company may require
that the entire structured settlement payment be paid to Novation and Novation remit
Page 3
Copyright. Novation Capital. LLC (2002-2004). All Rights Reserved
,
NOVATION CAPITAL, tLc:
the unassigned portion of the structured settlement payment back to you. If such a
circumstance arises in your transaction, you agree to this payment servicing
arrangement,
13. Grant of Security Interest: You intend to sell and Novation intends to buy your rights in
and to the "Assigned Payments. " Subject to the court's approval of the sale, you grant
to Novation a "first priarity security interest" in the Assigned Payments. Accordingly, you
agree that Novation shall have all of the rights of a secured party under the Uniform
Commercial Code and may exercise the remedies of a secured party.
14. 14. Change of Beneficiary: The payments you are selling (the Assigned Payments) are to
be paid to Novation in accordance with a set timetable -- even if you are no longer
living at the time the payments come due, To confirm that. you will sign and deliver to
Novation Attached Exhibit B which names your estate as the sole beneficiary of the
Assigned Payments under the Annuity during the term of the Assigned Payments. In
addition and to similar effect, this Agreement is and shall be deemed a "Testamentary
Agreement" in which you agree, for all time, to name Novation or its assigns as the party
that will inherit the Assigned Payments in the event of your death. You cannot and will
not amend, modify, alter or otherwise change the beneficiary designation or this
Testamentary Agreement without Novation's express prior written consent.
15. Agreement Binding on You and Your Successors: You agree that this Agreement in its
entirety, including the Testamentary Agreement set forth in the immediately preceding
paragraph and the beneficiary designation attached as Exhibit B, shall be binding upon
you, your heirs. successors. assigns, and any person claiming by. through, or under you.
16. You Want to Sell Your Payments: Many Structured Settlements were set up before
enactment of the laws that now allow people to sell their structured settlement payment
rights. Accordingly, your Structured Settlement Agreement may contain one or more
provisions that suggest that your payment rights cannot be sold. To the extent that your
Settlement Agreement or the Annuity contains such a provision that purports to restrict
or limit your ability to sell your payments, you hereby waive and release any such
restriction. Furthermore, you waive and release any rights under applicable statutes that
might be deemed to exempt the Assigned Payments from execution. attachment.
garnishment, seizure or other process by Novation. Consistent with the forgoing, you also
agree that you will never claim or contend that the payments you are now selling were
not transferable.
17. Novation Can Assign: Novation (and/or its wholly owned Clffiliate, Novation Holdings,
LLC) may pledge or assign all or any portion of its right, title, and interest in and to this
Agreement, the Settlement Agreement. the Annuity, and the Assigned Payments,
without your further consent. If and when that happens, all references to Novation in
this Agreement shall be read and understood to refer to Novation's immediate or
subsequent assigns.
18. This is a Sale, Not a Loan: You are selling your payment rights. You agree that this is not a
loan. If. from any possible construction of any document. it were determined that this
Agreement somehow calls for the payment of "interest" and if such interest would be
payable in excess of the Maximum Lawful Rate permitted by applicable laws, any such
Page 4
Copyright, Novation Capital, LLC (2002-2004). All Rights Reserved
.
NOVATION CAPIT A~ He;
construction shall be automatically reformed and the interest payable shall be
automatically reduced to the maximum lawful rate, without the necessity of execution
of any amendment of new document.
19. What Happens If Court Says "No"lt is always possible that someone who has not signed
this Agreement (such as your insurance company) could try and oppose the request for
court approval. That could result in unanticipated expense and delay. You understand
and agree that if someone opposes or contests the request for court approval, Novation
may choose to cancel this contract without further obligation. Similarly, if someone who
did not sign this Agreement (such as an insurance company) appeals a court's
approval. you agree that Novation may choose to cancel the transaction rather than
incur the expense and delay of litigation. In the vast majority of cases involving
structured settlement transfers, Novation wins court approval without undue expense or
delay. But if, for some reason, the court does not approve the sale, or if Novation elects
to cancel in light of the opposition of some other person, no payments will be transferred
from you, no monies will be paid to you, you will have no further obligation to Novation,
and Novation will have no further obligation to you.
20. General Provisions: The headings in this Agreement are to make it easier to read and
shall not affect the meaning of this Agreement. This Agreement and the attached
exhibits make up the entire agreement between you and Novation and replace all prior
arrangements and understandings, written or spoken. This Agreement can only be
changed, replaced, or canceled by a writing signed by you and Novation. If any part
of this Agreement is ever held to be to invalid under any applicable law, that provision
shall be deemed modified to the extent necessary to render it enforceable. If
modification is not possible, then the provision shall be severed and the validity of the
remaining provisions shall not be affected. In the event of a lawsuit to enforce this
Agreement, the unsuccessful party shall pay to the successful party all costs and
expenses, including, without limitation, actual attorneys' fees, expended or incurred.
Any dispute under this Agreement shall be resolved in a court in the state where you are
now residing, under the laws of that state. All of the terms and conditions of this
Agreement shall be binding on and be enforceable by you and Novation and you and
Novation's respective heirs, successors and assigns. All notices shall be in writing and
shall be deemed to have been duly given if mailed first class, postage prepaid, certified
United States mail. return receipt requested. This Agreement may be executed in two or
more counterparts, all of which shall be considered one and the same agreement and
shall become effective when two or more counterparts have been signed by each of
the parties hereto and delivered to the other parties, it being understood that all parties
need not sign the same counterpart thereof.
21. The Payments You Are Selling: The payments you are selling and their amount(s) and
due dates are described on Exhibit "A". These payments you are selling are referred to
as the "Assigned Payments".
22. Purchase Price: Novation has agreed to pay you (and you have agreed to accept) the
sum stated on Exhibit "A" as the "Purchase Price" for the Assigned Payments. You
acknowledge that Novation has provided a written Disclosure Statement to you prior to
your signing this Agreement as required by applicable state and federal law.
Page 5
Copyright, Novation Capital, LLC (2002-2004). All Rights Reserved
NOVATION CAPITAL. hb(
23. Independent Advisor: By signing this Agreement below, you acknowledge that Novation
has advised you In wriling to seek, and you have had the opportunity to seek,
Independent legal or other expert advice regarding the legal. financial. and tax
consequences of this Agreement.
By signing below, you agree to be bound by all of the terms of this Agreement.
-----,
,
Ital. LLC:
SE
By: Charles Lowe
Its: Chief Financial Officer
The foregoing insyYment was acknowledged
before me this ~ day of JePf<rnlJet;2ooS;:by the
above signed, who is either (0) personally known to
me or m9l who has produced fA- Pho-h> W as identification.
~F ~ALTII OF PENNSYLVANIA
Notary Ignature . I S I
A Notary Public in an for ~~tjilo/&::'ill N';:~ Public
Printed Nome: Orrstown Boro, Fr,ankhn Co~nfOO8
Commission Expires: Y . .., .
M9lTIosr, l-'ermsyr\l~1tld ,l.,=nA.,ation of Notanes
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
loge/a F. Unger, Notary Public
M rrstow'.l Bora, Franklin Count
Y Commission Expires Oct 7, 2bo8
Member, Pennsylvania Association of Notaries
Spousal Consent - IF APPLICABLE
I am at least 18 years old, am of sound mind, not under the influence of drugs or alcohol,
and am married to Jeromey Tasker. I consent and agree to this Agreement and waive any
right to or interest in the Assigned Payments, including, without limitation, any community
property interests. No one has forced me to sign this consent nor has anyone promised me
or my sp 'n other than what is stated in the Agreement.
Hie foregoing irwrument was acknowledged
before me this L day of .fRpfem~r, 200"- by
fhe above signed, who is either (0) personally
known to me or !fill who has produced dL
/11010 0 as identification.
NOVATION CAPITAL, LLC
1818 South Australian Avenue, Suite 450
West Palm Beach, Florida, 33409
(800) 7476472 www.Novationcap.com
Notary Ignature
A Notary Public in and for fhe Sfafe of
Printed Name:
Commission Expires:
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Angela F. Unger, Notary Public
Orrstown Bom, Franklin County
My Commission Expires Oct. 7, 2008
Member, Pennsylvania Association of Notaries
Page 6
Copyright, Novation Capital, LLC (2002.2004). All Rights Reserved
.
NOVATION CAPITAL, 1JC
Exhibit "A" to Agreement for Sole of Structured Settlement Payments@
The Structured Settlement Payments you have agreed to sell to Novation Capital,
LLC are:
Monthly payments of $496.00 commencing 7/15/2007 through
and including 6/15/2017
The Purchase Price you have agreed to accept in exchange for the sale of the Structured
Settlement Payments stated above is: $ 26.490.00
SELLER
Copyright, Novation Capital, LLC (2002-2004). All Rights Reserved
.
VIA UPS 2ND DAY DELIVERY
August 29, 2005
Jeromey Tasker
327 East Orange Street
Shippensburg, PA 17257
Re: Disclosure Statement
Dear Mr. Tasker:
Please find enclosed the Disclosure Statement that Novation must provide to you not less than
three (3) days before you execute a transfer agreement to transfer your structured settlement
payments. Please review the enclosed document carefully. Novation recommends that you
seek the advice of an attorney or licensed financial professional (i.e. certified public accountant
or licensed financial planner).
Novation will send the transfer agreement for your execution approximately three (3) days after
you were sent the enclosed disclosure statement.
If you have any questions or concerns, please do not hesitate to contact me.
Sincerely,
Dawn Epstein
Financial Product Sales Assistant
Novation Capital LLC
Enc.
I1C"
Exhibit
. , .
DISCLOSURE STATEMENT
I NAME: Jeromey Tasker I
1. DESCRIPTION OF TRANSFERRED PAYMENTS
I am transferring the following structured settlement payments:
Monthly payments of $496.00 commencing 7/15/2007 through
and including 6/15/2017
The aggregate total of these payments is $59,520.00.
2. GROSS ADVANCE AMOUNT
In exchange for these payments, I will receive a gross amount of
$26,490.00. Funding will not occur until all conditions required
under the transfer agreement have occurred.
3. TRANSFER EXPENSES
I understand that the following fees and expenses will be
deducted from the Gross Advance Amount payable to me or my
account:
Legal Fees (best estimate) $0.00
Broker Commission $0.00
Charaes $0.00
Fees $0.00 ,
Costs $0.00
EXDenses $0.00
4. NET ADVANCE AMOUNT
I understand that the Gross Advance Amount, as described
above, shall be reduced by the Transfer Expenses described
above resulting in the Net Advance Amount below:
I Net Advance Amount I $26,490.00 I
Disclosure Statement: DE, MN & PA Exhibit"o"
Copyright:. Novation Capital, LLC (2002-2004). All Rights Reserved
. ' .
I understand that I will receive this Net Advance Amount, minus
(a) any advances made to me or on my behalf by Novation
Capital LLC for notary fees, for cash advances related
to attorney fees to seek court approval; and
(b) any amounts necessary to satisfy any outstanding
liens, judgments, and credit-based obligations,
pursuant to the terms of the transfer agreement.
5. QUOTIENT
The net amount that you will receive from us in exchange for
your future structured settlement payment(s) represents 61.17 %
of the estimated current value of the payments based upon the
discounted value using the applicable federal rate.
6. DISCOUNTED PRESENT VALUE
This provides the calculation of the estimated current value of
the transferred structured settlement payments under federal
standards for valuing annuities. The Federal Rate that is used to
make this calculation is provided below in addition to the
Discounted Present Value.
Federal Rate used to
calculate the Discount
Present Value
Discount Present Value
4.80%
$43,305.19
7. PENAL TV IN THE EVENT OF BREACH OF CONTRACT
The amount of any penalty or liquidated damages, inclusive of
penalties, payable by me in the event I breach the transfer
agreement is zero.
8. You will not incur any obligation under a transfer agreement
until the tenth (10th) day after you receive this disclosure
statement.
Disdosure Statement: DE, MN & PA
Copyright, Novation Capital, LLC (2002-2004). All Rights Reserved
. '
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL DIVISION
IN RE: PETITION OF JEROMEY
TASKER A/K/A JEREMY MICHAEL
TASKER FOR APPROVAL OF
TRANSFER OF SfRUcrURED
SETTLEMENT PAYMENT RIGHTS
NO.
PETITION FOR APPROVAL OF
TRANSFER OF STRUCTURED
SETTLEMENT PAYMENT
RIGHTS
AFFIDAVIT OF JEROMEY TASKER IN SUPPORT OF
PETITION FOR APPROVAL OF TRANSFER OF
STRUCTURED SETTLEMENT PAYMENT RIGHTS
I am Jeromey Tasker, a/k/a Jeremy Michael Tasker and I make the within Affidavit of
Jeromey Tasker in Support of Petition for Approval of Transfer of Structured Settlement Payment
Rights ("Affidavit") based upon my personal knowledge:
I. I am an adult individual, and I firmly believe in the obligations of an oath.
2. I reside at 327 East Orange Street, Shippensburg, Pennsylvania 17257.
3. I am currently employed.
4. I am entitled to receive certain payments under a release and settlement
agreement that I entered into, with Court approval.
5. Pursuant to a settlement agreement, I became entitled to receive lump sum
payments as follows: monthly payments of $496.00 commencing August 15, 2007 guaranteed
through and including July 15, 2027 and life thereafter.
6. On or about September I, 2005, I entered into a written Agreement for Sale of
Structured Settlement Payments ("Sale Agreement") with Novation Capital, LLC ("Novation").
Exhibit"E"
... I' .
7. I entered into the Sale Agreement because I desire to transferlsell to Novation
certain of the payments due under the settlement agreement in exchange for a single, lump-sum
payment from Novation.
8. I have agreed to transfer, in consideration of payment of $26,490.00 from
Novation, monthly payments of $496.00 commencing July 15, 2007 through and including June
15,2017.
9. I do not/will not rely upon the aforementioned settlement payments to pay my
living expenses such as food, clothing, shelter, and medical care expenses.
10. I am currently single with no children.
II. I desire to sell the aforementioned payments to Novation so that I can payoff
some of my debts.
12. I fully understand that I will be giving up the right to receive the payments for a
one time, lump sum payment from Novation.
13. I have considered other means of raising the funds necessary to meet my needs,
but I do not have any property to sell, or collateral to borrow against, in order to receive a loan
from a conventional lender.
14. After weighing all of the options available to me, I have detenmned that selling a
portion of my structured settlement payment rights is the most efficient, and least expensive, way
for me to raise the funds that I need.
IS. I believe that the transfer is in my best interests, in the best interests of my
dependent, and the terms thereof are fair and reasonable.
16. Before entering into the Sale Agreement, I analyzed the financial and legal
consequences of the same.
17. On August 29, 2005, Novation provided me with a Disclosure Statement, that I
have read and fully understand.
2
... !' ..
18. I was advised by Novation, in writing, to seek independent legal advice regarding
the implications of the transfer.
19. I have waived independent legal advice regarding the implications of the transfer,
including the tax ramifications of the transfer.
20. I fully understand the transfer outlined herein and in the Sale Agreement.
21. I have read the Petition for Approval of Transfer of Structured Settlement
Payment Rights ("Petition"), and I fully understand the Petition.
22. I understand that the Petition must be approved by this Honorable Court before
the transferlsale can be completed.
23. Each of the factual allegations of the Petition is true and correct to the best of my
personal knowledge, information, and belief.
24. I have supplied my verification to the Petition.
25. I request that the Court approve the Petition.
SWORN and subscribed before me this 3-- day of ~Ai\).
, 200~, by
Jeromey Tasker an adult individual who provided proper identification.
.0:::::J
//~
( /;,l.. .. .
~/.~;..
,Jeromey T as. er
I
,
My Commission expires on:
NOTARIAL SEAL
TAMMY L. KETTERER, NOTARY PUBLIC
SWATARA TWP.. COUNTY OF DAUPHIN
MY COMMISSION EXPIRES OCTOBER 30, 2006
3
.. ", "
NOVATION CAPITAL, lh<::
Waiver of Independent Professional Advice
I, Jeromey Tasker, have been advised by Novation Capital LLC in writing, to seek
independent professional advice from a professional such as an afforney, an accountanl
or financial planner regarding fhe implications of transferring my future rights to structured
settlement payments. I have considered this option but I have chosen not to seek such
advice.
.sf
The foregoing instrument was acknowledged before me this ~ day of >-pft'".b;r 200S- by the above
signed, who is either 10, personally known to me or (~ who has prOduced ~ Ph*,.IO as
identification.
N~/'~
A Notary Public in and for the state of
Printed Nome:
Commission Expires:
COMMONWEALTH Of PENNSYLVANJA
Notarial Seal
Angela F. Unger, Notary Public
Omtown Bom, Franklin County
My Commission Expires Oct. 7, 2008
Member, Pennsylvar1l8 AsSOCIation of Notaries
Exhibit"F"
Copyrigbt, Novation Capital, LLC (2002-2004), All Rights Reserved
III ! ~ _
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL DIVISION
IN RE: PETITION OF JEROMEY
TASKER A/K/A JEREMY MICHAEL
TASKER FOR APPROVAL OF:
TRANSFER OF STRUCTURED
SEITLEMENT PAYMENT RIGHTS
NO.
PETITION FOR APPROVAL OF
TRANSFER OF STRUCTURED
SETTLEMENT PAYMENT
RIGHTS
VERIFICATION OF JEROMEY TASKER
I, Jeromey Tasker, have read the foregoing Petition for Approval of Transfer of
Structured Settlement Payment Rights and verify that the factual allegation of the
petition are true and correct to the best of my personal knowledge, information and
belief.
I understand that this verification is made subject to the penalties of 18 Pa. C.S.
13 4904 relating to unsworn falsification to authorities.
Dated: ~ 'i\r(:; .
-<~ .:,1,)
.,-, (.,
,200b
.. .. "
"",-,\
~ ".' ";?
~ ~ l.__
?- .'
...
~ ,
'J', c.
-. r \to
...4, ~
..::>
W -" d
v) r<'j
C>
" "
c~'>
~
0./
.IMI ? F:, iUUti
IN THE COURT OF COMMON PLEAS Cf
OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL DIVISION
IN RE: PETITION OF JEROMEY
TASKER AIKIA JEREMY MICHAEL
TASKER FOR APPROVAL OF
TRANSFER OF STRUCTURED
SEITLEMENT PAYMENT RIGHTS
NO. Of,. 'n,} (l1;;'l--r::.-
PETITION FOR APPROVAL OF
TRANSFER OF STRUCTURED
SETTLEMENT PAYMENT
RIGHTS
ORDER
AND NOW, this 3t-tL day of -4-~ 200W' upon
consideration of Petitioner's Petition for Approval of Transfer of Structured
Settlement Payment Rights, as filed with this Court on or about
~ ..:)5 200~, it is hereby ORDERED that the Court of Common
Pleas for Cumberland County will conduct a hearing on said matter on the~
day of Jk2~_ ,200 (PI at I D:OD l1.m. in Courtroom No.
'- C) of the Cumberland County Courthouse, One Courthouse Square,
Carlisle, Pennsylvania 17013-3387.
By ORDER OF THE COURT:
Dated: 3 F ~~ \'0~.t't-, 2001,
~~ ~ (
\. v
J.
~r
1.
~.
'"
w
r
. I. ","'",\ r n..i'_r..J~~
\;jp \iVJ\ T:\ :;>'. '~--;)'>~:"]n'"'
i!~,f1i"';.r,r-- ""-"":.r'i, J
/'u..J'"
"
fl
~
L C : II fJV 8 - 83J SOul
j,;.r,l'(i\ iiJ i C:'iJ 3Hl :10
'-l Y':"~'-l ".. "H- ~ '.'1-'1' ,
;~JH::iO-{;:J i:,'.1
o2i22/2006 15 04 FAX 6109938585
DRINKER 8IDDLE
L
1,!}01Q/018
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYL VANIA
IN RE: PETITION OF JEROMEY
TASKER, A/KJA JEREMY MICHAEL
TASKER AIKIA JEREMY TA.SKER
FOR APPROVAL OF A TRANSFER
OF STRUCTIJRED SETTLEMENT
PAYMENT RIGHTS
CIVIL DMSION
NO. 06-473
ORDER
r.-
AND NOW, this 1.'"\ day of February, 2006, upon consideration oflhe wwpposed
joint petition of Novation Capital, LLC (''Novation'1 and Jeromey Tasker allda Jeremy Michael
Tasker allda Jeremy Tasker ("Mr. Tasker"), and upon consideration of the court order attached
hereto as Exhibit "A" approving the underlying structured settlement, and subject to the written
approval of the Court of Common Pleas ofLanc;aster Counly, Pennsylvania, the Court hereby
finds as follows:
1. This Court has jurisdiction over this matter pursuant 10 the Pennsylvania
Structured Settlement Protection Act, 40 P .S, 9~ 4001 et seq.
2. The transfer of structured settlement proceeds, specifically monthly payments of
$496.00 each, commencing on August 15.2007 through and including July IS. 2017 (the
"Assigned PaymeIlt9"), by Mr. Tasker to Novation as described in the purchase agreement (the
"Purchase Agreement'1 between Mr. Tasker and Novation and in the petition in Ibis matter (the
"Proposed Transfer") (1) does not contravene any applicable federal or state statute or
regulations, or the oreer of any court or responsible governmental or administrative authority, or
any applicable law limiting the transfer of workers' compensation claims, and (ii) is in the best
interest of Mr. Tasker, taking into account the welfare and support of Mr. Taskec's dependents, if
any.
BIM4SI_
02/221200, 15 05 FAX ,10993B5B5
DRINKER BIDDLE
L
1lJ C 11/0 1 S
3. The Proposed Transfer complies with the requirements of the Structured
Settlement Protection Act, 40 P.S, ~~ 4001 et seq. and 215 ILCS 153/1 et IICq., and will not
contravene other applicable law.
4. Not less than ten (10) days prior to the date on which Mr. Tasker fint incurred
any obligation with respect to the Ptoposed Transfer, Novation provided to Mr. Tasker a
disclosure statement in full compliance with 40 P.S. S 4003(a)(2).
5. Novation has provided Mr, Tasker with a written notice on a sepante sheet in
compliance with 40 P.S, ~ 4003(b).
6. Mr. Tasker has received or expressly waived, in a seplll'ate written
acknowledgment ~igned by Mr. Tasker, independent legal advice regarding the implications of
the Proposed Transfer, including consideration of the tax ramifications of the Proposed Transfer.
7. No vation has given written notice of its name, address, and taxpayer identification
n\lIIlher to Allstate Settlement Colporation and Allstate Life Insurance Company ("Allstate
Life") (collectively, "A1Istl\te'), and has filed a COPY ofsuch notice with the Court.
S. Novation has timely filed and served on all interested parties, including Allstate, a
notice of the Proposed Transfer and the application for its authorization in compliance with the
requirements of 40 P.S. ~ 4004.
9. Mr. Tasker has COUSlllJted, in writing, to the Proposed Transfer, and Novatiott
shall seek the <tpprOval of the Court of Common Pleas of Lancaster County, Pennsylvania, which
previously approved the structured settlement.
Based on tile foregoing findings, IT IS HEREBY ORDERED THAT:
I. Pursuant to 40 PS. ~ 4003, the Proposed Transfer is approved subject to the
further written approval of the Court of Common Pleas of Lancaster County, Pennsylvania.
.ElTI'r! Vllkoo... ~lIt JlrtJplllrly-.me.
02/22/2006 15 05 FAX 8109938585
ORINKER BIGGLE
L
~012/01S
Until the due date of the last Assigned Payment, the designated beneficiary under lllllIUity
contract nos. 90702370 and 90702371 shall be the Estate of Mr. Tasker. However, it is the
intention of the parties that the Assigned Payments sha1l be made to Novation's assignee,
Novation Holdings, LLC ("Novation Holdings") even in the event of Mr. Tasker's death.
2. Allstate Life shall fOTWlU'd the Assigned Payments, within 7 days of the date due,
by check made payable to ''Novation Holdings, LLC (#52.0661)," at P.O. Box 102265, Atlanta,
GA 30368-2.2.65, Tax ID: 2.0- I 861 001, all follows: monthly payments of $496.00 each,
commencing on August 15, 2007 through and including July IS, 2017.
3. In the event Novation or Novation Holdings further assigns or otherwise transfers
the Assigned Payments (or any portion thereof or any interest therein) to any other person ot
entity (a "Reassignment"), Allstate !.ife wi1l not itself be obligated to redirect the Assigned
Payments (or any portion theroof) to any person or entity other than Novation Holdings or tll any
payment address other than that specified herein, and Novation and Novation Holdings shall
remain obligated to comply with all terms and conditions herein.
4. All remaining Periodic Payments (andlor portions thereot), if any, that are not the
subjecl of the Proposed Transfer IWd not previously assigned, shall be made payable to Mr.
Tasker and will be furwarded by Allstate Life, when due, to Mr. Tasker's most recent known
address or any payment address designated by Mr. Tasker, subject to Allstate's COMent.
5. Novation and Novation Holdings sball defend, indemnify, and hold hannle!lS
Allstate and its directors, shareholders. officers, agentll, employees, servants, successors, and
assigns, and any parent, subsidiary, or aflilialcl thereof, and their direclcrs, shareholders, officers,
agents, employees. servmrts, s==rs, and assigns, past and present, from and against any and
all liability, including but not limited to costs and reasonable attorney's fee!!, for any and all
Error! UpboWD doaurmat proputy lIUH.
02/22/2006 1506 FAX 6108838585
DRINKER 8IDDLE
L
~013/018
claiIns made in connection with, related to, or arising out of the Purchase Agreement, the
Proposed Transfer, the Assigned Payments, any Reassignment, or Allstate's compliance with the
parties' Stipulation or this Order, exc~t with respect to claims by Novation and Novation
Holdillgll agairurt Allstate to enforce Allstate's obligations to Novation and Novation Holdings
under the parties' Stipulation. To the extent that Novation or Novation HoIdin!!8 fails to honor
this indemnification and defense obligation, Allstate may, in addition to all other remedies
afforded by law, satisfy the same by withholding to its own credit any remaining Assigned
Payments.
6. AUstate's lack of opposition to this matter, or its, Novation's or Novation
Holdings' stipulation hereto Or compliance herewith, shall not constitute evidence in this or any
matter, lUld is not intended to constitute evidence in this or any matter, that:
a. payments undt:r a stroctmed settlement conlNlct or annuity or related
contracts can be assigned or that "anti-assignment" or "anti-encumbnmce"
provisions in strUCtured settlement contracts or annuities or related
contracts are not valid and enfurceahIe; or
b. other transactions entered into by Novation and/or Novation Holdings and
its customers coJlStitute valid sales and/or loans; or
c. Allstate has waived any right in connection with any other litigation Cof
claims; or
d. Novation and Novation Holdings have waived any right other than as
expressly set forth in the parties' Stipulation and this Order,
7. Novation, Novation Holdin!!8 and Mr. Tasker. for themselves lUld for their
respective directors, shareholders, omcees, agents, employees, servants, successors, heirs,
beneficiaries, contingent beneficiaries, executors, administrators, and assigns, and any paren t,
subsidiary, or ;lffilia:te thereof, ll1ld their directors, shareholders, officers, agenlS, employees,
servants, SIl(:Cessors,ll1ld assigns, past ll1ld present (the ''Releasors''), hereby remise, release and
forever discharge Allstate, and its directors, shareholders, officers. agentll, employees, servaats,
IlUCCeSBOrS, and assigns, and any parcmt, subsidiary, or affiliate thereof, and their dim:tors.
Errcir! Vnbo.,. doeoment p..-pmy .....
, .
02/22/2006 1507 FAX 610883B585
DRINKER BIDDLE
L
~Q14/01~
shateholders, officers, agllllts, llIllployees, servants, successors, and 118signs, past and present (the
"Allstate Releasees"), of and from any and all manner of actions and causes of action. suits,
debts, dues, lICCQunts, bonds, covenants, contracts, agreements, judgments, settIements, damages,
claims, and demauds whatsoever, in law or in equily, in connection with, related 10, or arising
out of any claim or allegation that was or could have been asserted in connection with, relat.:d to,
or arising out of the Purchase Agreement, the Assigned Payments, the Proposed Transfer, or the
parties' Stipulatiou, which against each other or the Allstate Releasees, the Releasors have or had
from the beginning of the world through the date of this Order, except for claims ofRelcll8Ors
against the Allstate Releasees to enforce the Allstate Releasees' obligations to Releasors, if any,
under the parties' Stipulation or this Order.
i"
DONE IN OPEN COURT this 1.'1 day of February, 2006.
'\~ --L
Judge
ElT9r' V.bow. doaurunC propc:rCf IIlUrIC.
-f
t;-
I:J
~
h
\'-...
'-(~
"()
"-
r
~
--'
~
'-<
(d
(")
I.''"
,
,- -~
-
~;
"
fA)
C.,
02/22/2008 15.07 FAX 6108836585
DRINKER BIDDLE
l
~015/016
EXHffirr A
BIl\341180\2
02/2212008 15 07 FAX 8109988585
DRINKER B1DDlE
L
lllOiB/01B
AlllTASII:ER
IN THE COURT OF COMMON PLeAS OF LANCASTER COUNTY, PENNSYLVANIA
CIVIL ACTION-LAW
v.
No. 3339 of 1989
.."
~
<.:1.
f'":'"""::t
l=l-<.:5
z;.>:
Ole::
;:::..-,.
(,1':1"";..
;;I ~~~
-.-
- -
. ..,
""'<::>
P"<\
-n
n
en
:", .
g
.. ,M
',>"'~"::
" ~
::0 m
I ;:g
en ""
".>>- pc;:
== :!
UI... ''l''''
o
,.
w
JEREMY TASKER, A MINOR BY.HtS
PAREN'tS Ii NATURAL: GUARDlJUlS,
SHARI TASKER 5 GERALD TAS~ER
5 SHARI TASKER i GBRALD TASKER
IN TREIR OWN RIGRT
:
=
=
BARL REALTY, lHe./ooTeR
IlOMDl!:RLMlP
:
2!R~!
AND !lOW t:his 5'" day of Apdl. 1990 upon cons1derllltion of
t:he Petition of Shari Tasker and Gerald TaBke~ relative to a pro-
posed settlement for 1~jurieB sustained by Minor Plaintiff Jere-v
Tasker in an accident on Defendants' pre.ises whiCh occurred on
August 15, 1987, the court: hereby ORDERS and DECREES the fOllo.inq,
1. Compromise of claim of Minor Plaintiff Jeremy Tasker
upon the teras set forth in the petition is hereby approved,
2. The toul settl,"""nt of $75,000.00 in p.y.ent. of all
clat.s of Minor Plaintiff Jeremy Taster.arlsinq out of the acel~
dent of August 15. 1987 shall be distrlbut&d'ae follOVSt
(a) .~ of the total s.t.tlellent.eu~c1 'value of ..
$75.000.00; or $37 "SOO~OO.sh"ll .'bCt uUlbed
by Respondents' insurance carrier. T.R.B. .
-1-
02/22/200G 1508 FAX S108838585
DRINKER 8IDDlE
L
IiJ O~I1' /018
':.':0
.. :'"
I",.ur.llee~IlY. fOT .,til.pJcIUI';'oi .':1\...
ailnui tl'i881i6d DY A1ls~t"'i,fe,IniNX:an~
COlItlaliy. and .aVnedb,YAlbtateBettlwrie;\
COrpOTationWlliChwill"J'o...ida,oua~.nte4id . . ..
future periodic .1'1l:pi8nte 'toM1nor.Pl.alnt'iff', .
Jeremy ,Tasker .i1i1 'lt1liidi:edln:thelli.stlailt ~... . ..'
petitionl .... ...... ... .. .
." '- ..'". . . ..,,',",
(bl rhere.ta.lni'ng ~ ofthesehl~ft(f~~,'...
$37,SOO.00 "hall. ~ distributed 'ail: fol1ow.i":~. ..
(1) Jere-r Taeter, Kinor Plaintiff
(sum to be placee! in a trust accoUnt
until Minor Plaintiff reaches the
ag. ot 18 years, at .II'1\1ch tie he
may withdraw the futtde and use th..
as he seeS tit with prior withdrawal
by Court order only) ,
$4 ;425.43 .
(2) Gerald Tasker, wage reimbursemont
(31 Shari Tasker, wage ret.bur~nt
.hi'097~S.2 ;.
. ..'$ 971.05
".'..-" "',
(4) Comaunity Anesthesia ASsociates, Ltd. $1,066.00
(5) ComlunHy Surgical Associates, Inc. . $4,940.00
(61 Going, Plank, Attorneys fee at . ,
33-1/3 fee of total settle..nt fund
value . . $25,OOO~OO
':, ,
Total
. . . .'
..U7;'500~Oo. . ,.
3. Any funds placed in " bank .account in ,trust for Mbor
:.i.'"
PIainUff JerelBY' Tasker shall beheld by the bank or Qi:h~i:;'tin4rieial
institution of petiti.oners' choieeltithsaldfunisil. to~.'~l.~:.in
"'''''''', '."
trust for Minor Plaintiff Jeremy .TAlIIter, .llorn Octobor .30.1!I80.,
-2-
. .
02/22/2008 ;5 08 HX 8108838585
DRINKER BIDDLE
L
~018/0H3
f
I
4. Tlleaett:.le_nt as henin apprOV'ed~J.1.li<lt lrL~gll
" .-,.' - , .'" .
settle_nl: of l:l!.e liability of al1DOfendants n'..a,:hiilr.:l~':!~itd,
. ",' , . .. - .' ~ ; ..: ... .-":: .: ,,: - \' -' "
~'.' ... ,; ,", .
their ins"t"ers for aU cau.ses of. 6o:tlon orclaiiil.t:liai:,:th'!"Plain-..
. .,:,d,n,.: ""'. ..:'...,' : .:':,": _", . ',; -' "..,"_.'. .'
tiffs or any other per.roft or pllrtyh~."e or ..airba.,,&;~is '.:.~il8i.lt,6f
.. ."-'i:,", ,_,:,:,~>,~:...:;,:,,~,,~:,~_,"".~ .'._,".\
the injudes 1I1.1$tained by Minor Plaintiff J.u:eIllYTaliker.bY'reaii"".
\; (",: ' ,,' , :, " '.: :. '.'. ',. ,.~
of the accident of August 15, 1987.
5. pt"oof of deposlt of any funds placed in trust for'
. . ..
Minor PlainUff shall be filed of record purlluanttoPli.1t.c. P. 2039Ib).
6. Upon approval of tne instant petition and pa,.ent of
all funds as contained therein. the ?etitionerssball enter 4.full
satisfaction of the withi;, aetion upon thed~ket.Ofthls"cOurt.
"7ao~'~
ter._. J.
Attest.
fJE1IUW~
.o>!,","'".....'~".lO"-"':~...;;
~~~~~l!'~:~ ~~:; ~~.!,'. ~" ..,
;~~~r:~.~~~l,~:~::
_...."';~"~.i....:.;...; ,...'.
~1~'~"...AI..,.J"~~"".. ,tgi'~""< $~
:!1"1t! ;;i~iA..',:!S~
-3-
IN RE: PETITION OF JEROMEY
TASKER, a/kJa JEREMEY
MICHAEL TASKER, for Approval
Of Transfer of Structured Settlement:
Payment Rights
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
06-473 CIVIL TERM
IN RE: PETITION TO APPROVE TRANSER OF STRUCTURED
SETTLEMENT PAYMENT RIGHTS
ORDER OF COURT
AND NOW, after hearing on this 24'h day of February, 2006, the Court finds that
the requested transfer complies with the requirements of the Structured Settlement
Protection Act, and does not contravene any of Federal or State statutes or regulations,
and that the transfer is in the best interest of Jeromey Tasker, accordingly, the Petition
for Approval of Transfer of Structured Settlement Payment Rights is GRANTED.
By the Court,
,,~ -t ~
M. L. Ebert, Jr.,
Allen D. Moyer, Esquire
8150 Derry Street
Harrisburg, PA 17111-5260
for Jeromey Tasker
'Up<f .0<4<:h<l. ;;l, J 1. tit....
C).v'
bas
',I,.
') I
.,
iil