On April 29, 2021 a
Exhibit,Appendix
was filed
involving a dispute between
J G Wentworth Originations Llc,
and
B B Ind,
B B Supplemental Needs Trust
A K A B.B. Individually,
B C Ind,
S B Trste
As Trustee Of The B.B. Supplemental Needs Trust And,
Talcott Resolution Cebsco,
Talcott Resolution Life Insurance Company,
for Special Proceedings - Other (transfer- structured sett)
in the District Court of Warren County.
Preview
FILED: WARREN COUNTY CLERK 04/29/2021 08:14 AM INDEX NO. EF2021-68968
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 04/29/2021
EXHIBIT B
FILED: WARREN COUNTY CLERK 04/29/2021 08:14 AM INDEX NO. EF2021-68968
Daru9gn Envelope ID: A2DD5A44-0C75-4DD4-8B8A-8D88B2FBF169
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 04/29/2021
Account ID: 1431591
Please complete and sign.
STATEMENT OF PROFESSIONAL REPRESENTATION
Please Choose Either Box A OR Box B Below.
After you have made your choice, SIGN AND DATE the appropriate box signature line.
YOU SHOULD SIGN ONLY ONE BOX - THE BOX YOU HAVE CHOSEN.
A. I HAVE BEEN ADVISED BY J.G. WENTWORTH ORIGINATIONS, LLC
("JGW") THAT I SHOULD OBTAIN INDEPENDENT PROFESSIONAL REPRESENTATION
CONCERNING THE LEGAL, TAX AND/OR FINANCIAL IMPLICATIONS OF THIS
TRANSACTION. I FULLY UNDERSTAND THE PURCHASE AGREEMENT AND THE
EFFECTS OF THE TRANSACTION AND I DO NOT WISH TO SEEK OUT SUCH
INDEPENDENT PROFESSIONAL REPRESENTATION.
DocuSignedby:
4/10/2021
USTEE OF ÏÏIE Date
EMENTAL NEEDS
TRUST AND A/K/A
B. IHAVE OBTAINED INDEPENDENT REPRESENTATION AND I FULLY UNDERSTAND
THE LEGAL, TAX AND/OR FINANCIAL IMPLICATIONS OF THE TRANSACTION,
THE PURCHASE AGREEMENT AND THE RELATED DOCUMENTS. I WAS NOT
REFERRED TO MY PROFESSIONAL ADVISOR BY JGW. THE NAME OF MY
PROFESSIONAL ADVISOR IS SET FORTH BELOW:
AS TRUSTEE OF THE Date
UPPLEMENTAL NEEDS
A/K/A
To Be Co...p:e:ed By Certified Professional Advisor
Only if you have signed Box B Above
Law Firm Name: Name of Professional:
Phone Number: (__) Attorney ID #
Address:
EIN #
I have personally met with and have provided indc;:cndent professional advice to in respect of the Purchase Contract with
JGW and the transaction contciardated thereby. as Trustee of th E:;;¹:rstal Needs Trust and
a/k/a Individually was re erred to me by the
Professional's Signature Date
ssc_cover_1etter_no_hold_1ifeanly-doc C 2011 J G Wentworth Onginations. LLC
Document Filed Date
April 29, 2021
Case Filing Date
April 29, 2021
Category
Special Proceedings - Other (transfer- structured sett)
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Preview
FILED: WARREN COUNTY CLERK 04/29/2021 08:14 AM INDEX NO. EF2021-68968 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 04/29/2021 EXHIBIT B FILED: WARREN COUNTY CLERK 04/29/2021 08:14 AM INDEX NO. EF2021-68968 Daru9gn Envelope ID: A2DD5A44-0C75-4DD4-8B8A-8D88B2FBF169 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 04/29/2021 Account ID: 1431591 Please complete and sign. STATEMENT OF PROFESSIONAL REPRESENTATION Please Choose Either Box A OR Box B Below. After you have made your choice, SIGN AND DATE the appropriate box signature line. YOU SHOULD SIGN ONLY ONE BOX - THE BOX YOU HAVE CHOSEN. A. I HAVE BEEN ADVISED BY J.G. WENTWORTH ORIGINATIONS, LLC ("JGW") THAT I SHOULD OBTAIN INDEPENDENT PROFESSIONAL REPRESENTATION CONCERNING THE LEGAL, TAX AND/OR FINANCIAL IMPLICATIONS OF THIS TRANSACTION. I FULLY UNDERSTAND THE PURCHASE AGREEMENT AND THE EFFECTS OF THE TRANSACTION AND I DO NOT WISH TO SEEK OUT SUCH INDEPENDENT PROFESSIONAL REPRESENTATION. DocuSignedby: 4/10/2021 USTEE OF ÏÏIE Date EMENTAL NEEDS TRUST AND A/K/A B. IHAVE OBTAINED INDEPENDENT REPRESENTATION AND I FULLY UNDERSTAND THE LEGAL, TAX AND/OR FINANCIAL IMPLICATIONS OF THE TRANSACTION, THE PURCHASE AGREEMENT AND THE RELATED DOCUMENTS. I WAS NOT REFERRED TO MY PROFESSIONAL ADVISOR BY JGW. THE NAME OF MY PROFESSIONAL ADVISOR IS SET FORTH BELOW: AS TRUSTEE OF THE Date UPPLEMENTAL NEEDS A/K/A To Be Co...p:e:ed By Certified Professional Advisor Only if you have signed Box B Above Law Firm Name: Name of Professional: Phone Number: (__) Attorney ID # Address: EIN # I have personally met with and have provided indc;:cndent professional advice to in respect of the Purchase Contract with JGW and the transaction contciardated thereby. as Trustee of th E:;;¹:rstal Needs Trust and a/k/a Individually was re erred to me by the Professional's Signature Date ssc_cover_1etter_no_hold_1ifeanly-doc C 2011 J G Wentworth Onginations. LLC