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JAMES R. FELTON, ESQ. (State Bar No. 138767) Superior Court
of California
jfelton@ gblawllp.com County of Butte
G&B LAW, LLP
16000 Ventura Boulevard, Suite 1000
Encino, California 91436
10/25/2023
Tel: (818) 382-6200 + Fax: (818) 986-6534
Attorneys for Petitioner
J.G. Wentworth Originations, LLC
“ WZ
) Deputy
Electronical ILED
SUPERIOR COURT OF THE STATE OF CALIFORNIA
FOR THE COUNTY OF BUITE, NORTH BUITE COUNTY COURTHOUSE
10
11 IN RE Petition of: CASE No.: 23CV 03085
12 J.G. WENTWORTH ORIGINATIONS, LLC, UNLIMITED JURISDICTION
13 Petitioner VERIFIED PETITION FOR APPROVAL
FOR TRANSFER OF PAYMENT RIGHTS
14
[PURSUANT TO CAL. INS. CODE §
15 10134 ET SEQ.]
16 DATE: December 20, 2023
TIME: : 9:00 am.
17 DEPT:
18
COMES NOW J.G. Wentworth Originations, LLC (hereinafter “Petitioner” or “Transferee”)
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by the undersigned counsel, which respectfully petitions this Court pursuant to §§ 10134 et seq. of
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the Califomia Insurance Code, as amended, for approval of the transfer of certain structured
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settlement payment rights, and in support hereof, states as follows:
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I
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INTRODUCTION
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1 This Court has jurisdiction to hear this Petition and grant the relief requested herein
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pursuant to California Insurance Code § 10134(c)(1);
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2 That Petitioner is a limited liability company organized to do business under the laws
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of the State of California and brings this petition on behalf of party in interest, Jana Idilbi, pursuant
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS
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to Insurance Code §§ 10139.3(B), 10139.5(c). Jana Idilbi, (hereinafter “Payee” or “Transferor”) is an
adult, who resides in BUTTE COUNTY, California. Venue is proper in this Court pursuant to
Insurance Code § 10139.5(f)(1).
3 That Payee became entitled to certain structured settlement payments resulting from a
claim for damages arising in connection with a medical malpractice claim from their father. Payee
inherited this claim;
4. That the settlement agreed to by the Transferor provides for periodic structured
payments including, but not limited to, A) 10 monthly payments of $675.43 each, beginning on
December 17, 2023 and ending on September 17, 2024 B) 60 monthly payments of $815.69 each,
10 increasing at 3% annually, beginning on October 17, 2024 and ending on September 17, 2029;
11 5 That the “annuity issuer” who has issued an insurance contract used to fund the
12 structured settlement payments is Allstate Life Insurance Company n/k/a Everlake Life Insurance
13 Company;
14 6 That the “structured settlement obligor” with respect to the aforementioned structured
15 settlement payments is A llstate Settlement Corporation n/k/a Everlake Settlement Corporation;
16 7 That Transferor has agreed to sell, and Transferee, J.G. Wentworth Originations,
17 LLC, has agreed to purchase certain monthly payments as referenced within their proposed Purchase
18 Agreement. A true and correct copy of the proposed Purchase Agreement is attached hereto as
19 Exhibit “A” and incorporated herein by this reference;
20 8 That in order to effectuate the transfer of the payments set forth in the Purchase
21 Agreement, Petitioner J.G. Wentworth Originations, LLC must first obtain court approval of the
22 transfer pursuant to amended Califomia Insurance Code § 10134, et seq.;
23 9 That in order for this Court to approve said transfer, certain statutory provisions as set
24 forth in Califormia Insurance Code §§ 10134-10139.5 must be met. The applicable provisions of
25 these code sections are:
26 (A) The transferee provide the transferor with a separate written
27 disclosure statement 10 or more days prior to the effective date of a
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transfer agreement accurately completed with the information that applies
to the transfer agreement as required by Cal. Ins. Code, § 10136(b) (a true
and correct copy of the separate written disclosure statement is attached
hereto as Exhibit “B” and incorporated herein by this reference);
(B) Notice of the proposed transfer and the application for its
authorization must be filed with a court of competent jurisdiction, to wit, a
court in the county in which the payee resides, see Cal. Ins. Code, §
10139.5(f)(1), and served on all interested parties pursuant to Cal. Ins.
Code, § 10139.5(f)(2); and
10 (1) The transfer of the structured settlement payment
11 rights is fair and reasonable and in the best interest of the
12 payee, taking into account the welfare and support of his or
13 her dependents (Cal. Ins. Code, § 10137(a)
14 (2) The transfer complies with the requirements of Cal.
15 Ins. Code, §§ 10134 et seq., will not contravene other
16 applicable law (Cal. Ins. Code, § 10137(b), and is to be
17 approved by a court as provided in Cal. Ins. Code, §
18 10139.5.
19 It is submitted that all of the foregoing requirements either have been met or will be met prior
20 to any scheduled hearing, and the Petitioner respectfully requests that this Court approve the transfer
21 of the structured settlement payments that are the subject of this Petition.
22 IL
23 REQUIREMENTS OF CALIFORNIA INSURANCE CODE § 10136(b) HAVE BEEN MET
24 @ISCLOSURE TO PAYEE)
25 Califormia Insurance Code § 10136(b) requires that at least ten days prior to the effective date
26 of the transfer agreement, the transferee shall provide the payee with a separate written disclosure
27 statement. The disclosure statement must be in at least 12-point type unless otherwise indicated and
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS
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accurately completed with the information that applies to the transfer agreement in a form
substantially similar to that set forth in California Insurance Code § 10136(b). The required separate
written disclosure is attached hereto as Exhibit “B” and incorporated herein by this reference.
Ti.
THE TRANSFER OF THE STRUCTURED SETTLEMENT PAYMENT RIGHTS IS FAIR
AND REASONABLE AND IN THE BEST INTEREST OF THE PAYEE
Califomia Insurance Code § 10137(a) requires that the transfer of the structured settlement
payment rights is fair and reasonable and in the best interest of the Payee, taking into account the
welfare and support of Payee’s dependents.
10 It is submitted that the best interest of Payee would be served by granting the relief requested
11 herein because the original structured settlement entered into by Payee’s father on or about 1984 was
12 intended as compensation for a medical malpractice claim. Payee inherited this claim.
13 Payee is 42 years old, married to Jeremiah Corlin with no minor children as will be set forth
14 in the declaration to be filed in this matter. Payee is currently unemployed. If approved, Payee will
15 receive $30,500.00 from this transaction. Payee feels it is in their best interest to enter into this
16 transaction with the Petitioner and sell a portion of their underlying annuity payments so that they
17 can have the financial means to pay off their Time Share to Hilton Honors, Discover and Capital
18 One Credit Cards as will be set forth in the declaration to be filed in this matter.
19 It is submitted that the funds received from the transaction contemplated in the Purchase
20 Agreement can be better used today to provide for the foregoing, rather than to provide support to
21 Payee several years from now.
22 Payee has been advised in writing to seek independent professional advice regarding the
23 transfer and has either received that advice or knowingly waived that advice in writing. A copy of
24 the Waiver is attached hereto as Exhibit “E”.
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IV.
REQUIREMENTS OF CALIFORNIA INSURANCE CODE § 10139.5()@) HAVE BEEN
MET (PROPER DOCUMENTS PRESENTED TO THIS COURT)
Califormia Insurance Code § 10139.5(f)(2) requires that a notice of the proposed transfer and
the application for its authorization be filed with the Court and served on all interested parties not
less than 20 days prior to the scheduled hearing on any petition for approval of a transfer of
structured settlement payment rights. This notice must include the following documents:
(1) A copy of the transferee’s current petition (which is this Petition) and information
regarding any other prior petition whether approved or withdrawn; that was filed with this court in
10 accordance with Califomia Insurance Code §10139.5(c)(6) (Section
VI, 7, if applicable);
11 (2) A copy of the proposed transfer agreement and disclosure form required by California
12 Insurance Code §10139.5(a) (Exhibit “A”);
13 (3) A listing of each of the payee’s dependents, together with each dependent’s age (see
14 Declaration);
15 (4) A copy of the disclosure required by California Insurance Code §10136(b) (Exhibit
“B”);
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17 (5) A copy of the annuity contract and a copy of any qualified assignment agreement, if
18 applicable (Exhibit “C”);
19 (6) A copy of the underlying settlement agreement, if available (Exhibit “D”);!
20 (7) Proof of Service showing compliance with the notification requirements of this
21 sections (Proof of Service to be filed after a hearing date and case number is obtained);
22 (8) Notification that any interested party is entitled to support, oppose, or otherwise
23 respond to the transferee’s application, either in person or by counsel, by submitting written
24 comments to the Court or by participating in the hearing;
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1 Payee is in the process of obtaining settlement documentation. Exhibit “D” will be
28 amended once/if it is received.
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(9) Notification of the time and place of the hearing and notification of the manner in
which and the time by which written responses to the application must be filed, which may not be
less than 15 days after service of the transferee’s notice, in order to be considered by the Court; and
(10) If the payee entered into the structured settlement at issue within five years prior to
the date of the transfer agreement, then the transferee shall provide notice to the payee's attorney of
record at the time the structured settlement was created;
Vv.
REQUIREMENTS OF CALIFORNIA INSURANCE CODE § 10139.5(h) HAVE BEEN MET
(ADVISORY STATEMENT TO PAYEE OF RIGHT TO SEEK INDEPENDENT COUNSEL
10 AND FINANCIAL ADVICE INCONNECTION WITH TRANSFER)
11 California Insurance Code § 10139.5(h) requires that no later than the time of filing of the
12 Petition for court approval, the Transferee shall advise the payee of the payee’s right to seek
13 independent counsel and financial advice in connection with the Transferee’s petition for court
14 approval of the transfer agreement, and that the Transferee shall further advise the payee that if the
15 payee retains counsel, a licensed certified public accountant, or a licensed actuary in connection with
16 a petition for an order approving the transfer agreement, then the Transferee shall pay the fees of the
17 payee’s counsel, accountant, or actuary, regardless of whether the transfer agreement is approved,
18 and regardless of whether the attorney, accountant, or actuary files any document or appears at the
19 hearing on the application for transfer, in an aggregate amount not to exceed one thousand five
20 hundred dollars ($1,500). Further, that such advice may not be provided by an accountant, counsel,
21 or actuary of the Transferee (Exhibit “B”).
22 It is submitted to this Court that this Petition, the Notice of Petition attached hereto, and the
23 advisory statement provided to the payee all comply with and satisfy the requirements of California
24 Insurance Code § 10139.5.
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VI
ADDITIONAL FACTORS PROMOTE THE GRANTING OF THIS PETITION
As of January 1, 2010, California Insurance Code section 10139.5 was amended to give the
Court additional factors to consider in determining whether to grant a Petition. As already set forth
above or as now set forth below, this Petition will either address those requirements that are
applicable and how such requirements support the granting of the Petition or that such additional
considerations do not apply.
1 Payee’s Financial Condition:
Payee is currently unemployed.
10 2 Whether the Payee is transferring Monthly or Lump Sum or All or a Portion of the
11 Future Payments:
12 Payee is transferring A) 10 monthly payments of $675.43 each, beginning on
13 December 17, 2023 and ending on September 17, 2024 B) 60 monthly payments of $815.69 each,
14 increasing at 3% annually, beginning on October 17, 2024 and ending on September 17, 2029.
15 There are future payments. Payee will be receiving $30,500.00 from this transaction.
16 3. Whether when the settlement was completed, the future periodic payment(s) that are
17 the subject of the proposed transfer were intended to pay for the future medical care and treatment of
18 the payee relating to injuries sustained by the payee in the incident that was the subject of the
19 settlement and whether the payee still needs those future payments to pay for that future care and
20 treatment.
21 The future periodic payment(s) that are the subject of the proposed transfer were not
22 intended to pay for the future medical care and treatment.
23 4. Whether when the settlement was completed, the future periodic payment(s) that are
24 the subject of the proposed transfer were intended to provide for the necessary living expenses of the
25 payee and whether the payee still needs the future structured settlement payments to pay for future
26 necessary living expenses.
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The future periodic payment(s) that are the subject of the proposed transfer were not
intended to provide for necessary living expenses.
5 Whether the payee is, at the time of the proposed transfer, likely to require future
medical care and treatment for the injuries that the payee sustained in connection with the incident
that was the subject of the settlement and whether the payee lacks other resources, including
insurance sufficient to cover those future medical expenses.
The future periodic payment(s) that are the subject of the proposed transfer were not
intended to provide for medical care and treatment.
6 Whether the payee has other means of income or support, aside from the structured
10 settlement payments that are the subject of the proposed transfer, sufficient to meet the payee’s
11 future financial obligations for maintenance and support of the payee’s dependents, specifically
12 including, but not limited to, the payee’s child support obligations, if any. The payee shall disclose
13 to the transferee and the court Payee’s court-ordered child support or maintenance obligations for the
14 court’s considerations.
15 Payee is currently unemployed. Payee has no court-ordered child support or
16 maintenance obligations.
17 7 Whether the payee completed previous transactions involving the payee’s structured
18 settlement payments and the timing and size of the previous transactions and whether the payee was
19 satisfied with any previous transaction.
20 Payee has not completed previous transactions involving the payee’s structured
21 settlement payments.
22 8 Whether the transferee attempted previous transactions involving the payee’s
23 structured settlement payments that were denied, or that were dismissed or withdrawn prior to a
24 decision on the merits, within the past five years.
25 Payee has not attempted previous transactions involving the payee’s structured
26 settlement payments that were denied, or that were dismissed or withdrawn.
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS
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9 Whether, to the best of the transferee’s knowledge after making inquiry with the
payee, the payee has attempted structured settlement payment transfer transactions with another
person or entity, other than the transferee, that were denied, or which were dismissed or withdrawn
prior to a decision on the merits, within the past five years.
Not applicable. See question No. 8 above.
10. Whether the payee, or her family or dependents, are in or are facing a hardship
situation.
Payee is facing a hardship situation. Payee would like to enter into this transaction
with the Petitioner and sell a portion of their underlying annuity payments so that they can have the
10 financial means to pay off their Time Share to Hilton Honors, Discover and Capital One Credit
11 Cards.
12 11. Whether the payee received independent legal or financial advice regarding the
13 transaction.
14 Payee has been advised in writing to seek independent professional advice regarding
15 the transfer and has either received that advice or knowingly waived that advice in writing. A copy
16 of the Waiver is attached hereto as Exhibit “E”.
17 VIL
18 REQUIREMENTS OF CALIFORNIA INSURANCE CODE §§ 1 (©), 1 ©) C)
19 AND 10136(b) HAVE BEEN MET (AUTHORITY TO ASSESS AND DEDUCT EXPENSES
20 FROM PURCHASE PRICE)
21 “Expenses” are defined under section 10134(e) of the California Insurance Code as.
«“
22 . . [AJll broker’s commissions, service charges, application or
23 processing fees, closing costs, filing or administrative charges, legal fees,
24 notary fees and other commissions, fees, costs, and charges that a payee
25 would have to pay to transfer the structured settlement payment rights of a
26 structured settlement agreement or that would be deducted from the gross
27 consideration that would be paid to the payee in connection with the
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS
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transfer of the structured settlement payment rights of a structured
settlement agreement.”
A transferee may deduct “expenses” from the gross purchase price to be paid to a payee. To
do so: “The aggregate amount of all expenses, if any, to be deducted from the purchase price to be
paid to the payee in exchange for the payments to be transferred, and an itemization of all expenses
by type and amount” must be set forth “clear and conspicuously, and in no less than 12-point type.”
(See Cal. Ins. Code, §§ 10136(c) and 10136(c)(4).)
Moreover, 10136(b) described how to “clear and conspicuously” set forth “expenses:
“Ten or more days before the payee executes a transfer agreement, the transferee
10 shall provide the payee with a separate written disclosure statement, accurately
11 completed with the information that applies to the transfer agreement .. . in at
12 least 12-point type unless otherwise indicated . . . [Further] “To figure the net
13 amount we are paying, we have charged you for the following expenses:
14 (itemize in a list by type and amount) for a total of $ in expenses.”
15 (emphasis added)
16 In the case pending before this Court, all “expenses” to be deducted from the purchase price
17 are itemized by type and amount in 14-point bold font in the separate written disclosure attached
18 hereto as Exhibit “B” and are also set forth in 14-point bold font in the Purchase A greement attached
19 hereto as Exhibit “A”. Both Exhibits “A” and “B” are incorporated herein by reference. The
20 “types” of expenses itemized in both Exhibits “A” and “B” are based on the definitions of expenses
21 set forth in section 10134(e).
22 Exhibit “B”, the disclosure statement, was provided to the payee in compliance with the
23 requirements of California Insurance Code § 10136, and the payee has also acknowledged the
24 deduction of the expenses.
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS
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VII.
“FILING AND RELATED EXPENSES” ARE NOT “COURT COSTS AND FILING FEES”
AS DESCRIBED IN SECTION 10139.5q) OF THE CALIFORNIA ,INSURANCE CODE
Section 10139.5(g) of the California Insurance Code provides that: “All court costs and filing
fees shall be paid by the transferee”. All court costs and filing fees related to the filing of the instant
Petition have been paid by the transferee and are not being deducted from the gross purchase price.
Ix.
CONCLUSION
Petitioner respectfully requests that upon fulfillment of all disclosures and notices set forth
10 under Califomia Insurance Code §§ 10134, et seq., this Court enter an Order approving the transfer
11 agreement attached hereto as Exhibit “A” by and between Transferor, and Transferee.
12 Dated: October 25, 2023 G&BL , LLP
13
14 By: a
JA R. FELTON
15 Attombys for Petitioner
J.G mtworth Originations, LLC
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS
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Transfer of Structured Settlement Payments: Jana Idilbi
Verification
I, Michael Rodden, Vice President of J.G. Wentworth Originations, LLC, am familiar
with the contracts utilized and the procedures adhered to in the course of transferring structured
settlement benefits, and I hereby verify that all of the conditions of Section 10136, 10137 and
10138 of the law governing the transfer of structured settlement payments (Chapter 624) have
been complied with.
I declare under penalty of perjury pursuant to the laws of the State of California that the
foregoing is true and correct. Executed October 24, 2023.
pal oe
Michael Rodden
EXHIBIT A
DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8
Account ID: 401431
CALIFORNIA PURCHASE CONTRACT
This is a Purchase Contract (“Contract”) for the sale of structured settlement payments between
Jana Idilbi (You, Your), and (We, Us, Our)
>
BACKGROUND
In connection with the resolution of a personal injury claim, You or someone acting for You,
signed a Settlement Agreement that entitles You to receive certain future payments (“Settlement
Payments”), according to a set schedule.
Those Settlement Payments are being paid to You from an annuity policy (“Annuity Policy”) purchased
by the Person responsible for making the Settlement Payments to You (“Obligor’”).
Rather than wait for the Settlement Payments to be made to You in the future, You want to sell all or
some of those Settlement Payments (“Purchased Payments”) to Us now for a lump sum.
DEFINED WORDS
Certain words used in this Contract have specific meanings, shown below.
Affiliate An entity controlled by, controlling, or under common control with, another
entity.
Annuity Policy The policy purchased by the Obligor to ensure that the Settlement Payments are
made to You as required by the Settlement Agreement.
Closing Documents Any documents necessary to carry out the purchase of the Purchased
Payments, other than the “Contract or Contract Documents” as defined
below.
Contract or Contract
Documents Collectively, only this Contract and the Disclosure Statement.
Contract Date The date Your signature at the end of this Contract is E-signed and date
stamped. However, if You happen to sign this Contract before the number
of days stated at the end of Your Disclosure Statement for waiting has
passed, You will have no obligation under Your Contract until that time has
passed.
Court Order A legally binding ruling issued by a judge or properly empowered administrative
officer, approving the sale of the Purchased Payments to Us (“Court Approval”).
Disclosure Statement The document which identifies for You, the Purchased Payments, expenses,
PURCHASE CONTRACT FORM 1
DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8
Account ID: 401431
Purchase Price and various other disclosures.
Encumbrance Any claim, right, lien, policy loan, or restriction. In addition, this includes
any limits on rights of ownership (such as the use, voting, transfer, receipt
of income, etc.).
Funding Date The date We pay You the Net Purchase Price.
Issuer The insurance company that issued the Annuity Policy.
Obligor The Person who is obligated to make payments to You under the Settlement
Agreement.
Party One of You or Us. Parties means both You and Us.
Person Any natural person or legal entity.
Purchased Payments Only those certain payments that We are purchasing from You under this
Contract.
Purchase Price:
Gross Purchase Price The amount shown as the “gross amount payable to seller (You)”
in Section 10 of this Contract. This is the sum We have agreed to
pay You before any deductions as set forth in the Contract Documents
Net Purchase Price The amount shown as the “net amount paid to seller (You)” in Section
10 of this Contract. This is the sum We have agreed to pay
You after any deductions as set forth in the Contract Documents.
Settlement Agreement The agreement that You and the Obligor signed to resolve Your personal
injury claim.
Settlement Payments All of the payments that the Obligor has agreed to make to You in the
Settlement Agreement.
We, Our, or Us , along with any of its
successors, assigns, and designees. Some of the Contract Documents or
Closing Documents may refer to Us as the purchaser.
You or Your The Person named on this Contract’s first page. Some of the Contract
Documents or Closing Documents may refer to You as the seller.
You and We agree as follows:
1 SALE OF THE PURCHASED PAYMENTS
A Upon the signing of this Contract and subject to certain conditions including Court Approval,
You sell, transfer and assign to Us the right to receive the Purchased Payments specifically
PURCHASE CONTRACT FORM 1
DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8
Account ID: 401431
identified in the Disclosure Statement.
We will pay You the Net Purchase Price as agreed to in the Contract Documents, subject to certain
conditions, including meeting Our underwriting requirements, Court Approval and satisfactory
completion of the Closing Documents. We will do this in exchange for You:
. selling the Purchased Payments to Us;
changing the beneficiary of the Annuity Policy to Your estate and not changing it again
until We have been paid all of the Purchased Payments;
having any current beneficiaries waive their rights to the Purchased Payments; and
fulfilling Your promises under this Contract.
If We are buying only a portion of Your payments, this will have no effect upon Your rights in
the unsold portion. You will continue to receive the unsold portion unless You have already
sold or encumbered that portion. However, sometimes the Issuer, the Obligor or the court may
require Us to receive the entire amount of Your payment. If so, We will then forward the
portion of the payment still due to You and You hereby agree to this payment servicing
arrangement.
2. PURCHASE PRICE
A The Gross and Net Purchase Prices are shown in Section 10 of this Contract and are fair and
acceptable to You and Us.
We will pay You the Net Purchase Price in the manner You designate for Us in exchange for the
following payments (Purchased Payments):
A) 10 monthly payments of $675.43 each, beginning on December 17, 2023 and ending on
September 17, 2024 B) 60 monthly payments of $815.69 each, increasing at 3% annually, beginning on
October 17, 2024 and ending on September 17, 2029
[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]
PURCHASE CONTRACT FORM 1
DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8
Account ID: 401431
Cc Before we pay You, You agree that We will adjust for the following amounts, if applicable:
. Purchased Payments Owed to Us — The Issuer may have already paid You some of the
Purchased Payments before We have paid You for them. If that happens, We will
deduct the amount of those Purchased Payments.
Holdbacks — Due to possible delays in the Issuer beginning to make the Purchased
Payments to Us instead of You, We will hold back an amount equal to any Purchased
Payments that the Issuer owes Us post Court Approval, that are due within 90 days of
the Funding Date. If We subsequently receive those particular Purchased Payments
directly, We will return the amount of any related holdback to You.
Payment of Debts Owed — If You owe any past due child support, bankruptcy payoffs
or taxes, or have any judgments or liens against You or Your assets, We may pay those
amounts and deduct them from the amount We pay You and You hereby provide Us
with specific authority to take such action. We will provide You with notice of the
amounts that We are going to pay, prior to actual payment.
If any Purchased Payments are mistakenly sent to You after We have paid You for them, You will
immediately contact Us. If We then determine that any deductions or holdbacks as set forth above
are not enough to reimburse Us, We will advise You of the amount You owe Us. You agree to
immediately send that amount to Us by bank or certified check.
3. YOUR REPRESENTATIONS AND WARRANTIES
You represent and warrant to Us the following:
A You understand that THIS IS A SALE AND NOT A LOAN.
B The Annuity Policy is in full force, You are the sole and undisputed recipient of the right to the
Purchased Payments, have the right to sell them, free and clear of any Encumbrances, and have not
previously sold any of the Purchased Payments to any other Person.
You understand that Court Approval is required for this purchase; and You agree to fully
cooperate with Us to obtain that approval.
You gave Us all requested information and signed all documents necessary to complete the
purchase. Every statement made by You in the Contract Documents and Closing Documents is
true and complete.
No law, divorce decree or other legal obstacle:
. requires You to keep the Purchased Payments for the benefit of a current or former spouse,
dependent children, or other Person; or
legally prevents You from contracting with Us, selling the Purchased Payments or changing
the Annuity Policy’s beneficiary.
F Either:
PURCHASE CONTRACT FORM 1
DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8
Account ID: 401431
. You have never filed for bankruptcy, will not do so before the Funding Date and there are no
lawsuits or efforts by any of Your creditors to put You into bankruptcy or take any of the
Purchased Payments; or
If You filed for bankruptcy, the Purchased Payments were not subject to the claims of Your
creditors. You will give Us a copy of any of Your bankruptcy documents that We request
including evidence of a final bankruptcy payoff or case closing, if any.
We can rely on Your representations, warranties, and promises in this Contract. These
representations, warranties, and promises are for Our benefit and the benefit of any future owners of
the Purchased Payments. You understand that Our reliance on any intentional misrepresentation by
You may result in Our enforcing Our rights against You in court.
You had enough time to consider the sale of the Purchased Payments, understand the terms of the
Contract Documents and Closing Documents, are of legal contracting age and sound mind, not under
the influence of drugs or alcohol, and freely and voluntarily, enter into this Contract and agree to all
of its terms.
You were advised by Us to obtain independent professional advice regarding any federal and state
income tax consequences arising from the proposed transfer and We may not refer You to any
specific advisor for that purpose.
We did not provide tax, financial, or legal advice to You about this Contract and advised you that
We may not refer You to any specific attorney for such purpose.
If You are married, Your spouse understands all of the terms and conditions of this Contract
including, but not limited to the fact that after the Funding Date, You (and Your spouse) will not
receive the same amount of money on the same payment schedule as You would have received
under the Annuity Policy. Your spouse has been provided with all information relating to the
transaction and has had every opportunity to review the terms of the transaction and to seek any
advice relating thereto. Your Spouse also understands that he or she will be giving up any property
or contract rights that he or she may have in the Purchased Payments.
We may sell, transfer, or assign Our right to the Purchased Payments in a sale, securitization, or
other financing transaction (resale). Any resale would involve disclosing certain information about
You (including Your personal information) to the parties to a resale.
Any future owner of the right to the Purchased Payments will have all of the same rights We have,
including the right to the duties You owe Us under this Contract. This includes the right to make a
claim against You for violating any of the representations, warranties, or promises You made in
this Contract.
You acknowledge and understand that this transaction does not create a cause of action on Your
part against the Issuer (or other payor) funding the Purchased Payments.
4. YOUR PROMISES TO US
PURCHASE CONTRACT FORM 1
DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8
Account ID: 401431
Before and after the Funding Date:
A You will tell us right away if Your address or telephone number changes and do
everything necessary, including completing and signing all Documents to:
¢ sell the right to the Purchased Payments to Us;
¢ change the beneficiary as
Preview
JAMES R. FELTON, ESQ. (State Bar No. 138767) Superior Court of California jfelton@ gblawllp.com County of Butte G&B LAW, LLP 16000 Ventura Boulevard, Suite 1000 Encino, California 91436 10/25/2023 Tel: (818) 382-6200 + Fax: (818) 986-6534 Attorneys for Petitioner J.G. Wentworth Originations, LLC “ WZ ) Deputy Electronical ILED SUPERIOR COURT OF THE STATE OF CALIFORNIA FOR THE COUNTY OF BUITE, NORTH BUITE COUNTY COURTHOUSE 10 11 IN RE Petition of: CASE No.: 23CV 03085 12 J.G. WENTWORTH ORIGINATIONS, LLC, UNLIMITED JURISDICTION 13 Petitioner VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAYMENT RIGHTS 14 [PURSUANT TO CAL. INS. CODE § 15 10134 ET SEQ.] 16 DATE: December 20, 2023 TIME: : 9:00 am. 17 DEPT: 18 COMES NOW J.G. Wentworth Originations, LLC (hereinafter “Petitioner” or “Transferee”) 19 by the undersigned counsel, which respectfully petitions this Court pursuant to §§ 10134 et seq. of 20 the Califomia Insurance Code, as amended, for approval of the transfer of certain structured 21 settlement payment rights, and in support hereof, states as follows: 22 I 23 INTRODUCTION 24 1 This Court has jurisdiction to hear this Petition and grant the relief requested herein 25 pursuant to California Insurance Code § 10134(c)(1); 26 2 That Petitioner is a limited liability company organized to do business under the laws 27 of the State of California and brings this petition on behalf of party in interest, Jana Idilbi, pursuant 28 1 VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS 2401354.1 - 3046414875, to Insurance Code §§ 10139.3(B), 10139.5(c). Jana Idilbi, (hereinafter “Payee” or “Transferor”) is an adult, who resides in BUTTE COUNTY, California. Venue is proper in this Court pursuant to Insurance Code § 10139.5(f)(1). 3 That Payee became entitled to certain structured settlement payments resulting from a claim for damages arising in connection with a medical malpractice claim from their father. Payee inherited this claim; 4. That the settlement agreed to by the Transferor provides for periodic structured payments including, but not limited to, A) 10 monthly payments of $675.43 each, beginning on December 17, 2023 and ending on September 17, 2024 B) 60 monthly payments of $815.69 each, 10 increasing at 3% annually, beginning on October 17, 2024 and ending on September 17, 2029; 11 5 That the “annuity issuer” who has issued an insurance contract used to fund the 12 structured settlement payments is Allstate Life Insurance Company n/k/a Everlake Life Insurance 13 Company; 14 6 That the “structured settlement obligor” with respect to the aforementioned structured 15 settlement payments is A llstate Settlement Corporation n/k/a Everlake Settlement Corporation; 16 7 That Transferor has agreed to sell, and Transferee, J.G. Wentworth Originations, 17 LLC, has agreed to purchase certain monthly payments as referenced within their proposed Purchase 18 Agreement. A true and correct copy of the proposed Purchase Agreement is attached hereto as 19 Exhibit “A” and incorporated herein by this reference; 20 8 That in order to effectuate the transfer of the payments set forth in the Purchase 21 Agreement, Petitioner J.G. Wentworth Originations, LLC must first obtain court approval of the 22 transfer pursuant to amended Califomia Insurance Code § 10134, et seq.; 23 9 That in order for this Court to approve said transfer, certain statutory provisions as set 24 forth in Califormia Insurance Code §§ 10134-10139.5 must be met. The applicable provisions of 25 these code sections are: 26 (A) The transferee provide the transferor with a separate written 27 disclosure statement 10 or more days prior to the effective date of a 28 2 VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS 2401354.1 - 3046414875, transfer agreement accurately completed with the information that applies to the transfer agreement as required by Cal. Ins. Code, § 10136(b) (a true and correct copy of the separate written disclosure statement is attached hereto as Exhibit “B” and incorporated herein by this reference); (B) Notice of the proposed transfer and the application for its authorization must be filed with a court of competent jurisdiction, to wit, a court in the county in which the payee resides, see Cal. Ins. Code, § 10139.5(f)(1), and served on all interested parties pursuant to Cal. Ins. Code, § 10139.5(f)(2); and 10 (1) The transfer of the structured settlement payment 11 rights is fair and reasonable and in the best interest of the 12 payee, taking into account the welfare and support of his or 13 her dependents (Cal. Ins. Code, § 10137(a) 14 (2) The transfer complies with the requirements of Cal. 15 Ins. Code, §§ 10134 et seq., will not contravene other 16 applicable law (Cal. Ins. Code, § 10137(b), and is to be 17 approved by a court as provided in Cal. Ins. Code, § 18 10139.5. 19 It is submitted that all of the foregoing requirements either have been met or will be met prior 20 to any scheduled hearing, and the Petitioner respectfully requests that this Court approve the transfer 21 of the structured settlement payments that are the subject of this Petition. 22 IL 23 REQUIREMENTS OF CALIFORNIA INSURANCE CODE § 10136(b) HAVE BEEN MET 24 @ISCLOSURE TO PAYEE) 25 Califormia Insurance Code § 10136(b) requires that at least ten days prior to the effective date 26 of the transfer agreement, the transferee shall provide the payee with a separate written disclosure 27 statement. The disclosure statement must be in at least 12-point type unless otherwise indicated and 28 3 VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS 2401354.1 - 3046414875, accurately completed with the information that applies to the transfer agreement in a form substantially similar to that set forth in California Insurance Code § 10136(b). The required separate written disclosure is attached hereto as Exhibit “B” and incorporated herein by this reference. Ti. THE TRANSFER OF THE STRUCTURED SETTLEMENT PAYMENT RIGHTS IS FAIR AND REASONABLE AND IN THE BEST INTEREST OF THE PAYEE Califomia Insurance Code § 10137(a) requires that the transfer of the structured settlement payment rights is fair and reasonable and in the best interest of the Payee, taking into account the welfare and support of Payee’s dependents. 10 It is submitted that the best interest of Payee would be served by granting the relief requested 11 herein because the original structured settlement entered into by Payee’s father on or about 1984 was 12 intended as compensation for a medical malpractice claim. Payee inherited this claim. 13 Payee is 42 years old, married to Jeremiah Corlin with no minor children as will be set forth 14 in the declaration to be filed in this matter. Payee is currently unemployed. If approved, Payee will 15 receive $30,500.00 from this transaction. Payee feels it is in their best interest to enter into this 16 transaction with the Petitioner and sell a portion of their underlying annuity payments so that they 17 can have the financial means to pay off their Time Share to Hilton Honors, Discover and Capital 18 One Credit Cards as will be set forth in the declaration to be filed in this matter. 19 It is submitted that the funds received from the transaction contemplated in the Purchase 20 Agreement can be better used today to provide for the foregoing, rather than to provide support to 21 Payee several years from now. 22 Payee has been advised in writing to seek independent professional advice regarding the 23 transfer and has either received that advice or knowingly waived that advice in writing. A copy of 24 the Waiver is attached hereto as Exhibit “E”. 25 26 27 28 4 VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS 2401354.1 - 3046414875, IV. REQUIREMENTS OF CALIFORNIA INSURANCE CODE § 10139.5()@) HAVE BEEN MET (PROPER DOCUMENTS PRESENTED TO THIS COURT) Califormia Insurance Code § 10139.5(f)(2) requires that a notice of the proposed transfer and the application for its authorization be filed with the Court and served on all interested parties not less than 20 days prior to the scheduled hearing on any petition for approval of a transfer of structured settlement payment rights. This notice must include the following documents: (1) A copy of the transferee’s current petition (which is this Petition) and information regarding any other prior petition whether approved or withdrawn; that was filed with this court in 10 accordance with Califomia Insurance Code §10139.5(c)(6) (Section VI, 7, if applicable); 11 (2) A copy of the proposed transfer agreement and disclosure form required by California 12 Insurance Code §10139.5(a) (Exhibit “A”); 13 (3) A listing of each of the payee’s dependents, together with each dependent’s age (see 14 Declaration); 15 (4) A copy of the disclosure required by California Insurance Code §10136(b) (Exhibit “B”); 16 17 (5) A copy of the annuity contract and a copy of any qualified assignment agreement, if 18 applicable (Exhibit “C”); 19 (6) A copy of the underlying settlement agreement, if available (Exhibit “D”);! 20 (7) Proof of Service showing compliance with the notification requirements of this 21 sections (Proof of Service to be filed after a hearing date and case number is obtained); 22 (8) Notification that any interested party is entitled to support, oppose, or otherwise 23 respond to the transferee’s application, either in person or by counsel, by submitting written 24 comments to the Court or by participating in the hearing; 25 26 27 1 Payee is in the process of obtaining settlement documentation. Exhibit “D” will be 28 amended once/if it is received. 5 VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS 2401354.1 - 3046414875, (9) Notification of the time and place of the hearing and notification of the manner in which and the time by which written responses to the application must be filed, which may not be less than 15 days after service of the transferee’s notice, in order to be considered by the Court; and (10) If the payee entered into the structured settlement at issue within five years prior to the date of the transfer agreement, then the transferee shall provide notice to the payee's attorney of record at the time the structured settlement was created; Vv. REQUIREMENTS OF CALIFORNIA INSURANCE CODE § 10139.5(h) HAVE BEEN MET (ADVISORY STATEMENT TO PAYEE OF RIGHT TO SEEK INDEPENDENT COUNSEL 10 AND FINANCIAL ADVICE INCONNECTION WITH TRANSFER) 11 California Insurance Code § 10139.5(h) requires that no later than the time of filing of the 12 Petition for court approval, the Transferee shall advise the payee of the payee’s right to seek 13 independent counsel and financial advice in connection with the Transferee’s petition for court 14 approval of the transfer agreement, and that the Transferee shall further advise the payee that if the 15 payee retains counsel, a licensed certified public accountant, or a licensed actuary in connection with 16 a petition for an order approving the transfer agreement, then the Transferee shall pay the fees of the 17 payee’s counsel, accountant, or actuary, regardless of whether the transfer agreement is approved, 18 and regardless of whether the attorney, accountant, or actuary files any document or appears at the 19 hearing on the application for transfer, in an aggregate amount not to exceed one thousand five 20 hundred dollars ($1,500). Further, that such advice may not be provided by an accountant, counsel, 21 or actuary of the Transferee (Exhibit “B”). 22 It is submitted to this Court that this Petition, the Notice of Petition attached hereto, and the 23 advisory statement provided to the payee all comply with and satisfy the requirements of California 24 Insurance Code § 10139.5. 25 26 27 28 6 VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS 2401354.1 - 3046414875 VI ADDITIONAL FACTORS PROMOTE THE GRANTING OF THIS PETITION As of January 1, 2010, California Insurance Code section 10139.5 was amended to give the Court additional factors to consider in determining whether to grant a Petition. As already set forth above or as now set forth below, this Petition will either address those requirements that are applicable and how such requirements support the granting of the Petition or that such additional considerations do not apply. 1 Payee’s Financial Condition: Payee is currently unemployed. 10 2 Whether the Payee is transferring Monthly or Lump Sum or All or a Portion of the 11 Future Payments: 12 Payee is transferring A) 10 monthly payments of $675.43 each, beginning on 13 December 17, 2023 and ending on September 17, 2024 B) 60 monthly payments of $815.69 each, 14 increasing at 3% annually, beginning on October 17, 2024 and ending on September 17, 2029. 15 There are future payments. Payee will be receiving $30,500.00 from this transaction. 16 3. Whether when the settlement was completed, the future periodic payment(s) that are 17 the subject of the proposed transfer were intended to pay for the future medical care and treatment of 18 the payee relating to injuries sustained by the payee in the incident that was the subject of the 19 settlement and whether the payee still needs those future payments to pay for that future care and 20 treatment. 21 The future periodic payment(s) that are the subject of the proposed transfer were not 22 intended to pay for the future medical care and treatment. 23 4. Whether when the settlement was completed, the future periodic payment(s) that are 24 the subject of the proposed transfer were intended to provide for the necessary living expenses of the 25 payee and whether the payee still needs the future structured settlement payments to pay for future 26 necessary living expenses. 27 28 7 VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS 2401354.1 - 3046414875, The future periodic payment(s) that are the subject of the proposed transfer were not intended to provide for necessary living expenses. 5 Whether the payee is, at the time of the proposed transfer, likely to require future medical care and treatment for the injuries that the payee sustained in connection with the incident that was the subject of the settlement and whether the payee lacks other resources, including insurance sufficient to cover those future medical expenses. The future periodic payment(s) that are the subject of the proposed transfer were not intended to provide for medical care and treatment. 6 Whether the payee has other means of income or support, aside from the structured 10 settlement payments that are the subject of the proposed transfer, sufficient to meet the payee’s 11 future financial obligations for maintenance and support of the payee’s dependents, specifically 12 including, but not limited to, the payee’s child support obligations, if any. The payee shall disclose 13 to the transferee and the court Payee’s court-ordered child support or maintenance obligations for the 14 court’s considerations. 15 Payee is currently unemployed. Payee has no court-ordered child support or 16 maintenance obligations. 17 7 Whether the payee completed previous transactions involving the payee’s structured 18 settlement payments and the timing and size of the previous transactions and whether the payee was 19 satisfied with any previous transaction. 20 Payee has not completed previous transactions involving the payee’s structured 21 settlement payments. 22 8 Whether the transferee attempted previous transactions involving the payee’s 23 structured settlement payments that were denied, or that were dismissed or withdrawn prior to a 24 decision on the merits, within the past five years. 25 Payee has not attempted previous transactions involving the payee’s structured 26 settlement payments that were denied, or that were dismissed or withdrawn. 27 28 8 VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS 2401354.1 - 3046414875, 9 Whether, to the best of the transferee’s knowledge after making inquiry with the payee, the payee has attempted structured settlement payment transfer transactions with another person or entity, other than the transferee, that were denied, or which were dismissed or withdrawn prior to a decision on the merits, within the past five years. Not applicable. See question No. 8 above. 10. Whether the payee, or her family or dependents, are in or are facing a hardship situation. Payee is facing a hardship situation. Payee would like to enter into this transaction with the Petitioner and sell a portion of their underlying annuity payments so that they can have the 10 financial means to pay off their Time Share to Hilton Honors, Discover and Capital One Credit 11 Cards. 12 11. Whether the payee received independent legal or financial advice regarding the 13 transaction. 14 Payee has been advised in writing to seek independent professional advice regarding 15 the transfer and has either received that advice or knowingly waived that advice in writing. A copy 16 of the Waiver is attached hereto as Exhibit “E”. 17 VIL 18 REQUIREMENTS OF CALIFORNIA INSURANCE CODE §§ 1 (©), 1 ©) C) 19 AND 10136(b) HAVE BEEN MET (AUTHORITY TO ASSESS AND DEDUCT EXPENSES 20 FROM PURCHASE PRICE) 21 “Expenses” are defined under section 10134(e) of the California Insurance Code as. «“ 22 . . [AJll broker’s commissions, service charges, application or 23 processing fees, closing costs, filing or administrative charges, legal fees, 24 notary fees and other commissions, fees, costs, and charges that a payee 25 would have to pay to transfer the structured settlement payment rights of a 26 structured settlement agreement or that would be deducted from the gross 27 consideration that would be paid to the payee in connection with the 28 9 VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS 2401354.1 - 3046414875 transfer of the structured settlement payment rights of a structured settlement agreement.” A transferee may deduct “expenses” from the gross purchase price to be paid to a payee. To do so: “The aggregate amount of all expenses, if any, to be deducted from the purchase price to be paid to the payee in exchange for the payments to be transferred, and an itemization of all expenses by type and amount” must be set forth “clear and conspicuously, and in no less than 12-point type.” (See Cal. Ins. Code, §§ 10136(c) and 10136(c)(4).) Moreover, 10136(b) described how to “clear and conspicuously” set forth “expenses: “Ten or more days before the payee executes a transfer agreement, the transferee 10 shall provide the payee with a separate written disclosure statement, accurately 11 completed with the information that applies to the transfer agreement .. . in at 12 least 12-point type unless otherwise indicated . . . [Further] “To figure the net 13 amount we are paying, we have charged you for the following expenses: 14 (itemize in a list by type and amount) for a total of $ in expenses.” 15 (emphasis added) 16 In the case pending before this Court, all “expenses” to be deducted from the purchase price 17 are itemized by type and amount in 14-point bold font in the separate written disclosure attached 18 hereto as Exhibit “B” and are also set forth in 14-point bold font in the Purchase A greement attached 19 hereto as Exhibit “A”. Both Exhibits “A” and “B” are incorporated herein by reference. The 20 “types” of expenses itemized in both Exhibits “A” and “B” are based on the definitions of expenses 21 set forth in section 10134(e). 22 Exhibit “B”, the disclosure statement, was provided to the payee in compliance with the 23 requirements of California Insurance Code § 10136, and the payee has also acknowledged the 24 deduction of the expenses. 25 26 27 28 10 VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS 2401354.1 - 3046414875, VII. “FILING AND RELATED EXPENSES” ARE NOT “COURT COSTS AND FILING FEES” AS DESCRIBED IN SECTION 10139.5q) OF THE CALIFORNIA ,INSURANCE CODE Section 10139.5(g) of the California Insurance Code provides that: “All court costs and filing fees shall be paid by the transferee”. All court costs and filing fees related to the filing of the instant Petition have been paid by the transferee and are not being deducted from the gross purchase price. Ix. CONCLUSION Petitioner respectfully requests that upon fulfillment of all disclosures and notices set forth 10 under Califomia Insurance Code §§ 10134, et seq., this Court enter an Order approving the transfer 11 agreement attached hereto as Exhibit “A” by and between Transferor, and Transferee. 12 Dated: October 25, 2023 G&BL , LLP 13 14 By: a JA R. FELTON 15 Attombys for Petitioner J.G mtworth Originations, LLC 16 17 18 19 20 21 22 23 24 25 26 27 28 11 VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAY MENT RIGHTS 2401354.1 - 3046414875, Transfer of Structured Settlement Payments: Jana Idilbi Verification I, Michael Rodden, Vice President of J.G. Wentworth Originations, LLC, am familiar with the contracts utilized and the procedures adhered to in the course of transferring structured settlement benefits, and I hereby verify that all of the conditions of Section 10136, 10137 and 10138 of the law governing the transfer of structured settlement payments (Chapter 624) have been complied with. I declare under penalty of perjury pursuant to the laws of the State of California that the foregoing is true and correct. Executed October 24, 2023. pal oe Michael Rodden EXHIBIT A DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8 Account ID: 401431 CALIFORNIA PURCHASE CONTRACT This is a Purchase Contract (“Contract”) for the sale of structured settlement payments between Jana Idilbi (You, Your), and (We, Us, Our) > BACKGROUND In connection with the resolution of a personal injury claim, You or someone acting for You, signed a Settlement Agreement that entitles You to receive certain future payments (“Settlement Payments”), according to a set schedule. Those Settlement Payments are being paid to You from an annuity policy (“Annuity Policy”) purchased by the Person responsible for making the Settlement Payments to You (“Obligor’”). Rather than wait for the Settlement Payments to be made to You in the future, You want to sell all or some of those Settlement Payments (“Purchased Payments”) to Us now for a lump sum. DEFINED WORDS Certain words used in this Contract have specific meanings, shown below. Affiliate An entity controlled by, controlling, or under common control with, another entity. Annuity Policy The policy purchased by the Obligor to ensure that the Settlement Payments are made to You as required by the Settlement Agreement. Closing Documents Any documents necessary to carry out the purchase of the Purchased Payments, other than the “Contract or Contract Documents” as defined below. Contract or Contract Documents Collectively, only this Contract and the Disclosure Statement. Contract Date The date Your signature at the end of this Contract is E-signed and date stamped. However, if You happen to sign this Contract before the number of days stated at the end of Your Disclosure Statement for waiting has passed, You will have no obligation under Your Contract until that time has passed. Court Order A legally binding ruling issued by a judge or properly empowered administrative officer, approving the sale of the Purchased Payments to Us (“Court Approval”). Disclosure Statement The document which identifies for You, the Purchased Payments, expenses, PURCHASE CONTRACT FORM 1 DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8 Account ID: 401431 Purchase Price and various other disclosures. Encumbrance Any claim, right, lien, policy loan, or restriction. In addition, this includes any limits on rights of ownership (such as the use, voting, transfer, receipt of income, etc.). Funding Date The date We pay You the Net Purchase Price. Issuer The insurance company that issued the Annuity Policy. Obligor The Person who is obligated to make payments to You under the Settlement Agreement. Party One of You or Us. Parties means both You and Us. Person Any natural person or legal entity. Purchased Payments Only those certain payments that We are purchasing from You under this Contract. Purchase Price: Gross Purchase Price The amount shown as the “gross amount payable to seller (You)” in Section 10 of this Contract. This is the sum We have agreed to pay You before any deductions as set forth in the Contract Documents Net Purchase Price The amount shown as the “net amount paid to seller (You)” in Section 10 of this Contract. This is the sum We have agreed to pay You after any deductions as set forth in the Contract Documents. Settlement Agreement The agreement that You and the Obligor signed to resolve Your personal injury claim. Settlement Payments All of the payments that the Obligor has agreed to make to You in the Settlement Agreement. We, Our, or Us , along with any of its successors, assigns, and designees. Some of the Contract Documents or Closing Documents may refer to Us as the purchaser. You or Your The Person named on this Contract’s first page. Some of the Contract Documents or Closing Documents may refer to You as the seller. You and We agree as follows: 1 SALE OF THE PURCHASED PAYMENTS A Upon the signing of this Contract and subject to certain conditions including Court Approval, You sell, transfer and assign to Us the right to receive the Purchased Payments specifically PURCHASE CONTRACT FORM 1 DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8 Account ID: 401431 identified in the Disclosure Statement. We will pay You the Net Purchase Price as agreed to in the Contract Documents, subject to certain conditions, including meeting Our underwriting requirements, Court Approval and satisfactory completion of the Closing Documents. We will do this in exchange for You: . selling the Purchased Payments to Us; changing the beneficiary of the Annuity Policy to Your estate and not changing it again until We have been paid all of the Purchased Payments; having any current beneficiaries waive their rights to the Purchased Payments; and fulfilling Your promises under this Contract. If We are buying only a portion of Your payments, this will have no effect upon Your rights in the unsold portion. You will continue to receive the unsold portion unless You have already sold or encumbered that portion. However, sometimes the Issuer, the Obligor or the court may require Us to receive the entire amount of Your payment. If so, We will then forward the portion of the payment still due to You and You hereby agree to this payment servicing arrangement. 2. PURCHASE PRICE A The Gross and Net Purchase Prices are shown in Section 10 of this Contract and are fair and acceptable to You and Us. We will pay You the Net Purchase Price in the manner You designate for Us in exchange for the following payments (Purchased Payments): A) 10 monthly payments of $675.43 each, beginning on December 17, 2023 and ending on September 17, 2024 B) 60 monthly payments of $815.69 each, increasing at 3% annually, beginning on October 17, 2024 and ending on September 17, 2029 [REMAINDER OF PAGE INTENTIONALLY LEFT BLANK] PURCHASE CONTRACT FORM 1 DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8 Account ID: 401431 Cc Before we pay You, You agree that We will adjust for the following amounts, if applicable: . Purchased Payments Owed to Us — The Issuer may have already paid You some of the Purchased Payments before We have paid You for them. If that happens, We will deduct the amount of those Purchased Payments. Holdbacks — Due to possible delays in the Issuer beginning to make the Purchased Payments to Us instead of You, We will hold back an amount equal to any Purchased Payments that the Issuer owes Us post Court Approval, that are due within 90 days of the Funding Date. If We subsequently receive those particular Purchased Payments directly, We will return the amount of any related holdback to You. Payment of Debts Owed — If You owe any past due child support, bankruptcy payoffs or taxes, or have any judgments or liens against You or Your assets, We may pay those amounts and deduct them from the amount We pay You and You hereby provide Us with specific authority to take such action. We will provide You with notice of the amounts that We are going to pay, prior to actual payment. If any Purchased Payments are mistakenly sent to You after We have paid You for them, You will immediately contact Us. If We then determine that any deductions or holdbacks as set forth above are not enough to reimburse Us, We will advise You of the amount You owe Us. You agree to immediately send that amount to Us by bank or certified check. 3. YOUR REPRESENTATIONS AND WARRANTIES You represent and warrant to Us the following: A You understand that THIS IS A SALE AND NOT A LOAN. B The Annuity Policy is in full force, You are the sole and undisputed recipient of the right to the Purchased Payments, have the right to sell them, free and clear of any Encumbrances, and have not previously sold any of the Purchased Payments to any other Person. You understand that Court Approval is required for this purchase; and You agree to fully cooperate with Us to obtain that approval. You gave Us all requested information and signed all documents necessary to complete the purchase. Every statement made by You in the Contract Documents and Closing Documents is true and complete. No law, divorce decree or other legal obstacle: . requires You to keep the Purchased Payments for the benefit of a current or former spouse, dependent children, or other Person; or legally prevents You from contracting with Us, selling the Purchased Payments or changing the Annuity Policy’s beneficiary. F Either: PURCHASE CONTRACT FORM 1 DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8 Account ID: 401431 . You have never filed for bankruptcy, will not do so before the Funding Date and there are no lawsuits or efforts by any of Your creditors to put You into bankruptcy or take any of the Purchased Payments; or If You filed for bankruptcy, the Purchased Payments were not subject to the claims of Your creditors. You will give Us a copy of any of Your bankruptcy documents that We request including evidence of a final bankruptcy payoff or case closing, if any. We can rely on Your representations, warranties, and promises in this Contract. These representations, warranties, and promises are for Our benefit and the benefit of any future owners of the Purchased Payments. You understand that Our reliance on any intentional misrepresentation by You may result in Our enforcing Our rights against You in court. You had enough time to consider the sale of the Purchased Payments, understand the terms of the Contract Documents and Closing Documents, are of legal contracting age and sound mind, not under the influence of drugs or alcohol, and freely and voluntarily, enter into this Contract and agree to all of its terms. You were advised by Us to obtain independent professional advice regarding any federal and state income tax consequences arising from the proposed transfer and We may not refer You to any specific advisor for that purpose. We did not provide tax, financial, or legal advice to You about this Contract and advised you that We may not refer You to any specific attorney for such purpose. If You are married, Your spouse understands all of the terms and conditions of this Contract including, but not limited to the fact that after the Funding Date, You (and Your spouse) will not receive the same amount of money on the same payment schedule as You would have received under the Annuity Policy. Your spouse has been provided with all information relating to the transaction and has had every opportunity to review the terms of the transaction and to seek any advice relating thereto. Your Spouse also understands that he or she will be giving up any property or contract rights that he or she may have in the Purchased Payments. We may sell, transfer, or assign Our right to the Purchased Payments in a sale, securitization, or other financing transaction (resale). Any resale would involve disclosing certain information about You (including Your personal information) to the parties to a resale. Any future owner of the right to the Purchased Payments will have all of the same rights We have, including the right to the duties You owe Us under this Contract. This includes the right to make a claim against You for violating any of the representations, warranties, or promises You made in this Contract. You acknowledge and understand that this transaction does not create a cause of action on Your part against the Issuer (or other payor) funding the Purchased Payments. 4. YOUR PROMISES TO US PURCHASE CONTRACT FORM 1 DocuSign Envelope ID: DA805DAE-BCF5-4DE4-AEAA-00A6489758D8 Account ID: 401431 Before and after the Funding Date: A You will tell us right away if Your address or telephone number changes and do everything necessary, including completing and signing all Documents to: ¢ sell the right to the Purchased Payments to Us; ¢ change the beneficiary as