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1 JAMES R. FELTON, ESQ. (State Bar No. 138767)
jfelton@gblawllp.com
2 G&B LAW, LLP
16000 Ventura Boulevard, Suite 1000
3 Encino, California 91436
Tel: (818) 382-6200 • Fax: (818) 986-6534
4
5 Attorneys for Petitioner
J.G. Wentworth Originations, LLC
6
7
8 SUPERIOR COURT OF THE STATE OF CALIFORNIA
9 FOR THE COUNTY OF SANTA BARBARA, NORTH COUNTY, COOK DIVISION
10
11 IN RE Petition of: CASE NO.:
12 J.G. WENTWORTH ORIGINATIONS, LLC, UNLIMITED JURISDICTION
13 Petitioner VERIFIED PETITION FOR APPROVAL
FOR TRANSFER OF PAYMENT RIGHTS
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14 and
[PURSUANT TO CAL. INS. CODE §
15 BRYAN LEAL, 10134 ET SEQ.]
16 Real Party-In-Interest/ DATE:
Transferor TIME:
17 DEPT:
18
19 COMES NOW J.G. Wentworth Originations, LLC (hereinafter “Petitioner” or “Transferee”)
20 by the undersigned counsel, which respectfully petitions this Court pursuant to §§ 10134 et seq. of
21 the California Insurance Code, as amended, for approval of the transfer of certain structured
22 settlement payment rights, and in support hereof, states as follows:
23 I.
24 INTRODUCTION
25 1. This Court has jurisdiction to hear this Petition and grant the relief requested herein
26 pursuant to California Insurance Code § 10134(c)(1);
27 2. That Petitioner is a limited liability company organized to do business under the laws
28 of the State of California and brings this petition on behalf of party in interest, Bryan Leal, pursuant
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAYMENT RIGHTS
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1 to Insurance Code §§ 10139.3(B), 10139.5(c). Bryan Leal, (hereinafter “Payee” or “Transferor”) is
2 an adult, who resides in SANTA BARBARA COUNTY, California. Venue is proper in this Court
3 pursuant to Insurance Code § 10139.5(f)(1).
4 3. That in or about January 8, 2010, Payee, by and through their Guardian ad Litem
5 Lorena Cabrera, became entitled to certain structured settlement payments resulting from a claim for
6 damages arising in connection with a personal injury claim;
7 4. That the settlement agreed to by the Transferor provides for periodic structured
8 payments including, but not limited to, A) 1 payment of $12,178.00 on April 17, 2028 B) 1 payment
9 of $12,178.00 on April 17, 2029 C) 1 payment of $12,178.00 on April 17, 2030 D) 1 payment of
10 $12,178.00 on April 17, 2031;
11 5. That the “annuity issuer” who has issued an insurance contract used to fund the
12 structured settlement payments is Metropolitan Life Insurance Company;
13 6. That the “structured settlement obligor” with respect to the aforementioned structured
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14 settlement payments is MetLife Tower Resources Group, Inc.;
15 7. That Transferor has agreed to sell, and Transferee, J.G. Wentworth Originations,
16 LLC, has agreed to purchase certain monthly lump sum payments as referenced within their
17 proposed Purchase Agreement. A true and correct copy of the proposed Purchase Agreement is
18 attached hereto as Exhibit “A” and incorporated herein by this reference;
19 8. That in order to effectuate the transfer of the payments set forth in the Purchase
20 Agreement, Petitioner J.G. Wentworth Originations, LLC must first obtain court approval of the
21 transfer pursuant to amended California Insurance Code § 10134, et seq.;
22 9. That in order for this Court to approve said transfer, certain statutory provisions as set
23 forth in California Insurance Code §§ 10134-10139.5 must be met. The applicable provisions of
24 these code sections are:
25 (A) The transferee provide the transferor with a separate written
26 disclosure statement 10 or more days prior to the effective date of a
27 transfer agreement accurately completed with the information that applies
28 to the transfer agreement as required by Cal. Ins. Code, § 10136(b) (a true
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAYMENT RIGHTS
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1 and correct copy of the separate written disclosure statement is attached
2 hereto as Exhibit “B” and incorporated herein by this reference);
3 (B) Notice of the proposed transfer and the application for its
4 authorization must be filed with a court of competent jurisdiction, to wit, a
5 court in the county in which the payee resides, see Cal. Ins. Code, §
6 10139.5(f)(1), and served on all interested parties pursuant to Cal. Ins.
7 Code, § 10139.5(f)(2); and
8 (1) The transfer of the structured settlement payment
9 rights is fair and reasonable and in the best interest of the
10 payee, taking into account the welfare and support of his or
11 her dependents (Cal. Ins. Code, § 10137(a)
12 (2) The transfer complies with the requirements of Cal.
13 Ins. Code, §§ 10134 et seq., will not contravene other
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14 applicable law (Cal. Ins. Code, § 10137(b), and is to be
15 approved by a court as provided in Cal. Ins. Code, §
16 10139.5.
17 It is submitted that all of the foregoing requirements either have been met or will be met prior
18 to any scheduled hearing, and the Petitioner respectfully requests that this Court approve the transfer
19 of the structured settlement payments that are the subject of this Petition.
20 II.
21 REQUIREMENTS OF CALIFORNIA INSURANCE CODE § 10136(b) HAVE BEEN MET
22 (DISCLOSURE TO PAYEE)
23 California Insurance Code § 10136(b) requires that at least ten days prior to the effective date
24 of the transfer agreement, the transferee shall provide the payee with a separate written disclosure
25 statement. The disclosure statement must be in at least 12-point type unless otherwise indicated and
26 accurately completed with the information that applies to the transfer agreement in a form
27 substantially similar to that set forth in California Insurance Code § 10136(b). The required separate
28 written disclosure is attached hereto as Exhibit “B” and incorporated herein by this reference.
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAYMENT RIGHTS
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1 III.
2 THE TRANSFER OF THE STRUCTURED SETTLEMENT PAYMENT RIGHTS IS FAIR
3 AND REASONABLE AND IN THE BEST INTEREST OF THE PAYEE
4 California Insurance Code § 10137(a) requires that the transfer of the structured settlement
5 payment rights is fair and reasonable and in the best interest of the Payee, taking into account the
6 welfare and support of Payee’s dependents.
7 It is submitted that the best interest of Payee would be served by granting the relief requested
8 herein because the original structured settlement entered into by Payee, by and through their
9 Guardian ad Litem Lorena Cabrera, on or about January 8, 2010, as indicated by and copy of the
10 Petition to Approve Compromise of Pending Action of Minor attached hereto as Exhibit “D” and
11 incorporated herein by reference was intended as compensation for a wrongful death claim..
12 Payee is 22 years old, single with one minor child; A. L. who is 3 years old, as will be set
13 forth in the declaration to be filed in this matter. Employment information will also be set forth in
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14 the declaration to be filed in this matter. If approved, Payee will receive $23,788.00 from this
15 transaction. Payee feels it is in their best interest to enter into this transaction with the Petitioner and
16 sell a portion of their underlying annuity payments so that they can have the financial means to pay
17 off debt obtained from purchasing work equipment as will be set forth in the declaration to be filed
18 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 ///
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAYMENT RIGHTS
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1 IV.
2 REQUIREMENTS OF CALIFORNIA INSURANCE CODE § 10139.5(f)(2) HAVE BEEN
3 MET (PROPER DOCUMENTS PRESENTED TO THIS COURT)
4 California Insurance Code § 10139.5(f)(2) requires that a notice of the proposed transfer and
5 the application for its authorization be filed with the Court and served on all interested parties not
6 less than 20 days prior to the scheduled hearing on any petition for approval of a transfer of
7 structured settlement payment rights. This notice must include the following documents:
8 (1) A copy of the transferee’s current petition (which is this Petition) and information
9 regarding any other prior petition whether approved or withdrawn; that was filed with this court in
10 accordance with California 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
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14 Declaration);
15 (4) A copy of the disclosure required by California Insurance Code §10136(b) (Exhibit
16 “B”);
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 (a Petition to Approve
20 Compromise of Pending Action of Minor is attached hereto as Exhibit “D”);
21 (7) Proof of Service showing compliance with the notification requirements of this
22 sections (Proof of Service to be filed after a hearing date and case number is obtained);
23 (8) Notification that any interested party is entitled to support, oppose, or otherwise
24 respond to the transferee’s application, either in person or by counsel, by submitting written
25 comments to the Court or by participating in the hearing;
26 (9) Notification of the time and place of the hearing and notification of the manner in
27 which and the time by which written responses to the application must be filed, which may not be
28 less than 15 days after service of the transferee’s notice, in order to be considered by the Court; and
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAYMENT RIGHTS
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1 (10) If the payee entered into the structured settlement at issue within five years prior to
2 the date of the transfer agreement, then the transferee shall provide notice to the payee's attorney of
3 record at the time the structured settlement was created;
4 V.
5 REQUIREMENTS OF CALIFORNIA INSURANCE CODE § 10139.5(h) HAVE BEEN MET
6 (ADVISORY STATEMENT TO PAYEE OF RIGHT TO SEEK INDEPENDENT COUNSEL
7 AND FINANCIAL ADVICE IN CONNECTION WITH TRANSFER)
8 California Insurance Code § 10139.5(h) requires that no later than the time of filing of the
9 Petition for court approval, the Transferee shall advise the payee of the payee’s right to seek
10 independent counsel and financial advice in connection with the Transferee’s petition for court
11 approval of the transfer agreement, and that the Transferee shall further advise the payee that if the
12 payee retains counsel, a licensed certified public accountant, or a licensed actuary in connection with
13 a petition for an order approving the transfer agreement, then the Transferee shall pay the fees of the
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14 payee’s counsel, accountant, or actuary, regardless of whether the transfer agreement is approved,
15 and regardless of whether the attorney, accountant, or actuary files any document or appears at the
16 hearing on the application for transfer, in an aggregate amount not to exceed one thousand five
17 hundred dollars ($1,500). Further, that such advice may not be provided by an accountant, counsel,
18 or actuary of the Transferee (Exhibit “B”).
19 It is submitted to this Court that this Petition, the Notice of Petition attached hereto, and the
20 advisory statement provided to the payee all comply with and satisfy the requirements of California
21 Insurance Code § 10139.5.
22 VI.
23 ADDITIONAL FACTORS PROMOTE THE GRANTING OF THIS PETITION
24 As of January 1, 2010, California Insurance Code section 10139.5 was amended to give the
25 Court additional factors to consider in determining whether to grant a Petition. As already set forth
26 above or as now set forth below, this Petition will either address those requirements that are
27 applicable and how such requirements support the granting of the Petition or that such additional
28 considerations do not apply.
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAYMENT RIGHTS
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1 1. Payee’s Financial Condition:
2 Employment information will be set forth in the declaration to be filed in this matter.
3 2. Whether the Payee is transferring Monthly or Lump Sum or All or a Portion of the
4 Future Payments:
5 Payee is transferring A) 1 payment of $12,178.00 on April 17, 2028 B) 1 payment of
6 $12,178.00 on April 17, 2029 C) 1 payment of $12,178.00 on April 17, 2030 D) 1 payment of
7 $12,178.00 on April 17, 2031. There are future payments. Payee will be receiving $23,788.00 from
8 this transaction.
9 3. Whether when the settlement was completed, the future periodic payment(s) that are
10 the subject of the proposed transfer were intended to pay for the future medical care and treatment of
11 the payee relating to injuries sustained by the payee in the incident that was the subject of the
12 settlement and whether the payee still needs those future payments to pay for that future care and
13 treatment.
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14 The future periodic payment(s) that are the subject of the proposed transfer were not
15 intended to pay for the future medical care and treatment.
16 4. Whether when the settlement was completed, the future periodic payment(s) that are
17 the subject of the proposed transfer were intended to provide for the necessary living expenses of the
18 payee and whether the payee still needs the future structured settlement payments to pay for future
19 necessary living expenses
20 The future periodic payment(s) that are the subject of the proposed transfer were not
21 intended to provide for necessary living expenses.
22 5. Whether the payee is, at the time of the proposed transfer, likely to require future
23 medical care and treatment for the injuries that the payee sustained in connection with the incident
24 that was the subject of the settlement and whether the payee lacks other resources, including
25 insurance sufficient to cover those future medical expenses.
26 The future periodic payment(s) that are the subject of the proposed transfer were not
27 intended to provide for medical care and treatment.
28
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAYMENT RIGHTS
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1 6. Whether the payee has other means of income or support, aside from the structured
2 settlement payments that are the subject of the proposed transfer, sufficient to meet the payee’s
3 future financial obligations for maintenance and support of the payee’s dependents, specifically
4 including, but not limited to, the payee’s child support obligations, if any. The payee shall disclose
5 to the transferee and the court Payee’s court-ordered child support or maintenance obligations for the
6 court’s considerations.
7 Employment information will be set forth in the declaration to be filed in this matter.
8 Payee has no court-ordered child support or maintenance obligations.
9 7. Whether the payee completed previous transactions involving the payee’s structured
10 settlement payments and the timing and size of the previous transactions and whether the payee was
11 satisfied with any previous transaction.
12 Payee has completed previous transactions involving the payee’s structured
13 settlement payments. 1
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14 8. Whether the transferee attempted previous transactions involving the payee’s
15 structured settlement payments that were denied, or that were dismissed or withdrawn prior to a
16 decision on the merits, within the past five years.
17 Payee has not attempted previous transactions involving the payee’s structured
18 settlement payments that were denied, or that were dismissed or withdrawn.
19 9. Whether, to the best of the transferee’s knowledge after making inquiry with the
20 payee, the payee has attempted structured settlement payment transfer transactions with another
21 person or entity, other than the transferee, that were denied, or which were dismissed or withdrawn
22 prior to a decision on the merits, within the past five years.
23 Not applicable. See question No. 8 above.
24 10. Whether the payee, or his family or dependents, are in or are facing a hardship
25 situation.
26
1
27 In August 2022, a petition was granted for Payee transferring A) 1 payment of $12,178.00 on April 17,
2023 B) 1 payment of $12,178.00 on April 17, 2024 C) 1 payment of $12,178.00 on April 17, 2025 D) 1
28 payment of $12,178.00 on April 17, 2026 E) 1 payment of $12,178.00 on April 17, 2027 (Case No.
22CV02294).
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAYMENT RIGHTS
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1 Payee is facing a hardship situation. Payee would like to enter into this transaction
2 with the Petitioner and sell a portion of their underlying annuity payments so that they can have the
3 financial means to pay off debt obtained from purchasing work equipment.
4 11. Whether the payee received independent legal or financial advice regarding the
5 transaction.
6 Payee has been advised in writing to seek independent professional advice regarding
7 the transfer and has either received that advice or knowingly waived that advice in writing. A copy
8 of the Waiver is attached hereto as Exhibit “E”.
9 VII.
10 REQUIREMENTS OF CALIFORNIA INSURANCE CODE §§ 10134(e), 10136(e), 10136(c)(4)
11 AND 10136(b) HAVE BEEN MET (AUTHORITY TO ASSESS AND DEDUCT EXPENSES
12 FROM PURCHASE PRICE)
13 “Expenses” are defined under section 10134(e) of the California Insurance Code as:
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14 “ . . . [A]ll broker’s commissions, service charges, application or
15 processing fees, closing costs, filing or administrative charges, legal fees,
16 notary fees and other commissions, fees, costs, and charges that a payee
17 would have to pay to transfer the structured settlement payment rights of a
18 structured settlement agreement or that would be deducted from the gross
19 consideration that would be paid to the payee in connection with the
20 transfer of the structured settlement payment rights of a structured
21 settlement agreement.”
22 A transferee may deduct “expenses” from the gross purchase price to be paid to a payee. To
23 do so: “The aggregate amount of all expenses, if any, to be deducted from the purchase price to be
24 paid to the payee in exchange for the payments to be transferred, and an itemization of all expenses
25 by type and amount” must be set forth “clear and conspicuously, and in no less than 12-point type.”
26 (See Cal. Ins. Code, §§ 10136(c) and 10136(c)(4).)
27 Moreover, 10136(b) described how to “clear and conspicuously” set forth “expenses:
28 “Ten or more days before the payee executes a transfer agreement, the transferee
9
VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAYMENT RIGHTS
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1 shall provide the payee with a separate written disclosure statement, accurately
2 completed with the information that applies to the transfer agreement . . . in at
3 least 12-point type unless otherwise indicated . . . [Further] “To figure the net
4 amount we are paying, we have charged you for the following expenses:
5 (itemize in a list by type and amount) for a total of $______ in expenses.”
6 (emphasis added)
7 In the case pending before this Court, all “expenses” to be deducted from the purchase price
8 are itemized by type and amount in 14-point bold font in the separate written disclosure attached
9 hereto as Exhibit “B” and are also set forth in 14-point bold font in the Purchase Agreement attached
10 hereto as Exhibit “A”. Both Exhibits “A” and “B” are incorporated herein by reference. The
11 “types” of expenses itemized in both Exhibits “A” and “B” are based on the definitions of expenses
12 set forth in section 10134(e).
13 Exhibit “B”, the disclosure statement, was provided to the payee in compliance with the
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14 requirements of California Insurance Code § 10136, and the payee has also acknowledged the
15 deduction of the expenses.
16 VIII.
17 “FILING AND RELATED EXPENSES” ARE NOT “COURT COSTS AND FILING FEES”
18 AS DESCRIBED IN SECTION 10139.5(g) OF THE CALIFORNIA INSURANCE CODE
19 Section 10139.5(g) of the California Insurance Code provides that: “All court costs and filing
20 fees shall be paid by the transferee”. All court costs and filing fees related to the filing of the instant
21 Petition have been paid by the transferee and are not being deducted from the gross purchase price.
22
23
24
25
26 ///
27 ///
28 ///
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VERIFIED PETITION FOR APPROVAL FOR TRANSFER OF PAYMENT RIGHTS
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IX.
2 CONCLUSION
3 Petitioner respectfully requests that upon fulfillment of all disclosures and notices set fo rth
4 under California Insurance Code §§ l O134, et seq. , this Court enter an Order approving the transfer
5 agreement attached hereto as Exhibit "A" by and between Transferor, and Transferee.
6 Dated: February 5, 2024 G&B LAW, LLP
7
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I1
V ERI FIED PETITION FOR APPROVAL FOR TRANSFER OF PAYM ENT RI GHTS
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Transfer of Structured Settlement Payments: Bryan Leal
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 February 1, 2024.
______________________
Michael Rodden
EXHIBIT A
DocuSign Envelope ID: 3BED1847-4A9F-44F9-AE9C-29687E938208
Account ID: 1912899
CALIFORNIA PURCHASE CONTRACT
This is a Purchase Contract (“Contract”) for the sale of structured settlement payments between
Bryan Leal (You, Your), and J.G. Wentworth Originations, LLC (We, Us, Our)
3993 Howard Hughes Parkway, Suite 250, Las Vegas, NV 89169-6754.
BACKGROUND
A. 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.
B. 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”).
C. 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: 3BED1847-4A9F-44F9-AE9C-29687E938208
Account ID: 1912899
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 J.G. Wentworth Originations, LLC, 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: 3BED1847-4A9F-44F9-AE9C-29687E938208
Account ID: 1912899
identified in the Disclosure Statement.
B. 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.
C. 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.
B. We will pay You the Net Purchase Price in the manner You designate for Us in exchange for the
following payments (Purchased Payments):
A) 1 payment of $12,178.00 on April 17, 2028 B) 1 payment of $12,178.00 on April 17, 2029 C) 1
payment of $12,178.00 on April 17, 2030 D) 1 payment of $12,178.00 on April 17, 2031
[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]
PURCHASE CONTRACT FORM 1
DocuSign Envelope ID: 3BED1847-4A9F-44F9-AE9C-29687E938208
Account ID: 1912899
C. 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.
D. 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.
C. You understand that Court Approval is required for this purchase; and You agree to fully
cooperate with Us to obtain that approval.
D. 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.
E. 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:
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Account ID: 1912899
• 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.
G. 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.
H. 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.
I. 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.
J. 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.
K. 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.
L. 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.
M. 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.
N. 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
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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 required by this Contract; and
• correct any documentation errors in the Contract Documents or Closing Documents.
B. You will also tell Us if any of the following occurs:
• a violation of this Contract; or
• anything that could negatively affect the Annuity Policy, the Purchased Payments,
or this Contract.
C. You will not:
• agree to sell the Purchased Payments to any Person other than Us;
• change the Annuity Policy’s beneficiary to any Person other than Your estate until we have
collected all of the Purchased Payments; or
• withdraw cash from, borrow against, or change the Annuity Policy.
D. You will give Us information necessary to update Your representations, warranties, and promises
in this Contract. You will also update any documents and information so they will be true and
complete