Preview
The other parties interested in this Application are listed as follows:
nnuity Issuer:
nnuity Owner:
ependents residing with Payee: None.
Dependents not residing with Payee: None.
ther Interested Parties/Named Beneficiaries:
Venue and Jurisdiction:
Venue and jurisdiction are proper in this Court pursuant to the Act. This
application is properly brought in the county or district court of the county in which the Payee
resides, or the court of original jurisdiction that authorized or approved the structured settlement,
without regard to the amount subject to the potential transfer, since the Act does not specify an
amount which would prohibit a County Court or a Probate Court from hearing an application.
Tex. Civ. Prac. & Rem. Code § 141.002(2).
Background on Structured Settlements Generally:
Contrary to popular misconception, structured settlements typically result from a
voluntary settlement of an underlying tort claim. While many believe that structured settlements
are typically court approved, court ordered or otherwise mandated by the court as a form of
spendthrift trust, this is simply not true. Structured settlements are a convenient and cost
effective way to settle personal injury claims, particularly where there is disagreement over the
size of the settlement as the perceived value of future payments is generally higher than their true
value. Simply put, structured settlements are a cost effective way for insurance carriers to settle
personal injury claims on favorable terms and are often used for garden variety cases. In the vast
majority of cases they are simply the result of a negotiated settlement between plaintiff and
defendant with no substantive court involvement.
Anti assignment provisions are often included in structured settlement agreements
under the mistaken belief that they are required to prevent the application of the “constructive
receipt” tax doctrine. These anti assignment provisions were not included as a form of
spendthrift trust nor were they intended as a restriction on alienation of the right to receive
structure settlement payments. Rather they are a result of an overly cautious reading of several
private letter rulings from the early 1980’s and a misunderstanding of the constructive receipt tax
Application for Approval of Page 2
A Transfer of Structured Settlement Payment Rights
doctrine. Any lingering doubts as to whether an anti assignment provision is required to prevent
constructive receipt were dispelled in 2002 with the passage of 26 USC Section 5891, et seq.
which made it clear by way of a clarification of existing law that a sale or transfer of structure
payments rights would not alter the tax treatment applicable to the annuitant or annuity issuers.
Notwithstanding this, anti assignment clauses remain a vestige of common practice and are
hence present in many settlement agreements.
The one common failing of structured settlements is that they are relatively
inflexible. Once established they cannot be altered. As a consequence, a secondary market for
structured settlements evolved in the 1990’s. Because of the significant demand from structured
settlement recipients to restructure/refinance how and when they receive these payments, a
secondary market flourished. In 2002, the United States Congress, after hearings before the
Ways and Means committee, passed 26 USC Section 5891, et seq. making it clear that structured
settlements could be transferred and that no adverse tax consequence would attach. As part of
providing this clarification, Congress required that a transfer of structured settlement payment
rights be pursuant to a state transfer statute finding that the transfer was in the best interest of the
selling annuitant. Employees and officers of the petitioner, U.R.M., appeared at the
congressional hearing referenced above and worked tirelessly in the late 90’s and early 2000’s to
obtain the passage of 26 USC Section 5891 and to pass state transfer laws around the country.
Almost every state now has a structured settlement statute which provides for unprecedented
levels of consumer safeguards prior to an individual being permitted to sell a structured
settlement. This is so notwithstanding the fact that the decision to accept the structured
settlement, as outlined above, is typically the result of a simple negotiation between plaintiff and
defendant and not as consequence of the independent judgment that the recipient is unable to
manage their financial affairs. The structured settlement transfer statutes and the provisions of 26
USC Section 5891, et seq. make it clear that both federal and state legislators recognized the
need for liquidity in the secondary market for structured settlement payments. Provided that the
transfer statute is adhered to, the court should permit the transfer of the structured settlement
payments provided that such transfer is in the best interest of the payee.
Application for Approval of Page
A Transfer of Structured Settlement Payment Rights
Statement of Facts:
All claims were settled on behalf of Payee arising out of a personal injury claim.
The resolution of the matter involved a structured settlement (the “Settlement Agreement”).
As a result of the Settlement Agreement, Payee became entitled to receive
“Periodic Payments” under an annuity.
In order to fulfill the obligation to Payee under the Settlement Agreement,
Structured Settlement Obligor purchased an annuity contract from Annuity Issuer, naming Payee
as the annuitant. Under the annuity, Annuity Issuer is obligated to make, and currently makes
the Periodic Payments directly to Payee.
Payee desires to sell a portion of the Periodic Payments in return for a lump sum
payment for payment for those purposes stated or as may be offered in testimony at the hearing
on this matter. Subject to this Court's approval, Payee, accordingly, has agreed to transfer to
Transferee, the following:
n this regard, Payee executed an Absolute Assignment Agreement (the
“Assignment Agreement”), under which Payee agreed to transfer to Transferee the Assigned
Payments. This document constitutes a Transfer Agreement as defined by the Act. (Exhibit 1)
JGW timely provided Payee with the Disclosure Statement required by the Act
not less than three (3) days prior to the date on which Payee executed the Transfer Agreement.
Tex. Civ. Prac. & Rem. Code § 14.1.003. (Exhibit 2)
Attached hereto as Exhibit is the Payee’s request that all identifiable
information be redacted pursuant to CPRC § 141.006 (d).
Attached hereto as Exhibit 4 is the Payee’s Statement of Professional
Representation.
JGW will provide written notice of the transfer to all interested parties, including
payee and the annuity issuer. Non redacted exhibits, identical to those redacted exhibits filed
with the court, have been served on all parties.
Application for Approval of Page 4
A Transfer of Structured Settlement Payment Rights
The transfer is in the best interests of Payee, taking into account the welfare and
support of Payee's dependents, if any. Payee has been advised in writing to seek independent
professional advice regarding the financial, legal, and tax implications of the transfer, as
provided in the Act.
More than twenty days prior to the hearing for approval of the transfer, Transferee
will send written notice of the hearing, along with Transferee's name, address, and taxpayer
identification number to Annuity Issuer, Annuity Owner, Structured Settlement, Obligor, and
Payee, and all other interested parties (if any), and will file same with the Court as provided in
the Act. Specifically, Annuity Issuer, Annuity Owner, Structured Settlement Obligor, Payee, and
all interested parties will be provided with the following documents:
A copy of this Application for Approval of a Transfer of Structured
Settlement Payment Rights;
A copy of the transfer Agreement;
A copy of the Disclosure Statement;
iv. A list of Payee's dependent(s), together with each dependent's age;
Notification that any interested party is entitled to support, oppose, or
otherwise respond to this Application, either in person or by counsel, by
submitting written comments to the court or by participating in the
hearing; and
vi. 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 in order to be considered by the court.
The transfer satisfies all statutory requirements of the Structured Settlement
Protection Act, Chapter 141 of the Texas Civil Practice and Remedies Code, and does not
contravene any applicable statute or an order of any court or other governmental authority; the
transfer also satisfies the Internal Revenue Code Section 5891 and does not contravene any
Federal or State statute or the order of any court or responsible administrative authority.
Application for Approval of Page
A Transfer of Structured Settlement Payment Rights
PRAYER
Based upon the foregoing, Applicant, J.G. Wentworth Originations, LLC, respectfully
requests that the court grant this Application and approve the transfer of the Assigned Payments
to Applicant, J.G. Wentworth Originations, LLC, its successors or assigns.
Respectfully submitted,
Korduba & Rogers, LLP
19535 Champion Forest Dr.
Spring, Texas 77379
KordubaRogers@gmail.com
(Telephone)
1180 (Facsimile)
KordubaRogers@gmail.com
/s/ Laryssa Korduba
Laryssa Korduba
State Bar No.:
ATTORNEY FOR APPLICANT
J.G. WENTWORTH ORIGINATIONS,
Application for Approval of Page
A Transfer of Structured Settlement Payment Rights
DocuSign Envelope ID: 613B7869-3C48-40D8-A1AB-3AAD825F4D55
PURCHASE CONTRACT
This is a Purchase Contract (“Contract”) for the sale of structured settlement payments between
( J.G. Wentworth Originations, LLC ( 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
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
(“Purchased Payments”) to Us now for a lump sum.
AN ARBITRATION PROVISION WHICH YOU SHOULD READ
CAREFULLY, AS IT WILL HAVE A SUBSTANTIAL IMPACT ON HOW DISPUTES BETWEEN YOU AND
US ARE RESOLVED.
by, controlling, or under common control with, another entity.
purchased by the Obligor to ensure that the Settlement Payments are made to You as
required by the Settlement Agreement.
osing Documents Any documents necessary to carry out the purchase of the Purchased Payments, other
than the “Contract or Contract Documents” as defined below.
Contract 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.
issued by a judge or properly empowered administrative officer,
approving the sale of the Purchased Payments to Us (“Court Approval”
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.
PURCHASE CONTRACT FORM 1
DocuSign Envelope ID: 613B7869-3C48-40D8-A1AB-3AAD825F4D55
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 the seller (You)” on the Disclosure
Statement. 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 payable to the seller (You)” on the Disclosure
Statement. 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.
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 thisContract’s first page. Some of the Contract Documents or
Closing Documents may refer to You as the seller.
and agree as follows:
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 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.
PURCHASE PRICE
A. The Gross and Net Purchase Prices are shown on the Disclosure Statement and are fair and acceptable to You and Us.
PURCHASE CONTRACT FORM
DocuSign Envelope ID: 613B7869-3C48-40D8-A1AB-3AAD825F4D55
B. We will pay You the Net Purchase Price in the manner You designate for Us.
we pay You, You agree that We will adjust for the following amounts,
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
– 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.
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.
REPRESENTATIONS AND WARRANTIES
You represent and warrant to Us the following:
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:
You to keep the Purchased Payments for the benefit of a current or former spouse, dependent children,
legally prevents You from contracting with Us, selling the Purchased Payments or changing the Annuity
F. Either:
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
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
reliance on any intentional misrepresentation by You may result in Our enforcing Our rights against You in court.
PURCHASE CONTRACT FORM
DocuSign Envelope ID: 613B7869-3C48-40D8-A1AB-3AAD825F4D55
H. You had enough time to consider the sale of the Purchased Payments, understand the terms of the Contract Documents
and Closing Documents (including the arbitration provision), 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 legal advice and professional tax advice about the sale of the Purchased
Payments and to have those advisors review the terms and legal, tax and other effects of this Contract with You prior to
Your execution of this Contract. You have also explored all appropriate financial options before
J. We did not provide tax, financial, or legal advice to You about this Contract and have 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
seek any advice relating thereto. Your Spouse also understands that he or
rights that he or she may have in the
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
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.
PROMISES TO US
A. You will tell us right away if Your address or telephone number changes and do
everything necessary, including completing
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:
violation of this Contract; or
that could negatively affect the Annuity Policy, the Purchased Payments, or this Contract.
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
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 on the Funding Date.
PURCHASE CONTRACT FORM
DocuSign Envelope ID: 613B7869-3C48-40D8-A1AB-3AAD825F4D55
DocuSign Envelope ID: 613B7869-3C48-40D8-A1AB-3AAD825F4D55
AMOUNT RECEIVED BY YOU. YOUR NOTICE MUST BE SENT TO:
J.G. Wentworth Originations, LLC
Attention: Manager of Operations
3993 Howard Hughes Parkway, Suite 250
Las Vegas, NV 89169-6754
B. GEORGIA RESIDENTS: YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO 5:00 P.M.
THE TWENTY-FIRST DAY FOLLOWING RECEIPT OF THE ENCLOSED “NOTICE OF
CANCELLATION RIGHTS” FORM, OR AT THE HEARING ON THE APPLICATION FOR
STRUCTURED SETTLEMENT PAYMENT RIGHTS, OR AT ANY
WHICHEVER EVENT OCCURS LAST (This is the Georgia rescission period). IN ORDER FOR THE
CANCELLATION TO BE EFFECTIVE, YOU MUST SIGN THE ENCLOSED “NOTICE OF
CANCELLATION RIGHTS” FORM AND MAIL OR DELIVER IT TO US AS SPECIFIED IN THAT
NOTICE AND YOU MUST RETURN ALL AMOUNTS (PURCHASE PRICE OR OTHERWISE) RECEIVED
BY YOU ACCORDING TO THE REQUIREMENTS OF 6 (A) (2) ABOVE.
IN ORDER FOR YOUR CANCELLATION TO BE EFFECTIVE, YOUR
SUBMITTED VIA PHONE, MAIL, OR FACSIMILE. ANY AMOUNTS ADVANCED BY
US IN CONTEMPLATION OF THE TRANSFER SHALL BE IMMEDIATELY REFUNDED TO US. IF YOU
DISMISS YOUR ACTION AFTER APPOINTMENT OF
TRANSFER AGREEMENT (PURCHASE CONTRACT) WITHIN THE RESCISSION PERIOD IN
6(A) (1) ABOVE, YOU SHALL BE RESPONSIBLE FOR THE FILING FEE AND ANY GUARDIAN AD
D. With respect to A through C above, to the extent permitted by applicable law, the arbitration provision in Section
9 of this Contract shall survive the termination, cancellation or rescission of this
A. All notices about this Contract must be in writing.
All notices must be sent either by: (1) certified or registered mail (return receipt requested); or (2) FedEx or another major
delivery tracking system and are considered given when delivered as follows: If to You:
to the most recent address for You listed in Our files. If to Us: to the address listed in Section 6(A) (2) of this Contract.
with any terms or conditions of this Contract; or
promises in this Contract.
If You are in default, even if You have not rejected the arbitration provision (see Section 9 of this Contract), We have the right to
enforce Our rights against You in court to make You perform Your promises or to get money from You. If We sue You in court
that is subject to arbitration under the arbitration provision in Section 9 of this Contract, and You have
not rejected the arbitration provision, You will have the option of remaining in court or seeking to compel arbitration of that
Claim under the terms of the arbitration
PURCHASE CONTRACT FORM 1
DocuSign Envelope ID: 613B7869-3C48-40D8-A1AB-3AAD825F4D55
To the extent permitted by applicable law, You and We agree to the following arbitration provision.
YOU HAVE THE RIGHT TO REJECT THIS ARBITRATION PROVISION AS SET FORTH BELOW. If You do not reject
this arbitration provision and a Claim is arbitrated, You will not have the right to: (1) have a court or a jury decide the Claim;
(2) engage in information gathering (discovery) to the same extent as in court; (3) participate in a class action in court or in
arbitration; or (4) join or consolidate a Claim with claims of any other person. The right to appeal is more limited in
arbitration than in court and other rights in court may be unavailable or limited in arbitration.
A “Claim” subject to arbitration is any claim, dispute or controversy between You and Us (other than
an Excluded Claim or Proceeding as set forth below), whether preexisting, present or future, which arises out of, or relates to the
Contract, the negotiations related thereto, the breach thereof or any other transaction conducted with us in connection with the
Contract. “Claim” has the broadest possible meaning and includes initial claims, counterclaims, cross-claims, third-party claims and
federal, state, local and administrative claims. It includes disputes based upon contract, tort, consumer rights, fraud and other
intentional torts, constitution, statute, regulation, ordinance, common law and equity and includes claims for money damages and
injunctive or declaratory relief. Upon the demand of You or Us, Claim(s) will be resolved by individual (not class or class-wide)
binding arbitration in accordance with the terms specified in this arbitration provision.
Solely for purposes of this arbitration provision, in addition to the meanings set forth in this Contract: (1) “We,”
“Us” and “Our” also (a) refer to Our employees, officers, directors, parents, controlling persons, subsidiaries and affiliates and (b)
apply to third parties if You assert a Claim against such third parties in connection with a Claim you assert against Us; and (2) “You”
or “Your” also refer to Your current or former spouse(s), children. heirs, estate, executors, successors, assigns, representatives and
. Notwithstanding the foregoing, “Claim” does not include any dispute or controversy about the
validity, enforceability, coverage or scope of this arbitration provision or any part thereof (including, without limitation, the “Class
Action Waiver” set forth below and/or this sentence); all such disputes or controversies are for a court and not an arbitrator to decide.
However, any dispute or controversy that concerns the validity or enforceability of the Contract as a whole is for the arbitrator, not a
court, to decide. In addition, We will not require You to arbitrate any individual action brought by You in small claims court or Your
state’s equivalent court, unless such action is transferred, removed, or appealed to a different court.
Federal Arbitration Notwithstanding any other provision in this Contract, You and We agree that this Contract evidences a
transaction involving interstate commerce and that the Federal Arbitration Act (Title 9 of the United States Code) (“FAA”) shall
govern its interpretation and enforcement and proceedings pursuant thereto. To the extent state law is applicable under the FAA, the
law of the state of Your domicile (where You regularly reside on the Contract Date) shall apply.
Notwithstanding any other provision of this Contract, if a Claim is arbitrated, neither You nor We will
have the right: (a) to participate in a class action, private attorney general action or other representative action in court or in
arbitration, either as a class representative or class member; or (b) to join or consolidate Claims with claims of any other
Persons. No arbitrator shall have authority to conduct any arbitration in violation of this provision (provided, however, that
the Class Action Waiver does not apply to any lawsuit or administrative proceeding filed against us by a state or federal
government agency even when such agency is seeking relief on behalf of a class of borrowers including You. This means that
We will not have the right to compel arbitration of any claim brought by such an agency). The Class Action Waiver is
nonseverable from this arbitration provision. If the Class Action Waiver is limited, voided or found unenforceable, then this
arbitration provision (except for this sentence) shall be null and void with respect to such proceeding, subject to the right to
appeal the limitation or invalidation of the Class Action Waiver.
If You or We seek to arbitrate a Claim, the Party seeking arbitration must notify the other Party in writing.
This notice can be given after the beginning of a lawsuit and can be given in papers filed in the lawsuit, such as a motion to compel
arbitration. Otherwise, Your notice must be sent to Us at the address specified in Section 6 (A) (2) of this Contract and Our notice
must be sent to the most recent address for You in our files. Any arbitration hearing that You attend will take place in a venue of Your
domicile. If a Party files a lawsuit in court asserting Claim(s) that are subject to arbitration, and the other Party files a motion to
compel arbitration with the court, which is granted, it will be the responsibility of the Party prosecuting the Claim(s) to select an
arbitration administrator in accordance with the paragraph below and commence the arbitration proceeding in accordance with the
administrator’s rules and procedures.
The arbitration will be administered by the American Arbitration Association (“AAA”), 1633 Broadway, 10 Floor, New York, NY
10019, www.adr.org, 1-800-778-7879 or JAMS, 1920 Main Street, Suite 300, Irvine, CA 92614, www.jamsadr.com, 1-800-352-5267.
PURCHASE CONTRACT FORM
DocuSign Envelope ID: 613B7869-3C48-40D8-A1AB-3AAD825F4D55
rules
DocuSign Envelope ID: 613B7869-3C48-40D8-A1AB-3AAD825F4D55
A. You give Us permission to conduct background checks on You, including obtaining information from the credit bureaus,
in order to verify Your legal residence, contact information, and any other information We deem necessary for this
transaction. We can also search records for UCC filings, bankruptcy filings, judgments, liens and child support
obligations against You.
B. his Contract is the entire agreement between You and Us.
C. If there is more than one of Us or You, this Contract applies to all of those people together, and to each of them on their
Both Parties must agree in writing to any change to this Contract or
E. Except as set forth in the arbitration provision in Section 9 of this Contract, if a court undoes any part of this Contract,
the rest of the Contract remains valid.
F. You cannot voluntarily or involuntarily sell, assign, or transfer this Contract, or any of Your rights or duties under this
Contract. Any such action taken by You in violation of this section shall be void and of no effect.
G. Except as otherwise required by applicable law, the law of the state of Your domicile (where You regularly reside on the
Contract Date) will govern this Contract and disputes under this Contract shall be determined in Your domicile State
(where You regularly reside on the Contract Date).
H. This Contract also holds responsible Your heirs, and executors. This Contract benefits only You and Us, and no one else.
However, if properly assigned by Us, this Contract will bind and benefit Our successors and assigns.
I. Failure to enforce any provision of this Contract is not a waiver of that provision.
J. The Parties may sign this Contract in one or more counterparts. Each counterpart will be considered an original. All
counterparts will form one Contract. A facsimile, pdf or other electronic copy of the signed Contract or any counterpart
will be considered an original and treated as such in any court [or arbitration] proceeding.
K. We have investigated the proposed transfer of the Purchased Payments and, in light of information available to Us, have
L. You will not receive an IRS Form 1099 from Us.
M. Titles and headings in this Contract are for convenience only. Do not use them to interpret this Contract.
N. Except as otherwise set forth in this Contract (including the arbitration provision in Section 9 of this Contract), You and
We will pay our respective costs and expenses in carrying out this Contract.
O. You give Us permission to request from our Affiliates information and documentation You have previously provided to
them which we deem necessary for this transaction, including, bankruptcy filings, judgments, settling documents,
annuity documents, liens, child support obligations, divorce documents
You and We, intending to be legally bound, have signed this Contract as of the Contract Date below, and agree to all of its
terms and conditions, including the arbitration provision.
PURCHASE CONTRACT FORM 1