On April 10, 2024 a
Exhibit,Appendix
was filed
involving a dispute between
In The Matter Of The Petition Of J.G. Wentworth Originations, Llc,
First Berkshire Hathaway Life Insurance Company, Bhg Structured Settlements, Inc. And Denis Shannon, Jr., As Interested Persons Pursuant To Gol Section 5-1701,
and
for Special Proceedings - Other (Transfer-Structured Sett.)
in the District Court of Queens County.
Preview
FILED: QUEENS COUNTY CLERK 04/10/2024 04:57 PM INDEX NO. 707730/2024
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 04/10/2024
EXHIBIT A
FILED: QUEENS COUNTY CLERK 04/10/2024 04:57 PM INDEX NO. 707730/2024
NYSCEF Envelope
DocuSignDOC. NO.ID: D3FD5C79-97D8-4DFC-A368-6001CE5BOF80
3 RECEIVED NYSCEF: 04/10/2024
Account ID: 1990467
March 14, 2024
NEW YORK
DISCLOSURE STATEMENT
We will purchase the following payments (Purchased Payments) from You:
A) 97 monthly payments of $1,000.00 each, beginning on January 10, 2027 and ending on
January 10, 2035 B) 84 monthly payments of $1,335.00 each, beginning on February 10,
2035 and ending on January 10, 2042 C) 1 payment of $300,000.00 on February 10, 2042
(THE REMAINDER OF THE PAGE INTENTIONALLY LEFT BLANK)
STATEDISCLOSURE
FORMI
FILED: QUEENS COUNTY CLERK 04/10/2024 04:57 PM INDEX NO. 707730/2024
DocuSignDOC.
NYSCEF Envelope
NO.ID: D3FD5C79-97D8-4DFC-A388-6D01CE5BOFBC
3 RECEIVED NYSCEF: 04/10/2024
Account ID: 1990467
March 14, 2024
The aggregate amount of the Purchased Payments is $509,140.00.
The discounted present value of the aggregate Purchased Payments at the federal interest
rate of 5.00% is $251,110.80. The discounted present value is the calculation of the
current value of the transferred structured settlement payments (Purchased Payments)
under federal standards for valuing annuities.
The gross amount payable to seller (You) is $135,521.37.
No other expenses are incurred by You.
The net amount payable to the seller (You) is $135,521.37. The net cash payment You
receive in this transaction from Us was determined by applying the specified discount rate
to the amount of future payments received by Us, less the total amount of commissions,
fees, costs, expenses and charges payable by You.
The net amount that You will receive from Us in exchange for Your future structured
settlement payments represents 53.96% of the estimated current value of the payments
based upon the discounted value using the applicable federal rate.
BASED ON PRICE QUOTES FROM METLIFE INVESTORS INSURANCE
COMPANY AND NEW YORK LIFE INSURANCE COMPANY THE CURRENT
COSTS OF PURCHASING A COMPARABLE ANNUITY FOR THE AGGREGATE
AMOUNT OF PAYMENTS TO BE TRANSFERRED IS $258,270.73 AND $274,751.00
RESPECTIVELY.
Based on the net amount that You will receive in payment from Us and the amounts and
timing of the structured settlement payments that You are selling to Us, this is the
equivalent of interest payments to Us at a rate of 9.99% per year. PLEASE NOTE
THAT THIS IS NOT A LOAN, BUT A SALE OF PAYMENT RIGHTS AND THE
INTEREST FIGURE IS ONLY PROVIDED AS AN ILLUSTRATION OF THE
ECONOMIC IMPACT OF THE SALE.
Notice of Cancellation Rights:
You may cancel without penalty or further obligation, not later than the fifth business day
after Your receipt of payment from Us under the transfer agreement (Purchase Contract).
Please be advised there are no penalties or liquidated damages payable by You in the
event of any breach of the transfer agreement (Purchase Contract) by You.
STATEDISCLOSURE
FORM1
FILED: QUEENS COUNTY CLERK 04/10/2024 04:57 PM INDEX NO. 707730/2024
NYSCEF
DocuSignDOC. NO.
Envelope 3
ID: 03FD5C79-97D8-4DFC-A368-6001CE580F8C RECEIVED NYSCEF: 04/10/2024
Account m: I990467
March 14, 2024
Please be advised that You may be subject to adverse federal and state income tax
consequences as a result of the proposed transaction. You should consult Your own
counsel, accountant, or financial advisor regarding any federal or state income tax
consequences arising from the proposed transfer.
By signing below, You are confirming receipt of this Disclosure Statement at least 10 days
prior to You executing the transfer agreement (Purchase Contract).
DocuSigned
by:
UA 5 SIGN HERE
7F00D1AF8987467
DENIS ROBERT SHANNON JR.
STATEDISCLOSURE
FORM1
FILED: QUEENS COUNTY CLERK 04/10/2024 04:57 PM INDEX NO. 707730/2024
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 04/10/2024
e March 28, 2024
Dear Customer,
The following is the proof-of-delivery for tracking number: 775696053817
DelIvery InformaUon:
Status: Delivered Delivered To: Residence
Signed (br by: Signature not required Delivery Location:
Service type: FedEx Priority Ovemight
Special Handling: Deliver Weekday;
Ba ys Ide , NY ,
Residential Delivery
Delivery date: Mar 27, 2024 11:47
Shipping Information:
Tracking number: 775696053817 Ship Date: Mar 28, 2024
Weight 0.5 LB/0.23 KG
Recipient Shipper:
Bayside, NY, US, Chesterbrook, PA, US,
Proof-of-delivery details appear below; however, no signature Is avallable for this FedEx Express shipment
because a signature was not required,
Thank you for choosing FedEx
Document Filed Date
April 10, 2024
Case Filing Date
April 10, 2024
Category
Special Proceedings - Other (Transfer-Structured Sett.)
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Preview
FILED: QUEENS COUNTY CLERK 04/10/2024 04:57 PM INDEX NO. 707730/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 04/10/2024 EXHIBIT A FILED: QUEENS COUNTY CLERK 04/10/2024 04:57 PM INDEX NO. 707730/2024 NYSCEF Envelope DocuSignDOC. NO.ID: D3FD5C79-97D8-4DFC-A368-6001CE5BOF80 3 RECEIVED NYSCEF: 04/10/2024 Account ID: 1990467 March 14, 2024 NEW YORK DISCLOSURE STATEMENT We will purchase the following payments (Purchased Payments) from You: A) 97 monthly payments of $1,000.00 each, beginning on January 10, 2027 and ending on January 10, 2035 B) 84 monthly payments of $1,335.00 each, beginning on February 10, 2035 and ending on January 10, 2042 C) 1 payment of $300,000.00 on February 10, 2042 (THE REMAINDER OF THE PAGE INTENTIONALLY LEFT BLANK) STATEDISCLOSURE FORMI FILED: QUEENS COUNTY CLERK 04/10/2024 04:57 PM INDEX NO. 707730/2024 DocuSignDOC. NYSCEF Envelope NO.ID: D3FD5C79-97D8-4DFC-A388-6D01CE5BOFBC 3 RECEIVED NYSCEF: 04/10/2024 Account ID: 1990467 March 14, 2024 The aggregate amount of the Purchased Payments is $509,140.00. The discounted present value of the aggregate Purchased Payments at the federal interest rate of 5.00% is $251,110.80. The discounted present value is the calculation of the current value of the transferred structured settlement payments (Purchased Payments) under federal standards for valuing annuities. The gross amount payable to seller (You) is $135,521.37. No other expenses are incurred by You. The net amount payable to the seller (You) is $135,521.37. The net cash payment You receive in this transaction from Us was determined by applying the specified discount rate to the amount of future payments received by Us, less the total amount of commissions, fees, costs, expenses and charges payable by You. The net amount that You will receive from Us in exchange for Your future structured settlement payments represents 53.96% of the estimated current value of the payments based upon the discounted value using the applicable federal rate. BASED ON PRICE QUOTES FROM METLIFE INVESTORS INSURANCE COMPANY AND NEW YORK LIFE INSURANCE COMPANY THE CURRENT COSTS OF PURCHASING A COMPARABLE ANNUITY FOR THE AGGREGATE AMOUNT OF PAYMENTS TO BE TRANSFERRED IS $258,270.73 AND $274,751.00 RESPECTIVELY. Based on the net amount that You will receive in payment from Us and the amounts and timing of the structured settlement payments that You are selling to Us, this is the equivalent of interest payments to Us at a rate of 9.99% per year. PLEASE NOTE THAT THIS IS NOT A LOAN, BUT A SALE OF PAYMENT RIGHTS AND THE INTEREST FIGURE IS ONLY PROVIDED AS AN ILLUSTRATION OF THE ECONOMIC IMPACT OF THE SALE. Notice of Cancellation Rights: You may cancel without penalty or further obligation, not later than the fifth business day after Your receipt of payment from Us under the transfer agreement (Purchase Contract). Please be advised there are no penalties or liquidated damages payable by You in the event of any breach of the transfer agreement (Purchase Contract) by You. STATEDISCLOSURE FORM1 FILED: QUEENS COUNTY CLERK 04/10/2024 04:57 PM INDEX NO. 707730/2024 NYSCEF DocuSignDOC. NO. Envelope 3 ID: 03FD5C79-97D8-4DFC-A368-6001CE580F8C RECEIVED NYSCEF: 04/10/2024 Account m: I990467 March 14, 2024 Please be advised that You may be subject to adverse federal and state income tax consequences as a result of the proposed transaction. You should consult Your own counsel, accountant, or financial advisor regarding any federal or state income tax consequences arising from the proposed transfer. By signing below, You are confirming receipt of this Disclosure Statement at least 10 days prior to You executing the transfer agreement (Purchase Contract). DocuSigned by: UA 5 SIGN HERE 7F00D1AF8987467 DENIS ROBERT SHANNON JR. STATEDISCLOSURE FORM1 FILED: QUEENS COUNTY CLERK 04/10/2024 04:57 PM INDEX NO. 707730/2024 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 04/10/2024 e March 28, 2024 Dear Customer, The following is the proof-of-delivery for tracking number: 775696053817 DelIvery InformaUon: Status: Delivered Delivered To: Residence Signed (br by: Signature not required Delivery Location: Service type: FedEx Priority Ovemight Special Handling: Deliver Weekday; Ba ys Ide , NY , Residential Delivery Delivery date: Mar 27, 2024 11:47 Shipping Information: Tracking number: 775696053817 Ship Date: Mar 28, 2024 Weight 0.5 LB/0.23 KG Recipient Shipper: Bayside, NY, US, Chesterbrook, PA, US, Proof-of-delivery details appear below; however, no signature Is avallable for this FedEx Express shipment because a signature was not required, Thank you for choosing FedEx