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1 JUAN C. LOZANO, ESQ. (State Bar No. 241930) THE LAW OFFICE OF JUAN C. LOZANO 2 3555 Rosecrans St., Suite 114-208 San Diego, CA 92110 3 PHONE: (619)647-9129/ FAX: (619)330-9979 EMAIL: lozanolaw@gmail.com 4 5 Attorneys for Petitioner, INTELIFUND, LLC 6 7 8 SUPERIOR COURT OF THE STATE OF CALIFORNIA 9 FOR THE COUNTY OF SAN MATEO 10 11 12 In Re Petition of: ) Case No.: ) 13 INTELIFUND, LLC ) PETITION FOR APPROVAL OF ) TRANSFER OF STRUCTURED 14 ) SETTLEMENT PAYMENT RIGHTS Petitioner ) 15 ) [Per Ins. Code. Section 10134, et seq.] (Real Party In Interest: I.M.) ) 16 ) ) 17 ) ) 18 ) ) 19 20 21 COMES NOW INTELIFUND, LLC, by the undersigned counsel, which respectfully 22 petitions this Court pursuant to §§10134 et seq. of the California Insurance Code, as 23 amended, for approval of the transfer of certain structured settlement payment rights, and in 24 support hereof, states as follows: 25 1. Petitioner, INTELIFUND, LLC is a Delaware Limited Liability Company. 26 27 28 1 [VERIFIED PETITION FOR APPROVAL OF TRANSFER RIGHTS] 1 2. Transferor, I.M. (the "Payee") is a statutory interested party in the present 2 matter. Petitioner is informed and believes and upon that basis alleges that Payee is an adult 3 resident of the County of San Mateo, in California, and is over 18 years old. 4 3. Talcott Resolution CEBSCO (the "Obligor"), is the Structured Settlement 5 6 Obligor, as defined by Cal. Ins. Code § 10134(k), which has a continuing periodic payment 7 obligation to the Payee under a structured settlement agreement or a qualified assignment 8 agreement. 9 4. Talcott Resolution Life Insurance Company (the "Annuity Issuer"), an 10 insurance company authorized to do business in the State of California, has issued an 11 12 insurance contract used to fund the structured settlement payment obligations of the 13 Obligor. 14 5. This Court has subject matter jurisdiction over the instant action pursuant to 15 Cal. Ins. Code § 10135(c) as either (1) the payee was domiciled in California at the time 16 17 the transfer agreement was signed by the Payee, or (2) the payee was not domiciled in 18 California at the time the transfer agreement was signed and the state where the payee was 19 domiciled does not have a structured settlement transfer statute, but either the Obligor or the 20 Annuity Issuer is domiciled in California. 21 6. Payee, by and through their guardian ad litem, entered into an agreement for 22 23 the settlement of a claim for damages arising in connection with a personal injury claim; 24 7. Petitioner is informed and believes and upon that basis alleges that the 25 underlying structured settlement that established the annuity at issue in the present case 26 contained language that restricted and/or prohibited the right and/or power to assign the 27 Assigned Payments in question. Notwithstanding such language, where no interested parties 28 2 [VERIFIED PETITION FOR APPROVAL OF TRANSFER RIGHTS] 1 object to the transfer of structured settlement payment rights, the anti- assignment 2 provisions in an annuity contract, settlement agreement, or other related contracts do not bar 3 court-approved transfers of structured settlement payments. 321 Henderson Receivables 4 Origination LLC v. Sioteco, 93 Cal. Rptr. 3d 321, 334 (Cal. Ct. App. 2009); 5 6 8. The settlement agreed to by the Transferor provides for certain lump sum and 7 periodic structured payments, including but not limited to the payments that are the subject 8 of this Petition; 9 9. Payee has agreed to sell, and Transferee, INTELIFUND, LLC, has agreed to 10 purchase certain lump sum payments, as referenced within their proposed Transfer 11 12 Agreement. A true and correct copy of the proposed Transfer Agreement will be filed 13 subsequently hereto. 14 10. INTELIFUND, LLC, shall, upon this Court entering an Order approving the 15 Transfer Agreement, assign all its right, title and interest in and to the said proposed 16 17 Transfer Agreement to its assignee, to be designated at the time of the hearing on the 18 present matter. 19 11. Pursuant to Cal. Ins. Code § 10137(a)(1) and Cal. Ins. Code § 10139.5(a)(1) 20 as well as 26 USC § 5891(b)(2)(A)(ii), Petitioner alleges that that transfer of structured 21 settlement payment rights in the present matter is fair and reasonable and in the best 22 23 interests of the Payee, taking into account the welfare and support of the Payee's 24 dependents, if any. 25 12. Pursuant to Cal. Ins. Code §§ 10137(b) and 10139.5(a)(4) as well as 26 USC 26 § 5891(b)(2)(A)(i), Petitioner alleges that the transfer complies with the requirements of 27 Cal. Ins. Code § 10134, et seq., and will not contravene other applicable law, does not 28 3 [VERIFIED PETITION FOR APPROVAL OF TRANSFER RIGHTS] 1 contravene any applicable statute or the order of any court or other government authority, 2 and does not contravene any Federal or State statute or the order of any court or responsible 3 administrative authority. 4 13. Pursuant to Cal. Ins. Code § 10139.5(a)(2), Petitioner alleges that the Payee 5 6 has been advised in writing by the transferee to seek independent professional advice 7 regarding the transfer and has either received that advice or knowingly, in writing, waived 8 the opportunity to receive the advice. 9 14. Pursuant to Cal. Ins. Code § 10139.5(a)(3), the Petitioner has complied, or 10 will comply at the time of the hearing, with the notification requirements of Cal. Ins. Code 11 12 § 10139.5(f)(2) and the Petitioner (or its predecessor) has provided the Payee with a 13 disclosure statement that complies with Cal. Ins. Code § 10136(b) and the transfer 14 agreement complies with Cal. Ins. Code §§ 10136(c) and 10138. 15 15. Pursuant to Cal. Ins. Code § 10139.5(a)(5), the Payee understands the terms 16 17 of the transfer agreement, including the terms set forth in the disclosure statement required 18 by Cal. Ins. Code § 10136(b). 19 16. Pursuant to Cal. Ins. Code § 10139.5(a)(6), the Payee understands and does 20 not wish to exercise the Payee's right to cancel the transfer agreement. 21 17. Pursuant to Cal. Ins. Code § 10139.5(f) the following documents shall be 22 23 served along with a copy of this Petition and Notice of Hearing: 24 (A) A copy of the transferee's current petition and any other prior petition, whether 25 approved or withdrawn, that was filed with the court in accordance with Cal. Ins. 26 Code § 10139.5(c)(6). 27 (B) A copy of the proposed transfer agreement and disclosure statement required by Cal. 28 Ins. Code § 10136(b). 4 [VERIFIED PETITION FOR APPROVAL OF TRANSFER RIGHTS] 1 (C) A listing of each of the payee's dependents, together with each dependent's age. 2 (D) A copy of the annuity contract, if available. 3 (E) A copy of the qualified assignment agreement, if available. 4 (F) A copy of the underlying structured settlement agreement, if available. 5 6 18. It is submitted that all of the foregoing requirements either have been met or 7 will be met prior to any scheduled hearing, and the Petitioner respectfully requests that this 8 Court approve the transfer of the structured settlement payments that are the subject of this 9 Petition. 10 11 19. California Insurance Code section 10139.5(h) requires that no later than the 12 time of filing of the Petition for court approval, the Transferee shall advise the Payee of the 13 payee's right to seek independent counsel and financial advice in connection with the 14 transferee's petition for court approval of the transfer agreement, and that the transferee 15 shall further advise the payee that if the payee retains counsel, a licensed certified public 16 17 accountant, or a licensed actuary in connection with a petition for an order approving the 18 transfer agreement, that the transferee shall pay the fees of the payee's counsel, accountant, 19 or actuary, regardless of whether the transfer agreement is approved, and regardless of 20 whether the attorney, accountant, or actuary files any document or appears at the hearing on 21 22 the Petition for transfer, in an aggregate amount not to exceed one thousand five hundred 23 dollars ($1,500). Further, that such advice may not be provided by an accountant, counsel, 24 or actuary of the transferee. 25 20. It is submitted to this Court that this Petition, the Notice of Petition attached 26 hereto, and the advisory statement provided to the payee all comply with and satisfy the 27 28 requirements of California Insurance Code section 10139.5. 5 [VERIFIED PETITION FOR APPROVAL OF TRANSFER RIGHTS] 1 Wherefore, Petitioner respectfully requests that upon fulfillment of all 2 disclosures and notices set forth under California Insurance Code sections 10134, et seq., 3 this Court enter an Order approving the Transfer Agreement by and between Payee and 4 INTELIFUND, LLC, Transferee. 5 6 7 THE LAW OFFICE OF JUAN C. LOZANO 8 9 10 By: _______________________________ Juan C. Lozano 11 Attorney for PETITIONER, INTELIFUND, LLC 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 6 [VERIFIED PETITION FOR APPROVAL OF TRANSFER RIGHTS] Transfer of Structured Settlement Payments: I.M. / County of SAN MATEO VERIFICATION I, KATHERINE E. SABA, GENERAL COUNSEL for INTELIFUND, 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 April 18, 2024. ____________________________ NAME EXHIBIT A Structured Settlement Payments Purchase Agreement This Structured Settlement Payments Purchase Agreement ("Agreement") is made between: An individual residing in San Mateo County, California, will be referred to throughout the Agreement as "You" and Your." INTELIFUND, LLC A limited liability company with its principal place of business at 3524 Silverside Road, Suite 358, Wilmington, Delaware 19810. Intelifund, LLC will be referred to throughout the Agreement as "We" or "Us." This Agreement is dated and effective as of the last date signed below or on such later date prescribed by applicable statutory law. You and We will sometimes be referred to collectively in this Agreement as the "Parties," and, individually, as a "Party." You agree to sell, assign, and convey to Us and our assigns, through an assignment of all rights and interest in and to, the following payments: ("Assigned Payments") This Agreement is not effective until the date on which a court enters a final order approving the transfer agreement. Payment to You pursuant to the transfer agreement will be delayed up to 30 days or more after the date that You signed the transfer agreement in order for the court to review and approve the transfer agreement. Total dollar amount of the payments You are selling: The aggregate amount of all expenses, if any, to be deducted from the purchase price to be paid to You in exchange for the payments to be transferred: NONE Net amount paid to You: Discounted Present value of amount You are selling. Thisis the"Satred settlement in current dollars: The applicable federal interest rate most recently published by the Internal Revenue Service is 5% YOU WILL BE PAYING THE EQUIVALENT OF AN INTEREST RATE OF PER YEAR. Initial Initial Based on the net amount that You will receive from Us and the amounts and timing of the structured settlement payments that You are transferring to Us, if the transferred structured settlement payments were installment payments on a loan, with each payment applied first to accrued unpaid interest and then to principal, it would be as if You were paying interest to Us of per year, assuming tung on the eftectve ate of transfer. The net amount that You will receive from Us in exchange for your future structured settlement payments represents[oercent of the estimated current value of the payments and is calculated by dividing the net payment amount by the discounted present value of the payments. You should obtain independent professional advice regarding any federal and state income tax consequences arising from the proposed transfer. We may not refer You to any specific advisor for that purpose. The court approving the transfer agreement retains continuing jurisdiction to interpret and monitor implementation of the Agreement as justice may require. If You believe You were treated unfairly or were misled as to the nature of the obligations You assumed upon entering into this agreement, You should report those circumstances to your local district attorney or the office of the Attorney General. Definitions • Agreement means this Agreement for Structured Settlement Payments Purchase Agreement with all attachments. • Annuity Issuer means the insurance company or other entity making payments to you as a result of a structured settlement agreement. • Annuity Owner and/or Settlement Obligor mean the entity that is legally obligated to provide payments to you for the underlying claim that was resolved by your structured settlement. • Assigned Payments means those payments due to you under your structured settlement that are being sold, assigned, and transferred as provided by this Agreement. • Court Order means a final, judgment and order from the court of competent jurisdiction overseeing the transfer of your Assigned Payments. • Disclosure Statement means a document setting forth and identifying various information concerning the sale and transfer of the Assigned Payments. • Encumbrances means any lien, pledge, judgement, mortgage, security interest, charge, child support, adverse claim, right or equity of redemption, or other right, interest or claim of any nature or description whatsoever by any other person or entity in the Assigned Payments. .- • Transaction means the sale, assignment, transfer, and related court action of your structured settlement payments to us that is governed by this Agreement. Initial • Purchase Price shall have the meaning as described in Section 2. Terms and Conditions 1. Agreement to Sell and Buy. You agree to sell, assign, and transfer to us and our assigns and successors all your rights and interests in the Assigned Payments as provided by the terms of this Agreement. We promise to pay you the Purchase Price through your specified method of payment on the Closing Date, once the funds become available. You agree to make the sale and assignment of the Assigned Payments to Purchaser free and clear of all Encumbrances. 2. Purchase Price. In exchange for all 2. all of your rights, title and interest in and to the Assigned Payments, We shall pay to the you, at Closing, the Purchase Price. The Purchase Price is the agreed upon amount of money to be provided to you for your rights, title and interest in the Assigned Payments as listed in the Agreement and Disclosure Statement and reduced by (a) any advances made to you prior to the Closing; (b) all Assigned Payments received by you after entering this Agreement through and including the Closing Date; and (c) any funds paid to your independent advisors, your creditors, or any other person or entity as requested by you and approved by us in our sole discretion. In the event that any portion of the Assigned Payments is sent to you after a Court Order approving the transfer, you agree to hold these payments in trust on our behalf and immediately turn them over to us. In the event that Encumbrances are disclosed by you or discovered by us during this Transaction, We may be obligated to satisfy these Encumbrances at or prior to closing. You agree to our paying these Encumbrances with Purchase Price funds prior to any disbursements to you. Should We elect to disburse some or all of the Purchase Price prior to obtaining all credit reports, Uniform Commercial Code (UCC) searches, or other searches that may identify Encumbrances, you agree that We, or its assignees, may hold back from the disbursement two(2) times the total amount of such Encumbrances as reasonably estimated by us. In such event, you will execute any and all documentation reasonably requested by us to identify the amounts to be withheld. 3. 3. Recitals. The recitals are hereby incorporated into this Agreement as if fully set forth herein. 4. Disclosure Statement. You acknowledge receipt of and agree to the terms of the 4. Disclosure Statement setting out various information regarding the Transaction. The terms set forth in the Disclosure Statement, including any later amendments to the document, are incorporated into this Agreement. � Initial 5. Closing. The closing ("Closing") shall occur upon satisfactory completion of certain conditions, which include, but are not limited to: (a) the Assigned Payments are free and clear of all Encumbrances either paid by you or paid by us with funds from the Purchase Price; (b) receipt of all necessary Court Orders; (c) termination of any UCC financing statements with a security interest in the Assigned Payments; (d) execution of any required stipulations between you, us, our assignee, and the Annuity Owner and Annuity Issuer; (e) written confirmation from the Annuity Issuer that you are entitled to the Assigned Payments and that it agrees to issue all of the Assigned Payments to us and our assignees as indicated in the Court Order; and (f) and any other condition reasonably deemed necessary by us. Upon the date that We determine, in our sole discretion, that all of the conditions required for Closing are satisfied (the "Closing Date") We or our assigns shall pay or distribute the Purchase Price to you. 6. Representations and Warranties. As a material inducement to Purchaser to enter into this Agreement, and to take steps and incur costs in connection with discharging its obligations hereunder, including but not limited to paying the Purchase Price, you represent and warrant that: 6.1 Title and Authority. You are the sole owner of the Assigned Payments with good, marketable, and defensible title, free and clear of all Encumbrances, and have full power and authority to enter into this Agreement and any related documents. You have not previously assigned, pledged or otherwise encumbered any portion of the Assigned Payments and none of the Assigned Payments have been attached, levied, foreclosed upon, seized, restricted, or subjected to garnishment or other legal process or proceeding. 6.2 Capacity. You are an adult of sound mind, not acting under duress, the influence of alcohol or other drugs, you are not currently subject to a court ordered guardianship or conservatorship, or impaired by any condition that would prevent you from fully consenting to this Agreement 6.3 Place of Residence. That you reside in the place designated in this contract and all application and supporting documents prepared as part of this transaction. 6.4 Access to Information. You authorize us or our agents to conduct any investigation, including, obtaining credit and background reports; contacting the Settlement Obliger, the Annuity Issuer, and/or the Annuity Owner to verify information related to the Settlement Payments; and undertaking other inquiries 1JInitial and searches necessary to confirm any information required to complete the Transaction. 6.5 The Settlement Documents. You agree to provide us with true and correct copies of your Settlement Agreement, Annuity Contract, a current benefits letter, and all other documents required by us that are necessary to complete the transaction. You warrant that these documents are complete copies and have not been changed or altered in any way. 6.6 No Judgments, liens or Actions. Except as previously disclosed in writing, there are no unsatisfied, outstanding judgments or liens against you and there are no lawsuits or claims pending or threatened against you, your property, or the Assigned Payments including child support, alimony, local state, or federal, taxes, and you do not know of any basis for any such lawsuit or claim. Except as previously disclosed by you, you have not voluntarily filed for bankruptcy or been subject to an involuntary bankruptcy proceeding. Should you have filed for bankruptcy, that it is now discharged or dismissed and if applicable, you disclosed the Annuity as required in the Bankruptcy filings. 6.7 6.7 Independent Advice. You were advised to seek independent professional advice regarding this Transaction. YOU FULLY ACKNOWLEDGE YOU HAD THE OPPORTUNITY TO RECEIVE LEGAL, TAX, FINANCIAL, ACCOUNTING AND/OR BUSINESS OR PERSONAL ADVICE REGARDING THE TRANSACTION CONTEMPLATED BY THIS AGREEMENT AND YOU (A) EITHER CONSULTED WITH SUCH ADVISORS OR (B) KNOWINGLY AND VOLUNTARILY WAIVED AND DECLINED THE OPPORTUNITY TO SEEK SUCH ADVICE. You have not relied on any representations or statements made by us, our agents, or attorneys regarding this Transaction or its tax consequences. You further acknowledge that you are fully aware of the economic consequences of the transaction contemplated by this Agreement. 6.8 Full Disclosure; No Adverse Facts. You have made no misrepresentations or any other misleading statements of fact or information concerning this Transaction, either orally or set forth in this Agreement or any related documents. You represent there are no facts that adversely affect or, as you can reasonably foresee, could adversely affect, your ability to perform your obligations under this Agreement. You are not aware of information which might (i) (i) diminish the value of the Assigned Payments or our rights and benefits under the terms of this Agreement; (ii) impair or delay our ability to receive and utilize the Assigned Payments; or (iii) otherwise affect our willingness to acquire the Assigned Payments. 4 Initial 6.9 Other Attempts to Assign; Cessation of Other Negotiations; Exclusivity. You have not previously assigned, pledged or otherwise encumbered any portion of the Assigned Payments. You made no attempt to pledge, encumber or transfer the Assigned Payments to any other person or entity. To the extent that you previously had discussions or negotiations with other persons or entities regarding the possible sale, assignment, transfer, other conveyance of the Assigned Payments, you represent and warrant that these discussions or negotiations have ceased and any and all contracts, agreements, letters of intent and other documents concerning these discussions and/or negotiations were cancelled. 6.10 This Is Not a Loan. THE PARTIES ACKNOWLEDGE AND AGREE THAT THE TRANSACTION DESCRIBED IN THIS AGREEMENT IS SALE AND TRANSFER OF THE ASSIGNED PAYMENTS FROM THE YOU TO US AND IS NOT A LOAN. You are not obligated to pay us funds subject to a rate of interest as a result of entering into this Agreement, excepting any return of advances in the event you cancel this Transaction, which will not be subject to interest charges. 6.11 Restrictions on Assignment. Your Settlement Agreement may contain language or provisions restricting or prohibiting your right or power to accelerate, defer, increase, decrease, assign, sell, transfer, mortgage, encumber, alienate, or convey the Assigned Payments. You hereby WAIVE any such restrictions on behalf of yourself and your heirs, beneficiaries, executors, administrators, successors, and legal representatives. 6.12 Beneficiaries. You acknowledge We, or our assigns, are entitled to receive the Assigned Payments and you designate us or our assigns as your beneficiary to the Assigned Payments. Upon Closing, you and any beneficiary, heir, executor, representative and/or dependent of yours shall be totally and forever divested of any right, title, claim or interest in the Assigned Payments. You agree to execute any additional beneficiary designation form, or other documents as may be required by the Annuity Owner or Annuity Issuer to carry out the intent of this paragraph. 6.13 Post Closing Matters. In the event you are selling less than the entire amount of any individual Settlement Payment, the Settlement Obligor, the Annuity Issuer or the court may require us, or our assigns, to receive the full amount of each installment and remit any amount above and beyond the Assigned Payment (i.e., the unassigned portion of the installment) to you through a "Servicing Arrangement." You acknowledge that a Servicing Arrangement may impede your ability to assign the unassigned portion of the settlement payment in the future. 6.14 Continuing Cooperation. Upon your execution of this Agreement, the Parties shall cooperate in commencing a legal action with the court of appropriate jurisdiction seeking court approval as required by the appropriate state structured 1 1 Initial settlement transfer statute. You agree to cooperate and take all action necessary to facilitate the completion of the Transaction, including being a party to a legal action and appearing at all necessary court hearings. You agree to promptly execute and deliver any additional instruments and documents and to do any acts as may be necessary to accomplish the terms and conditions of this Agreement. You hereby authorize us to correct any typographical errors or to make any ministerial revisions to this Agreement and to any other supporting documents signed by you if such revisions are necessary to effectuate the terms and conditions of this Agreement. You also agree to notify us in writing of any delay in performance or changes to the Assigned Payments, and to furnish to us with all information received by you regarding the Assigned Payments. 7. Conditions to Closing. Our obligation to proceed to Closing is subject to the satisfaction {unless waived in writing by us) of each of the following conditions: 7.1 Representations and Warranties. All representations made by you pertaining to this Transaction shall be true, correct, complete and not misleading. If you become aware of any fact or change of circumstances that would make your representations untrue or misleading, you shall immediately notify us of the change. All representations and warranties made in the Agreement and related to the Transaction shall survive Closing. 7.2 Access to Documents. When requested, you shall provide, or assist us in obtaining, the following documents, in a form and substance acceptable to us, which may include, but is not limited to: (i) a copy of the underlying settlement and release agreement/order under which you are entitled to receive the Assigned Payments; (ii) the Annuity contractts); (iii) a qualified assignment and release; (iv) a complete and accurate signed application; (v) if you are married, an agreement evidencing the consent of your spouse to the Transaction ("Spousal Consent") or a copy of your divorce decree and related property settlement/division documents and agreements; (vi) a current driver's license or government issued personal identification card; (vii) a social security card or other evidence or your social security number; (viii) copies of a recent check, payment stub or bank account records and statements showing a deposit to your account of a recent Settlement Payment; (ix) a statement of legal representation; (x) your most recent federal and state income tax returns; (xi) an executed affidavit certifying certain information about you; (xii) and such other documents and information as We may reasonably request. 7.3 Court Approval of the Transaction. A Court Order is required to complete the Transaction. You shall cooperate and assist us, in all respects, to secure the Court A A Initial Order. You will not be paid by us until We receive a valid, signed Court Order approving the sale, assignment, and transfer of the Assigned Payments; and after the Settlement Obligor and/or Annuity Owner and the Annuity Issuer provide written acknowledgement of receipt and approval of the Court Order, in a form and substance satisfactory to us and our assigns; and makes all findings required by applicable state and federal law. 7.4 Further Acts. You shall do, make, execute, and deliver any and all such additional and further acts, assignments, assurances, and instruments as We or our assigns may reasonably request for the purpose of completely vesting in us or our assigns the rights to the Assigned Payments. 8. Your Right to Cancel. You have the right to cancel this Agreement without any further obligation to until the date the court approves this transfer, as required by law ("Statutory Cancellation Period"). To cancel this Agreement during the Statutory Cancellation Period, you must provide written notice to us at the address listed at the beginning of this agreement that you desire to cancel this Agreement. We must be in receipt of your notice no later than the date of the court hearing to approve this transfer in order for it to be effective. 1n addition, you shall return any advances or promotional items provided to You by Us as may be permitted by law. 9, Termination. You acknowledge that We may terminate this Agreement at any time for any reason, even after initiation of the proceeding to secure the Court Order. In the event of termination by us, this Agreement shall become void and there shall be no liability or obligation on the part of the Parties or any of their respective officers, directors, employees, agents, attorneys, partners, trustees, affiliates, or associates. To the extent that the termination of this Agreement results from the willful breach by you of any representations, warranties, covenants or agreements set forth in this Agreement, nothing shall prejudice our ability from seeking damages from you, excluding recovery for attorney's fees. 10. 10. Special Irrevocable Durable Power of Attorney. You grant us or our assigns, a Special Irrevocable Durable Power of Attorney with full power of substitution, to act in your name, place and stead regarding the Assigned Payments, including, without limitation, the authority to negotiate, endorse and execute checks, drafts and other instruments in your name, the power to alter, edit and change payment instruction and/or beneficiary designations and any other act We deem necessary to obtain all the benefits of the bargain contemplated by this Agreement. This durable power of attorney shall be coupled with an interest, and shall survive your death, disability, incompetence or incapacity. You declare this durable power of attorney to be irrevocable and renounce Initial Initial all right to revoke it or appoint any other person to perform the acts referred to in this provision. 11. Acknowledgement of Assignment. You acknowledge that We may assign the rights under this Agreement and the Purchased Payments to a third-party funder and agree that all rights and representations under this Agreement will transfer to the third-party funder. 12. Entire Agreement. This Agreement and any related documents represent the entire agreement between the Parties and supersedes and cancels any prior negotiations, oral or written agreements, arrangements, and understandings related to transaction hereby contemplated. 13. Counterparts, Facsimile, and Electronic Signatures. This Agreement may be executed in several counterparts, each of which shall be deemed an original and all of which shall constitute one and the same instrument, and shall become effective when counterparts have been signed by each of the Parties; it being understood that all Parties need not sign the same counterparts. The exchange of copies of this Agreement and of signature pages by facsimile transmission, by electronic mail in "portable document format" ("pdf") form, or by any other electronic means intended to preserve the original graphic and pictorial appearance of a document, shall constitute effective execution and delivery of this Agreement as to the Parties and may be used in lieu of the original Agreement for all purposes. Signatures of the Parties transmitted by facsimile or in pdf shall be deemed to be their original signatures for all purposes. 14. Amendments. No provision of this Agreement or any related documents may be 14. amended, modified or waived except by written agreement duly executed by each of the Parties. 15. Severability. If any portion of this Agreement is determined to be invalid or unenforceable, it shall be modified to the extent necessary to render it lawful and enforceable. If it cannot be modified, such provision will be excluded to the extent of such invalidity and unenforceability. All remaining provisions of the Agreement will continue to be valid and enforceable. 16. Survival of Obligations. The representations, warranties, agreements, covenants, 16. acknowledgments, indemnifications, obligations, liabilities, waivers and disclaimers made or contained in this Agreement shall survive the Closing Date and completion of the Transaction, and shall remain in full force and effect until the expiration of any applicable statute of limitations. ±l ±l Initial 17. Governing law. 17. Governing law. This Agreement shall be governed, construed and enforced in accordance with the laws of the state of California. Disputes under this Agreement, including any claim that the You breached this Agreement, shall be determined in and under the laws of the state of California. SIGNATURE PAGE FOLLOWS •• Initial Initial IN WITNESS WHEREOF, the Parties have caused this Agreement to be executed by their duly authorized representatives effective as of the last date signed below or on such later later date prescribed by applicable statutory law. You have the the right to cancel this agreement without any cost or obligation until the date the court approves this agreement. You will receive notice of the court hearing date when approval may occur. You must cancel in writing and send your cancellation to: Intelifund, Intelifund, LLC, Attention: Gordon Zweig, 3524 3524 Silverside Road, Suite 358, 358, Wilmington, DE 19810-4929 19810-4929 set+ Date PURCHASE} Intelifund, LLC data.ea Acknowledgment for lI o..,6 ■- ■ o.06 %%or 1 i wot -known Bpcil pcil 2o_2t,etore me personaly 2oHetore known to me to be the person de!>rnbed described iin personally appeared n and who executed the foregoing document and acknowledged to me that he/she executed the same. [SEAL] EXHIBIT B DEPENDENT INFORMATION FOR Instructions: Instructions: Please list Please list all all of of your dependents below. your dependents below. If If You You have have no no dependents, dependents, please put zero. please put zero. Dependents" include Dependents" include your spouse, children your spouse, children under under 18 years of 18 years age, and of age, and all all other other family family members and members and other persons for other persons for whom whom You You are are legally obligated to legally obligated to provide provide support, support, including alimony. I-low many I-low many dependents dependents do do You You have? have? {specify {specify number) 0 number) ------- Name Relationship Relationship Date of Date of Birth Birth Age All of All of my dependents, if any, my dependents, any, are are listed listed above: above: Mg/ Date Date EXHIBIT C INDEPENDENT PROFESSIONAL INDEPENDENT PROFESSIONAL ADVICE ADVICE have been have been advised advised in writing by in writing by Intelifund, Intelifund, LLC, LLC, toto seek seek independent independent professional professional advice advice from from a a professional professional such such as as an an attorney, attorney, an an accountant, accountant, or aa financial or financial expert, expert, before II sign before sign the the Structured Structured Settlement Settlement Purchase Purchase andand Sale Sale Agreement, regarding the Agreement, regarding the consequences of consequences of transferring my future transferring my rights to future rights to structured structured settlement payments. II understand settlement payments. understand that iitt is that is my right to my right to choose choose to to receive receive such such advice advice or or not. not. II have have considered considered this this advice, advice, and: and: Please initial Please initial at your choice at your choice either "Option A" either "Option A" or Option B" B" BUT BUT NOT NOT BOTH BOTH OPTION A OPTION A � II have have chosen chosen to to waive waive my right to my right to seek seek Initial Initial such professional advice. such professional advice. OR OPTION B OPTION B II have have chosen chosen to to seek seek such advice, and such advice, and Initial Initial have received have received such such independent professional advice independent professional advice regarding regarding my my proposed proposed transfer transfer from from the the below below listed listed person: person: [vgmne professional [vgmne professional A(drsor. A(drsor. Address: Address: _ _ Phone Number: Phone Number: _ _ II affirm affirm that that the the above above referenced referenced individual