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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
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5 Attorneys for Petitioner,
INTELIFUND, LLC
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8 SUPERIOR COURT OF THE STATE OF CALIFORNIA
9 FOR THE COUNTY OF SAN MATEO
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12 In Re Petition of: ) Case No.:
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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.) )
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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.
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[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
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resident of the County of San Mateo, in California, and is over 18 years old.
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3. Talcott Resolution CEBSCO (the "Obligor"), is the Structured Settlement
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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
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agreement.
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4. Talcott Resolution Life Insurance Company (the "Annuity Issuer"), an
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insurance company authorized to do business in the State of California, has issued an
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12 insurance contract used to fund the structured settlement payment obligations of the
13 Obligor.
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5. This Court has subject matter jurisdiction over the instant action pursuant to
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Cal. Ins. Code § 10135(c) as either (1) the payee was domiciled in California at the time
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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
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Annuity Issuer is domiciled in California.
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6. Payee, by and through their guardian ad litem, entered into an agreement for
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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
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contained language that restricted and/or prohibited the right and/or power to assign the
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Assigned Payments in question. Notwithstanding such language, where no interested parties
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[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
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court-approved transfers of structured settlement payments. 321 Henderson Receivables
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Origination LLC v. Sioteco, 93 Cal. Rptr. 3d 321, 334 (Cal. Ct. App. 2009);
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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
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of this Petition;
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9. Payee has agreed to sell, and Transferee, INTELIFUND, LLC, has agreed to
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purchase certain lump sum payments, as referenced within their proposed Transfer
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12 Agreement. A true and correct copy of the proposed Transfer Agreement will be filed
13 subsequently hereto.
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10. INTELIFUND, LLC, shall, upon this Court entering an Order approving the
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Transfer Agreement, assign all its right, title and interest in and to the said proposed
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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)
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as well as 26 USC § 5891(b)(2)(A)(ii), Petitioner alleges that that transfer of structured
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settlement payment rights in the present matter is fair and reasonable and in the best
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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
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§ 5891(b)(2)(A)(i), Petitioner alleges that the transfer complies with the requirements of
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Cal. Ins. Code § 10134, et seq., and will not contravene other applicable law, does not
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[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
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administrative authority.
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13. Pursuant to Cal. Ins. Code § 10139.5(a)(2), Petitioner alleges that the Payee
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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
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the opportunity to receive the advice.
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14. Pursuant to Cal. Ins. Code § 10139.5(a)(3), the Petitioner has complied, or
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will comply at the time of the hearing, with the notification requirements of Cal. Ins. Code
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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
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agreement complies with Cal. Ins. Code §§ 10136(c) and 10138.
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15. Pursuant to Cal. Ins. Code § 10139.5(a)(5), the Payee understands the terms
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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
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not wish to exercise the Payee's right to cancel the transfer agreement.
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17. Pursuant to Cal. Ins. Code § 10139.5(f) the following documents shall be
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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).
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[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.
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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
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Court approve the transfer of the structured settlement payments that are the subject of this
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Petition.
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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
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payee's right to seek independent counsel and financial advice in connection with the
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transferee's petition for court approval of the transfer agreement, and that the transferee
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shall further advise the payee that if the payee retains counsel, a licensed certified public
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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,
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or actuary, regardless of whether the transfer agreement is approved, and regardless of
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whether the attorney, accountant, or actuary files any document or appears at the hearing on
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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.
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20. It is submitted to this Court that this Petition, the Notice of Petition attached
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hereto, and the advisory statement provided to the payee all comply with and satisfy the
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28 requirements of California Insurance Code section 10139.5.
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[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.,
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this Court enter an Order approving the Transfer Agreement by and between Payee and
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INTELIFUND, LLC, Transferee.
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7 THE LAW OFFICE OF JUAN C. LOZANO
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10 By: _______________________________
Juan C. Lozano
11 Attorney for PETITIONER,
INTELIFUND, LLC
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[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.
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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.
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• Transaction means the sale, assignment, transfer, and related court action of your
structured settlement payments to us that is governed by this Agreement.
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• 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.
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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
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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.
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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
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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.
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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.
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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
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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
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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.
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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
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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
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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
â– -
â–
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