Preview
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024
NYSCEF DOC. NO. 2 RECEIVED
R1947
NYSCEF:
'98
04/23/2024
21 218 PEB 12 35:89
. At 4n 248 Part 13 of the
Onurt the Atate of anew 7og4,
the m*
a tag county of Kings.
the comarthouse Assated as Mt sutens
8sooklyn, .Waw Tertr on the
. strees.,
of 49Rs.
y
P R a a m m t s
.
N05, sntRBR$T Emalapt
austice
....-......--........-----,-----an="w--.x
GMgWRL SRMBDY pad SANDy $39RD74. infa 43
their mother and natural as .
:putmars
anumumammem amann
Ig@ivi
P1mintiffs. . 4564/95
-against-
SPMABY DWWE 05NENT , ItC.,
magendanta. . 3
--.. *.---......”........----o .....-n
petition of mogItque saMEpt, th
pon and filing ass
weeding
tasant plainstiffs. eleuost, mant
mottMay sad nateral guesdåma of she
SAND28 versfiegi the SOEM day c
and sampt saM8py A/E/A 5A9tBDif, duly
. the maid infants ateft bora on t$
BBPTEMBER, 1957, showists that
the Affirmation of ELENT CDPFT3UhS.
firm of 5.4,TAPAKta, P .c., attorneys tor c)
menuber of the sut&25Nf,
of January, 19ser and si
plaintiffs heroin, dated thes 1955 day
all proceedinge tunretofes
annexed medical =and upon the
reporte(
had heroing .
anMgns aim8 BRMDT 8AMBDr A/K/A SAND.
a 19 the infants. SAMtRR
anairdian and their attor:geye movi:
5AMERr tnmir assegral
anA
1899, and the cotr
6 15 CPUrt ER E 8 th IGmy Of 5teven8pse,
eme due deliberation havi:
tumvtag
emmuntsame ane sustmew4spans them,
been mad thermon,
te3themes&mAsieason of this Cmurt that t;he
Jenh it appearias
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024
NYSCEF DOC. NO. 2 23 RECEIVED
meer as
NYSCEF:
ra ass 04/23/2024
tenes
to Mmmit the eompromise of tt
is good and muffie!was remess
setion an habaXX of the imEast platatiffma
of that seiMion wi11 t
45p4 At spgearitgt ,thanthe exnnpromAme h9
heat ant4tests et the ingmat platntiffs
the advantage mud in the
:
it appearing further that the petit40ser is mi<1ing
mant
eattlement at tMa came offered :
apempt the congaramine amus the
defendent are to par z
sts defeneanna man that the see4y
'ampunce as diawated-by this centres
satstement
Spid.ETAN 4 LEAMatts. P.h attorneym tot C
most, an manian of
stainsists homeim. Es Air
mastrous 4uwner, mother and emewraX quas44an
ORARIUsp. that
SAM207 ag4 INGAME SERGAMI 3/R4 $30A5
the idm@ plaintiff s, 1M98385.
author$sed ane emposered to mantle t
as ERar, he atet tw heux49
for the total sus of FTV2 5Rt09
motion of the infams plaintiffa
and condird9n
FIPTV TH00B880 and 90/100 54550,005.40) USLWhRS,
pree4pians to expeace a mammi
upon immughanem e4th the fonevingr
to sonompush 5)
relespe and to mi n all . papers ancessary
the proceeds thereot s amt
settlement and anitect and distribute
metiam sas it is furatuar
tendent 55 BY DEVI DE9Entr QQgth and,
GRDBRED. that th$ 4
FTTE EUNNRRD PEP#7 $500B,
their regaramentatives pay the amount qC
mer*
actions pendingt apmanet mafendant be
Oc¾nak assi that the
dancemaimmed, sad it to tearsher
$1F8555 UEVELABNENT 0d31P , , ad
GRdMMP. sphet the defendant
es rzva mustange rtrTV taous
their supsesenses4ves pay the apegme
2
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024
NYSCEF DOC. NO. 2 RECEIVEDFEB
NYSCEF:
MS
04/23/2024
15:99
14Eu.5 21B PBS/grf 12
09/100 ($555 age.cot ad&Msts as Se&!ews:
, mad
attaft$mys for
ti) gg gggavagg a rapsgsts, P.C.,
plaintiffe in h maid actione am und for their 44"bormesense, t)
Twimstr-seqa and 43/ t
sum Fzza tacosamp Tunes summask
eg
(45,324,63)"9aumns
P.c.. seturneys for a
(n we sura.xvas a sapJutts.
steerseys' · fe
r,tem mass mattest.ees mas tor their
plaintists $n
520N77 0N8 THOUSAND gX95 HQdBR
thereof the sue of ONE ItUNDIRED
PEP5W1ttSRT and 39/100 ($181,558.39) DOMARSt
infante* set proceeds shal4
sptDst$5, that the
infants* Itfetians as follower
. wrouctues thr1uughest the
assummL amener
for four (4) yonze. beg%mping
sm) 135,00s.09 ammunX4
ane August as, seat, mod
alugust 29, 3009 anding
shall be made to SAMt
thur tot%owing Xump sums
En m@$itten,
BAMger:
payable on august as, so
sso,oco.on, guaranteed temp sum
ta)
August .
guarampeme sum payahte on
th) vse.one.ok 1ump
. 20a9,
i to SAM
Finally. the Óe11çnr$ng manshly
gaggag,
a yme
$3,1964tF per ment56 for .
W
tm)
.... -e made
on s9/t&/20tt. guaraw
beginning
es/e%/5%!a
sunnumar.Jh#tgh maumatm sannamr
quotnr
for four (41 years, battianing
tap $30,000s sunguntly
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024
21s PasqP KO 12 '® 25
August 3 , 2008 and ending Ampust as. aeat, mme
Os a44ition, the EM4owing lamp aume she21 be ande to 8ANE
angspy A/E/A mast sugendra
(a) 430,nae.co. guarant,eed kmp sum gavabia an assumm ±w, von
BF semans,#o. gnatupteed sum
lumep payable on augmme ve, asse
Viam217, the tolloping agetbly 4mGUEs sh 11 be M On RA SAGE
811955pr AfKfA 54MDXM SAN5DT
tail 4sat.00 per utant or 142m, pearenteed 30 years. be a
ma as/gaf301L Last guarantee paytnent SL11 be on on
sugge /te44
mest. ass payout matemen a )
guarantee4 puapnenta as set farth in Sashlb4t Sa". then and ta the
vvens, phe guarensated putNmente whion weekd have been made pursuan
to the Uteer whm11 he made so the Betatee of plaintif fs, $AMOBf
aliMRUT an4 BMNMr 5AMEDS A/E/A 3895)T% SMAR3L end it is further
0st01580, anet the filing of a band, An aceareance with stu
peaviatona ve essa 12%a tc) be hereby ittimpensed wicer mad it is
further
ammaran, that canditioned upmn tin31 momp1&nnes with she townto
95 thim 9748% the Petit498mr thm<) #Js hischarged and relemmed $rep
ska 1&ability arthane gram a11 mastere and tÊimes e race an thin
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024
3 T B 4 r
.
g W
3
v.
U
a
a
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024
Allstate Life insurance Company of New York
Addriams-
A StnA Comperv * Hone 0$ce FarmthgvBle,Meer York 11788
Single Premium Immediate Life Annuity
payment of the eingle prenMn, the opattel and the pplk lon -
,a ofwshleattnened.andsu
entlee can . All statementamage In An applim@on are rapnnsenistices and notammmits N
tiaim orin unid this genÞant unless R 16 in mo st§ndd sppQoe on.
statement wm beused try us Rs defens#We
colysur chensethiscontract or wal95 a right ce requkemers, hapnt may do His.
ameersmay
df New York (called or 'WÝWE mnke-Sto payments shownon 3
Nisneeise Insurance company
that em Measudng Life is alive, in 1
ite Measuring tEe or other psyee dealgnated by ABC
payments showr Cartsh(Psyments on Rage 3 wM be made to the
the Measuring I. ale not INing,any
·
amnesalary.
RfleMr T0 CANGEL-tf ABC is ret agesSed WI 1this 00nifact, he welded by retu A gtsts th
New York 11738 agent, ASC stunt us end talufn
kmurance Compgmy qINew Famdngvile,
me ponny by midnight of em10th aRer ABC.ruceives 10 N a A mail aw ndum of the gongest 5
addressedta weweretanthesingle
manareoffe@eon eming imaned.property
paymen made, within 10 days anor we reåelve the poHer and notice,
pamten, lessany aheady
in a legar oontract between ASC and us. READ THIS POLICY CAREFULLY.
Titis
COPY
yet.
so Pmsided
NYLtRi7
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024
r .
..
TABLE DF CONTENTS
-.. r
Contract --..-...-.-m...... Ilonel8thxy --....-o-,m...... ,’- 4
....----------- 1 . %) N BBilitMy .m......-..-.................:..a- 4
ghth0erical
thihedule M PaymmMs .. ...e-.......- 3 Amatessmatef er Ben,¾.-,-. 4
Lirakfamudtion...-..... . ...... Psufcf . ......---..........-a.... 4
3
MagnwrIng
Values....... m.,,.a.. ...-..... 4
0ontract Nuintier-. . ,.....--.-... S
......-..-.-...-....-... -,...e . -,.,-..,,-..-..--.... 4
Owner
he u HIIII .. , . . .... 3
b
-
- a .
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024
SCHEDULE OF PAYMENTS
DATE AMaufit
Aue go, noon 4. 200a0 ,08 ANNUALLY
'
THROUGH
AUG 29, 2011
AUS 29 , 2818 50s00.0
AUS 29, 2028 4 48786,0
MANE DATE DF BIR.IM
MEASURING LIFEs SANDIE SAMEpY FEMALS
FIRST PAYMENT: 9 20009.00 0M AuS 19 2008
LAST PAYMENTt . * 44788.09 ON AUn 29, 2020
CGNTRACT MGMBER: OPMERs ACLSTAT SETTLEáENT CORP
ISSUE DATEs DGT 15: 1997
PAGE 5
POLeCY ·DATA PAGE FOR MVLU214
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024
SCH2DOLE OF PAYMENT4
.. ... DATE . AMOUNT
SEP 1, 2011 * 851.00 MONTHLY
AND
THEREAFTER
CERTAIN PAYMENTS: THE FIRST 568 PAYMENTS.SHGWN AB0VE, THE LAST ONE
SCHEDULED FOR AUS 1, 2041.
.
...BAME DATE 45F RERTN
MEASUN2NG LIFE: sARDIE. SAMEDY ·PSALE
NUMBERs 0M863: ALLaTATE S$TTL IENT CORP
CONTRACT
ISSUE DATEs OCT 35, 1997
POLICV PATA PAGE FOR NVLH217
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024
ALJ.MATE INSURANCE COMP OF91EWYORK
Henne 019ee: FarmingviNo, 19gns Yorst11738
Application far Single Premhnn latñgsilmie AnnuRy
ress
tonist SecurMyNo.: Date or8rtin time F
2, hinementisLies(if applicable)
Full Name:
Phone:( )
Soulat 8scurRy No.: . pate d8irth: Sex:
Relationshiptar Measuring lilk
& Gener
asil Nasns: ADstate Settlement Cørpomat(Hbn Phone:(
Additas:
. I
4. Payne (will b4 Meescring Lifeif .
letblani@
Puff Name:
Phone:( )
elliGGMBhip to Maasuring LIRE ..
& infonsullon¬8utanit for
W
smoefof age or Jointillspay ents.)
hpa (e.g, itergate, 15ev . . Numbor or or .
Prequency
E lump sum.JdinG eymenta Peants
6/29/2608 certain $20 000 4 annual
9/1/ 2011 life $ 851 360 monthly
8/29/2015 sum $30,000 - 1
lump
S/29/2020 lump sus $48, 788 1
.Feb Name: Phone: ( )
Addreast
Scalat Security No: ilfe:
RelatistsidpapMeasurie
7. Pnanhan _, ,,n,,4derahen
The Appliennt represota that se statements and answewon this Appnotion are oustothe bout of
es or her knowlease ans emiter ans completely rpoordeø.terain .
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024
'
BENEFICIARMinless .
. try ASG, the beneBolant is de tienati in the appilnetion. lf thess la no
named or living, benearJayr la the Measuring L3irs estate, For purposes of this sectlan.
benecolary
"Ilving"
of
shall mean IMng on the earlier
1. The day we receive due proof at the Measuring t#e's desh or
" 2. Tha i5th day pàst the Measuring 1,lfe's death.
ynless ABC states otherwise frrevocaWy noming a . . , ABO may thah a the benenstery while the
Life.1s alive. A must be modelp us In . . .Tlyn ch(mper must be secepte51s to .
ideasudng
0ame vre accept the change, it eBact as orthe day ASC signe tequest Each shange is au)ect m
Preview
FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024 NYSCEF DOC. NO. 2 RECEIVED R1947 NYSCEF: '98 04/23/2024 21 218 PEB 12 35:89 . At 4n 248 Part 13 of the Onurt the Atate of anew 7og4, the m* a tag county of Kings. the comarthouse Assated as Mt sutens 8sooklyn, .Waw Tertr on the . strees., of 49Rs. y P R a a m m t s . N05, sntRBR$T Emalapt austice ....-......--........-----,-----an="w--.x GMgWRL SRMBDY pad SANDy $39RD74. infa 43 their mother and natural as . :putmars anumumammem amann Ig@ivi P1mintiffs. . 4564/95 -against- SPMABY DWWE 05NENT , ItC., magendanta. . 3 --.. *.---......”........----o .....-n petition of mogItque saMEpt, th pon and filing ass weeding tasant plainstiffs. eleuost, mant mottMay sad nateral guesdåma of she SAND28 versfiegi the SOEM day c and sampt saM8py A/E/A 5A9tBDif, duly . the maid infants ateft bora on t$ BBPTEMBER, 1957, showists that the Affirmation of ELENT CDPFT3UhS. firm of 5.4,TAPAKta, P .c., attorneys tor c) menuber of the sut&25Nf, of January, 19ser and si plaintiffs heroin, dated thes 1955 day all proceedinge tunretofes annexed medical =and upon the reporte( had heroing . anMgns aim8 BRMDT 8AMBDr A/K/A SAND. a 19 the infants. SAMtRR anairdian and their attor:geye movi: 5AMERr tnmir assegral anA 1899, and the cotr 6 15 CPUrt ER E 8 th IGmy Of 5teven8pse, eme due deliberation havi: tumvtag emmuntsame ane sustmew4spans them, been mad thermon, te3themes&mAsieason of this Cmurt that t;he Jenh it appearias FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024 NYSCEF DOC. NO. 2 23 RECEIVED meer as NYSCEF: ra ass 04/23/2024 tenes to Mmmit the eompromise of tt is good and muffie!was remess setion an habaXX of the imEast platatiffma of that seiMion wi11 t 45p4 At spgearitgt ,thanthe exnnpromAme h9 heat ant4tests et the ingmat platntiffs the advantage mud in the : it appearing further that the petit40ser is mi<1ing mant eattlement at tMa came offered : apempt the congaramine amus the defendent are to par z sts defeneanna man that the see4y 'ampunce as diawated-by this centres satstement Spid.ETAN 4 LEAMatts. P.h attorneym tot C most, an manian of stainsists homeim. Es Air mastrous 4uwner, mother and emewraX quas44an ORARIUsp. that SAM207 ag4 INGAME SERGAMI 3/R4 $30A5 the idm@ plaintiff s, 1M98385. author$sed ane emposered to mantle t as ERar, he atet tw heux49 for the total sus of FTV2 5Rt09 motion of the infams plaintiffa and condird9n FIPTV TH00B880 and 90/100 54550,005.40) USLWhRS, pree4pians to expeace a mammi upon immughanem e4th the fonevingr to sonompush 5) relespe and to mi n all . papers ancessary the proceeds thereot s amt settlement and anitect and distribute metiam sas it is furatuar tendent 55 BY DEVI DE9Entr QQgth and, GRDBRED. that th$ 4 FTTE EUNNRRD PEP#7 $500B, their regaramentatives pay the amount qC mer* actions pendingt apmanet mafendant be Oc¾nak assi that the dancemaimmed, sad it to tearsher $1F8555 UEVELABNENT 0d31P , , ad GRdMMP. sphet the defendant es rzva mustange rtrTV taous their supsesenses4ves pay the apegme 2 FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024 NYSCEF DOC. NO. 2 RECEIVEDFEB NYSCEF: MS 04/23/2024 15:99 14Eu.5 21B PBS/grf 12 09/100 ($555 age.cot ad&Msts as Se&!ews: , mad attaft$mys for ti) gg gggavagg a rapsgsts, P.C., plaintiffe in h maid actione am und for their 44"bormesense, t) Twimstr-seqa and 43/ t sum Fzza tacosamp Tunes summask eg (45,324,63)"9aumns P.c.. seturneys for a (n we sura.xvas a sapJutts. steerseys' · fe r,tem mass mattest.ees mas tor their plaintists $n 520N77 0N8 THOUSAND gX95 HQdBR thereof the sue of ONE ItUNDIRED PEP5W1ttSRT and 39/100 ($181,558.39) DOMARSt infante* set proceeds shal4 sptDst$5, that the infants* Itfetians as follower . wrouctues thr1uughest the assummL amener for four (4) yonze. beg%mping sm) 135,00s.09 ammunX4 ane August as, seat, mod alugust 29, 3009 anding shall be made to SAMt thur tot%owing Xump sums En m@$itten, BAMger: payable on august as, so sso,oco.on, guaranteed temp sum ta) August . guarampeme sum payahte on th) vse.one.ok 1ump . 20a9, i to SAM Finally. the Óe11çnr$ng manshly gaggag, a yme $3,1964tF per ment56 for . W tm) .... -e made on s9/t&/20tt. guaraw beginning es/e%/5%!a sunnumar.Jh#tgh maumatm sannamr quotnr for four (41 years, battianing tap $30,000s sunguntly FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024 21s PasqP KO 12 '® 25 August 3 , 2008 and ending Ampust as. aeat, mme Os a44ition, the EM4owing lamp aume she21 be ande to 8ANE angspy A/E/A mast sugendra (a) 430,nae.co. guarant,eed kmp sum gavabia an assumm ±w, von BF semans,#o. gnatupteed sum lumep payable on augmme ve, asse Viam217, the tolloping agetbly 4mGUEs sh 11 be M On RA SAGE 811955pr AfKfA 54MDXM SAN5DT tail 4sat.00 per utant or 142m, pearenteed 30 years. be a ma as/gaf301L Last guarantee paytnent SL11 be on on sugge /te44 mest. ass payout matemen a ) guarantee4 puapnenta as set farth in Sashlb4t Sa". then and ta the vvens, phe guarensated putNmente whion weekd have been made pursuan to the Uteer whm11 he made so the Betatee of plaintif fs, $AMOBf aliMRUT an4 BMNMr 5AMEDS A/E/A 3895)T% SMAR3L end it is further 0st01580, anet the filing of a band, An aceareance with stu peaviatona ve essa 12%a tc) be hereby ittimpensed wicer mad it is further ammaran, that canditioned upmn tin31 momp1&nnes with she townto 95 thim 9748% the Petit498mr thm<) #Js hischarged and relemmed $rep ska 1&ability arthane gram a11 mastere and tÊimes e race an thin FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024 3 T B 4 r . g W 3 v. U a a FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024 Allstate Life insurance Company of New York Addriams- A StnA Comperv * Hone 0$ce FarmthgvBle,Meer York 11788 Single Premium Immediate Life Annuity payment of the eingle prenMn, the opattel and the pplk lon - ,a ofwshleattnened.andsu entlee can . All statementamage In An applim@on are rapnnsenistices and notammmits N tiaim orin unid this genÞant unless R 16 in mo st§ndd sppQoe on. statement wm beused try us Rs defens#We colysur chensethiscontract or wal95 a right ce requkemers, hapnt may do His. ameersmay df New York (called or 'WÝWE mnke-Sto payments shownon 3 Nisneeise Insurance company that em Measudng Life is alive, in 1 ite Measuring tEe or other psyee dealgnated by ABC payments showr Cartsh(Psyments on Rage 3 wM be made to the the Measuring I. ale not INing,any · amnesalary. RfleMr T0 CANGEL-tf ABC is ret agesSed WI 1this 00nifact, he welded by retu A gtsts th New York 11738 agent, ASC stunt us end talufn kmurance Compgmy qINew Famdngvile, me ponny by midnight of em10th aRer ABC.ruceives 10 N a A mail aw ndum of the gongest 5 addressedta weweretanthesingle manareoffe@eon eming imaned.property paymen made, within 10 days anor we reåelve the poHer and notice, pamten, lessany aheady in a legar oontract between ASC and us. READ THIS POLICY CAREFULLY. Titis COPY yet. so Pmsided NYLtRi7 FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024 r . .. TABLE DF CONTENTS -.. r Contract --..-...-.-m...... Ilonel8thxy --....-o-,m...... ,’- 4 ....----------- 1 . %) N BBilitMy .m......-..-.................:..a- 4 ghth0erical thihedule M PaymmMs .. ...e-.......- 3 Amatessmatef er Ben,¾.-,-. 4 Lirakfamudtion...-..... . ...... Psufcf . ......---..........-a.... 4 3 MagnwrIng Values....... m.,,.a.. ...-..... 4 0ontract Nuintier-. . ,.....--.-... S ......-..-.-...-....-... -,...e . -,.,-..,,-..-..--.... 4 Owner he u HIIII .. , . . .... 3 b - - a . FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024 SCHEDULE OF PAYMENTS DATE AMaufit Aue go, noon 4. 200a0 ,08 ANNUALLY ' THROUGH AUG 29, 2011 AUS 29 , 2818 50s00.0 AUS 29, 2028 4 48786,0 MANE DATE DF BIR.IM MEASURING LIFEs SANDIE SAMEpY FEMALS FIRST PAYMENT: 9 20009.00 0M AuS 19 2008 LAST PAYMENTt . * 44788.09 ON AUn 29, 2020 CGNTRACT MGMBER: OPMERs ACLSTAT SETTLEáENT CORP ISSUE DATEs DGT 15: 1997 PAGE 5 POLeCY ·DATA PAGE FOR MVLU214 FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024 SCH2DOLE OF PAYMENT4 .. ... DATE . AMOUNT SEP 1, 2011 * 851.00 MONTHLY AND THEREAFTER CERTAIN PAYMENTS: THE FIRST 568 PAYMENTS.SHGWN AB0VE, THE LAST ONE SCHEDULED FOR AUS 1, 2041. . ...BAME DATE 45F RERTN MEASUN2NG LIFE: sARDIE. SAMEDY ·PSALE NUMBERs 0M863: ALLaTATE S$TTL IENT CORP CONTRACT ISSUE DATEs OCT 35, 1997 POLICV PATA PAGE FOR NVLH217 FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024 ALJ.MATE INSURANCE COMP OF91EWYORK Henne 019ee: FarmingviNo, 19gns Yorst11738 Application far Single Premhnn latñgsilmie AnnuRy ress tonist SecurMyNo.: Date or8rtin time F 2, hinementisLies(if applicable) Full Name: Phone:( ) Soulat 8scurRy No.: . pate d8irth: Sex: Relationshiptar Measuring lilk & Gener asil Nasns: ADstate Settlement Cørpomat(Hbn Phone:( Additas: . I 4. Payne (will b4 Meescring Lifeif . letblani@ Puff Name: Phone:( ) elliGGMBhip to Maasuring LIRE .. & infonsullon¬8utanit for W smoefof age or Jointillspay ents.) hpa (e.g, itergate, 15ev . . Numbor or or . Prequency E lump sum.JdinG eymenta Peants 6/29/2608 certain $20 000 4 annual 9/1/ 2011 life $ 851 360 monthly 8/29/2015 sum $30,000 - 1 lump S/29/2020 lump sus $48, 788 1 .Feb Name: Phone: ( ) Addreast Scalat Security No: ilfe: RelatistsidpapMeasurie 7. Pnanhan _, ,,n,,4derahen The Appliennt represota that se statements and answewon this Appnotion are oustothe bout of es or her knowlease ans emiter ans completely rpoordeø.terain . FILED: ONONDAGA COUNTY CLERK 04/23/2024 10:11 AM INDEX NO. 004211/2024 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/23/2024 ' BENEFICIARMinless . . try ASG, the beneBolant is de tienati in the appilnetion. lf thess la no named or living, benearJayr la the Measuring L3irs estate, For purposes of this sectlan. benecolary "Ilving" of shall mean IMng on the earlier 1. The day we receive due proof at the Measuring t#e's desh or " 2. Tha i5th day pàst the Measuring 1,lfe's death. ynless ABC states otherwise frrevocaWy noming a . . , ABO may thah a the benenstery while the Life.1s alive. A must be modelp us In . . .Tlyn ch(mper must be secepte51s to . ideasudng 0ame vre accept the change, it eBact as orthe day ASC signe tequest Each shange is au)ect m