HomeMy WebLinkAboutAgreement A-22-564 Qualified Assignment and Release Agreement REDACTED.pdf Agreement No. 22-564
Qualified Assignment and Release Agreement
In Accordance With Internal Revenue Code Section 130
"Claimant(s)": Alexander R_ (See Addendum No. 1 ) "Assignor": County of Fresno
"Settlement Agreement":
"Settlement Agreement and Release" re ALEXANDER R-, a minor, by and
through his Guardian Ad Litem, ELISA PEREZ ("Claimant"); and Respondent the County of
Fresno, a political subdivision of the State of California ("County") and attached Orders.
[Date and title of settlement agreement, order or other document embodying
the Assignor's obligation to make the agreed periodic payments]
"Assignee": Melife Assignment Comfy., Inc.
"Annuity Issuer": Metropolitan Tower Life Insurance Comfy
"Effective Date":
This Qualified Assignment and Release Agreement is made and entered into as of the Effective Date
by and among the undersigned parties with reference to the following facts:
A. Claimant(s)and Assignor are parties to or are otherwise subject to or entitled to receive payments
under the above-referenced Settlement Agreement, under which Assignor has liability to make
certain periodic payments to or for the benefit of Claimant(s) as specified or referred to in paragraph
12 of this Agreement (the "Periodic Payments"); and
B. Assignor and Assignee wish to effect a "qualified assignment"within the meaning and subject to the
conditions of Section 130(c)of the Internal Revenue Code of 1986, as amended (the "Code").
Now, therefore, in consideration of the foregoing and for other good and valuable consideration, the
parties agree as follows:
1. Assignment and Assumption; Release of Assignor.Assignor hereby assigns to Assignee, and
Assignee hereby accepts and assumes, all of Assignor's liability to make the Periodic Payments
described in paragraph 12. Each Claimant hereby accepts and consents to such assignment by
Assignor and assumption by Assignee. Effective on the Effective Date, each Claimant hereby
releases and discharges Assignor from all liability to make the Periodic Payments.
2. Nature of Periodic Payments. The Periodic Payments constitute
i. damages (other than punitive damages), whether by suit or agreement, or
ii. compensation under a workers' compensation act,
on account of personal injury or sickness in a case involving physical injury or physical sickness,
within the meaning of Sections 130(c) and 104(a) of the Code.
3. Extent of Assignee's Liability. Assignee's liability to make the Periodic Payments shall be no
greater than the liability of Assignor immediately prior to the Effective Date. Assignee assumes no
liability other than the liability to make the Periodic Payments. Assignee's liability to make the Periodic
Payments described in Addendum No. 1 shall be unaffected by any bankruptcy or insolvency of
Assignor.
4. Qualified Funding Asset. Assignee will fund the Periodic Payments by purchasing from Annuity
Issuer a "qualified funding asset,"as defined in Section 130(d)of the Code, in the form of an annuity
contract(the "Annuity") issued by Annuity Issuer and providing for payments corresponding to the
Periodic Payments. Assignee shall be designated as the owner of the Annuity. All rights of legal
ownership and control of the Annuity shall (subject to paragraph 9 of this Agreement) be and remain
vested exclusively in Assignee; provided, however, that the Annuity shall be used by Assignee to
fund the Periodic Payments and shall at all times be designated by Assignee on its records as being
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taken into account, under Section 130 of the Code, with respect to this Agreement. Notwithstanding
anything to the contrary contained in this Agreement, neither any Claimant nor any Successor Payee
shall have any rights with respect to the Annuity or the payments thereunder that would cause any
amount attributable to the Annuity to be currently includible in the recipient's income or would
otherwise affect the determination of when any recipient is treated as having received any payment
for income tax purposes, or would otherwise prevent this Agreement from satisfying all of the
conditions for a "qualified assignment"within the meaning of Section 130(c)of the Code.
5. Delivery of Payments. Assignee may have Annuity Issuer send payments directly to a Claimant, or,
if applicable, to a Successor Payee (as defined in paragraph 8 of this Agreement), or deliver
payments by electronic funds transfer to a depository institution in the United States for credit (directly
or indirectly)to an insured account in the name of such Claimant or Successor Payee. Such
direction of payments under the Annuity shall not be deemed to afford the Claimant or any Successor
Payee any rights of ownership or control of the Annuity. Each Claimant and any Successor Payee
shall at all times keep Annuity Issuer apprised of such Claimant's or Successor Payee's current street
address and telephone number and, if such Claimant or Successor Payee receives payments by
electronic funds transfer, the name, address, bank identifier number(BIN) and telephone number of
the applicable depository institution and the account number of the account to which the payments
are to be credited.
6. Discharge of Liability. The Assignee's liability to make each Periodic Payment to the Claimant or
Successor Payee designated to receive such payment shall be discharged automatically at such time
as a corresponding payment is made to such Claimant or Successor Payee by the Annuity Issuer.
7. Acceleration, Transfer of Payment Rights. None of the Periodic Payments and no rights to or
interest in any of the Periodic Payments (all of the foregoing being hereinafter collectively referred to
as "Payment Rights") can be
i. Accelerated, deferred, increased or decreased by any recipient of any of the Periodic Payments;
or
ii. Sold, assigned, pledged, hypothecated or otherwise transferred or encumbered, either directly or
indirectly, unless such sale, assignment, pledge, hypothecation or other transfer or encumbrance
(any such transaction being hereinafter referred to as a "Transfer") has been approved in
advance in a "Qualified Order" as defined in Section 5891(b)(2)of the Code (a "Qualified Order")
and otherwise complies with applicable state law, including without limitation any applicable state
structured settlement protection statute.
No Claimant or Successor Payee shall have the power to effect any Transfer of Payment Rights
except as provided in sub-paragraph (ii)above, and any other purported Transfer of Payment Rights
shall be wholly void. If Payment Rights under this Agreement become the subject of a Transfer
approved in accordance with sub-paragraph (ii) above the rights of any direct or indirect transferee of
such Transfer shall be subject to the terms of this Agreement and any defense or claim in
recoupment arising hereunder.
8. Beneficiaries. Any Periodic Payments to be made after the death of any Claimant or Successor
Payee shall be made to such party as shall have been designated in, or in accordance with, the
Settlement Agreement or, if the Settlement Agreement does not provide for such designation, then to
the party designated in conformity with this paragraph 8. Any party so designated is referred to in this
Agreement as a "Beneficiary." If no Beneficiary is living at the time of the death of a Claimant or
Successor Payee, payment shall be made to the decedent's estate. As used in this agreement the
term "Successor Payee" refers to a Beneficiary or an estate that has become entitled to receive
Periodic Payments following the death of a Claimant or a Successor Payee. Except as otherwise
provided in the Settlement Agreement, no designation or change of designation of a Beneficiary shall
be effective unless such change (i) is requested in a written request submitted to Assignee (or its
authorized agent) in accordance with Assignee's customary procedures for processing such requests;
and (ii) is confirmed by Assignee (or its authorized agent). Except for a designation that is expressly
identified in the Settlement Agreement as irrevocable, any designation of a Beneficiary shall be
deemed to be revocable; and no party that is designated as a Beneficiary (other than a party
irrevocably designated as a Beneficiary in the Settlement Agreement)shall, solely by virtue of its
designation as a Beneficiary, be deemed to have any cognizable interest in any Periodic Payments.
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9. Failure to Satisfy Section 130(c). If at any time prior to completion of the Periodic Payments, the
Settlement Agreement is declared terminated in a final, non-appealable order of a court of competent
jurisdiction (or in the case of a workers' compensation settlement, a final order of the applicable
workers' compensation authority)or if it is determined in any such final order that the requirements of
Section 130(c) of the Code have not been satisfied in connection with this Agreement: (i)the
assignment by Assignor to Assignee of the liability to make the Periodic Payments, Assignee's
acceptance of such assignment and the release by Claimant(s)of Assignor's liability shall be of no
force or effect; (ii)Assignee shall be conclusively deemed to be acting as the agent of Assignor; (iii)
the Annuity shall be owned by Assignor, which shall retain the liability to make the Periodic
Payments; (iv)Assignee shall have no liability to make any Periodic Payments; and (v)the parties
hereto agree to cooperate in taking such actions as may be necessary or appropriate to implement
the foregoing.
10. Governing Law; Disclosure of Certain Tax Information; Binding Effect.
(i) This Agreement shall be governed by and interpreted in accordance with the internal laws of the
State of Delaware; provided, however, that any Transfer of Payment Rights under this Agreement
may be subject to the laws of other states in addition to the state designated above.
(ii) This Agreement shall be binding upon the parties hereto and their respective successors, heirs,
executors, administrators and permitted assigns, including without limitation any party asserting
an interest in Payment Rights.
11. Advice, Comprehension of Agreement. In entering into this Agreement, each Claimant represents
and warrants that(i)such Claimant has relied solely upon the legal and tax advice of such Claimant's
own attorneys and other advisors, who are the attorneys and advisors of such Claimant's choice,
concerning the legal and income tax consequences of this Agreement; and (ii)the terms of this
Agreement have been completely read by and explained to such Claimant and are fully understood
and voluntarily accepted by such Claimant.
12. Description of Periodic Payments. The Periodic Payments are as set forth immediately below or(if
not set forth below) as set forth in attached Addendum No. 1, which is hereby incorporated in and
made a part of this Agreement.
Description of Periodic Payments:
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This Qualified Assignment and Release Agreement is signed in one or more counterparts as of the
Effective Date by the following:
Assignor: County of Fresno Assignee: MetLife Assignment Company, Inc.
By: By: d�Qi1 t A
Authorized Representative Authorized Representative
Title: Title: Authorized Agent
This agreement is not valid until receipt of applicable
consideration.
Claimant(s): Alexander R Approved as to Form and Content:
Alexander a minor, by and through his Claimant's Attorney-Christopher Watters
ad Guardian lexander R_
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This Qualified Asignment and Release Agreement is signed in one or more counterparts as of the
Effective Date by the following:
Assignor: County of Fresno Assignee: MetLife Assignment Company, Inc.
By: L 041.— By: --
BRIAN PACHECO, Authorized Representative
Title: Title:
Chairman of the Board of Supervisors of the
County of Fresno.
Claimant(s): Alexander 19� Approved as to Form and Content:
Alexander minor, ;,,and through his Claimant's Attorney-Christopher Wafters
Guardian a�i, exander R�
ATTEST:
BERNICE E.SEIDEL
Clerk of the Board of Supervisors
County�of/F�resno,State of California
By —b�G.`s---..__ Deputy
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Addendum No. 1
Description of Periodic Payments
Claimant(1): Alexander R_
Claimant Address:
Claimant Social Security Number: Date of Birth: 01/21/2008
Payee Name: Alexander R_
Payee Address:
Benefit(s): 1. Period Certain Annuity- $15,000.00 payable semi-annually, guaranteed for
4 year(s)which is 8 payments, beginning on 06/15/2026,with the last
guaranteed payment on 12/15/2029.
2. Guaranteed Lump Sum- $25,000.00 paid as a lump sum on 01/21/2026
guaranteed.
3. Guaranteed Lump Sum- $84,230.00 paid as a lump sum on 01/21/2030
guaranteed.
Initials
Assignor:
Assignee:
Claimant(s):
Claimant-
Attorney
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Addendum No. 1
Description of Periodic Payments
Claimant(1): Alexander R_
Claimant Address:
Claimant Social Security Number: Date of Birth: 01/21/2008
Payee Name: Alexander R_
Payee Address:
Benefit(s): 1. Period Certain Annuity- $15,000.00 payable semi-annually, guaranteed for
4 year(s)which is 8 payments, beginning on 06/15/2026,with the last
guaranteed payment on 12/15/2029.
2. Guaranteed Lump Sum- $25,000.00 paid as a lump sum on 01/21/2026
guaranteed.
3. Guaranteed Lump Sum- $84,230.00 paid as a lump sum on 01/21/2030
guaranteed.
Initials
Assignor:
Assignee:
Claimant(s):
Claimant-
Attorney
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Addendum No. 1
Description of Periodic Payments
Claimant(1): Alexander F�
Claimant Address:
Claimant Social Security Number: Date of Birth: 01/21/2008
Payee Name: Alexander Pl=�
Payee Address:
Benefit(s): 1. Period Certain Annuity-$15,000.00 payable semi-annually,guaranteed for
4 year(s)which is 8 payments, beginning on 06/15/2026,with the last
guaranteed payment on 12/15/2029.
2. Guaranteed Lump Sum-$25,000.00 paid as a lump sum on 01/21/2026
guaranteed.
3. Guaranteed Lump Sum-$84,230.00 paid as a lump sum on 01/21/2030
guaranteed.
ATTEST:
Initials BERNICE E.SEIDEL
Clerk of the Board of Supervisors
Assignor: Country f Fresno,State of California
Assignee: By ' Deputy
Claimant(s): f'
Claimant- Y LJ
Attorney
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