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attachment to any Assignment Agreement entered into pursuant to the provisions of Paragraph 4 6.0 Discharge of Obligation
of this Agreement.
The obligation of the Payor and/or the Insurer to make each Periodic Payment shall
3.0 Rights to Payments be discharged upon the mailing of a valid check in the amount of such payment to the designated
address of the Payee(s) named in Section 2 of this Fund Agreement or by deposit, via wire or
Payee acknowledges that the Periodic Payments cannot be accelerated, deferred, ACH, to a bank account designated by the Payee named in Section 2 of this Fund Agreement.
increased or decreased by the Payee; nor shall the Payee have the power to sell, mortgage,
encumber, or anticipate the Periodic Payments, or any part thereof, by assignment or otherwise. Administrator: Eastern Point Trust Company as Fund Administrator
f/b/o XYZ Sample QSF
4.0 Consent to Non-Qualified Assignment By: _________________________________
Title: ________________________________
4.1 Payee acknowledges and agrees that the Payor may enter into a Non-Qualified Date: ________________________________
Assignment with Kenmare Assignment Company Ltd. (“Kenmare”). Kenmare’s obligation for
payment of the Periodic Payments shall be no greater than that of the Payor (whether by Payee: The Sample Law Firm, LLC
judgment or agreement) immediately preceding the transfer of the Periodic Payments obligation.
By: _________________________________
4.2 Any such transfer, if made, shall be accepted by the Payee without right of Title: ________________________________
rejection and shall completely release and discharge the Payor/Insurer from the Periodic Date: ________________________________
Payments obligation assigned to Kenmare. The Payee recognizes that, in the event of such an
assignment, Kenmare shall be the sole Obligor with respect to the Periodic Payments obligation,
and that all other releases with respect to the Periodic Payments obligation that pertain to the
liability of the Payor shall thereupon become final, irrevocable and absolute.
5.0 Right to Purchase Assets, an Annuity or a Funding Agreement
The Payor and/or the Insurer, itself or through Assignee, reserve the right to fund
the liability to make the Periodic Payments through the purchase of an annuity contract or a
funding agreement or through the purchase of any investments of any kind whatsoever. The
Defendant, the Insurer or Assignee shall be the sole owner of any such funds, assets or
investments and shall have all rights of ownership therein. In the event that an annuity contract
or funding agreement is purchased to fund the liability to make the Periodic Payments, the
Defendant, the Insurer, Assignee or a trust established by Assignee shall be the sole owner of the
annuity contract and/or funding agreement and shall have all rights of ownership therein. The
Defendant, the Insurer, Assignee, or the trust established by Assignee may have a third party
mail payments directly to the Payee. The Payee shall be responsible for maintaining a current
mailing address with the Assignee.
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