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INSURANCE NOT REQUIRED Return ORIGINAL executed copy to COTC, A-2020-198 WORK MAY PROCEED M-30 f1CiERK OF COUNCII. �rr. CI /ill �'pIMlA/i l �') (�01�✓(T.�Ct/1 �✓�YY71 Il Y�) f �P J f Qualified Assignment and Release Agreement In Accordance With Internal Revenue Code Section 130 "Ciaenant(s)": "Assignor": rder Approving Unopposed Petition for Compromise of the arms o "Settlement AgreomenV: BMlnor ,.8yand hT rough His Guardian Ad Litem, Yaneli Alonso Dated 09/24/2020 [Date and title of settlement agreement, order or other document embodying the Assignor's obligation to make the agreed periodic payments] "Assignee": Mall w+ ns,; gmm�nt mm�an� Inr "Annuity Issuer": mranna Comm "Effective Data": This Qualified Assignment and Release Agreement is made and entered Into as of the Effective Dale by and among the undersigned parties with reference to the following facts: A. Clalmant(s) and Assignor are parties to or are otherwise sub act 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 Clalmant(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 Iiabillt 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 1. 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 Pa ments by purchasing from Annuity Issuer a "qualified funding asset," as defined In Section 130(d�af the Code, In the form of an annuity contract (the "Annuity") issued by Annuity Issuer and providing foe payments corresponding to the Pen dk Payments. Assignee shall be desi nated as the owner of the Annuity. All rights of Legal ownership and control of the Annuity shallsubJect to paragraph 9 of this Agreement) be and remain vested exclusively in Assignee; provided, however, that the Annuity shell be used by Assignee to fund the Periodic Payments and shall at all times be designated by Assignee on Its records as being taken Page 1 Version v12.00/r12.00 - QAR