AFFIDAVIT
1, Shanara L. Mobley, of full age, being duly sworn according to law, upon my oath
depose and say:
Licunenty widest Gog’ Monme Ave Tiekime te Le.
currently reside at Me 223
2. Lam the rgcipient of certain guaranteed payments under a structured settlement
og
dated on or about Zeoy _. The entity presently obligated to make oS .
the payments due yénder the structured settlement is_/7Zau- : 5 Tks: |b
In order to meet its obligations pinder the seftlement agreement jennie (Sosp.Faf
Purchased an annuity from w tock CPO .
3. [ voluntarily entered into a Structutred Settlement Annuity Sale and
Assignment Agreement (the “Agreement”) dated Sep 5" 2e09 with Deborah H.
Miller (“Miller”). Under that Agreement, I agreed to’sell and assign to Miller the
following payments due to me under the structured settlement:
“ =
L&O__ monthly payments each in the amount of $°/& 2 2
commencing £2020 _ and continuing through and including
ep oat (the “Assigned Payments”)
4, Lunderstand that I will forego receipt of the Assigned Payments under the
Agreement. I understand that my beneficiaries/heirs and I will no longer receive the
Assigned Payments or any portion of the Assigned Payments. I understand that all of the
Assigned Payments will go to Miller.
5. Lalso understand that this Affidavit is submitted for use in the court approval
process initiated by Miller and myself to seek court approval of the transfer of payments
{0 Miller.
6. L also received from Miller a Disclosure Statement detailing the terms of the
Agreement that I signed and retumed to Miller. I carefully reviewed the Disclosure
‘Statement and fully and completely understand all terms of the Disclosure Statement.
7. In the Disclosure Statement, Miller advised me to seek professional advice
regarding the agreement from attorney, accountant or other professional of my choice.
A.A tnitials: 1 chose not to retain or consult with such a professional.
T understand that at all times, including at the time I entered the Agreement and received
the Disclosure Statement, and for all time, I knowingly waive the right to seek or obtain
for myself independent professional advice regarding the Agreement.
B. Initials: I chose to retain or consult with an attorney, account or
other licensed professional advisor of my choice.~ ~
81am_27___yearold and have supported myself for the last ?
years.
9. Lhave thoroughly considered this transaction, my alternatives and the use to
which I will put the proceeds of this sale. I have considered the impact of this transaction
on my dependents and me and have determined that I will be able to improve our present
standard of living if | am permitted to transfer and assign my right to receive the
Assigned Payments to Miller as described in this Affidavit. After considering these
factors, I believe that this transaction is in my best interest and the best interest of my
family.
10. 1 intend to use the proceeds I receive from Miller under the Agreement to
pag, Cee Ge Sra amianenia mre Aege
11. Iwill not be using any portion of the proceeds from the Agreement for day-to-
day expenses. I have never assigned, sold or pledged any of the payments that are
proposed to be assigned in this transaction, to any party or entity, Ihave sufficient
income to support myself. I have determined that the proceeds from the Agreement with
Miller is in my best interests and the best interest of my family and will improve our
quality of life.
Shanara L. Mobley
State of Florida
‘County of Duval
a
Onis tte_/ oct dethenben. 2009, before mee Notary Publi pesos epee, Shar
‘Mobley, known (0 me (oF satisfactory proven fo Be the person whose name is subscribed tothe within instrument,
and acknowledged that said signatory executed the same forthe purposes therein contained.
T wleness whereof, I hereunto st my hand and sealWAIVER OF INDEPENDENT PROFESSIONAL ADVICE
(Florida)
1, Shanara L. Mobley, understand that I may consult with an independent
professional advisor regarding the legal, tax and financial implications of the transfer of
‘my structured settlement payments. I have chosen not to consult with an independent
professional advisor and hereby expressly waive such right.
Shanara L. Wishes oe
Dated: O 9 -Q3- 2009