NUNLEY, TIFFANY, A GUARDIAN AD LITEM FOR PLAINTIFF HAILLEY HALLSTROM

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Nof Pied Assignment and Release Agreement -to A fcord ttce With I tertrtrl Reverraae 0040 Seetlota 130 < I.aluadnt(a } "; Hailley qalistrom by and through her Guardian ad Lltem 'Wary Nunlery, J "Assignor"t City af'garttaArta "Settlement Agreement ", [Data and title ofsetilcmentagrcomcnt,: order or other document embodying the Assignor's Obligation to make the agreed periodic payments] "Assignee": Mutual of omaha Structured Settlement company ( "MOSSCO-) "Anmuity issuer ": lJoited of Omaha Life Insurance Company ("Ytnitad") "Effective Date "''. This Qualified Assignment and Release Agreement is made and catered into as of the Effective Bate by and among the undersigned parties with Micro= to the following, facts. A Claimants) and Assignor tae parties to or are otherwise subject to ar 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'Claiment(s) as specified or referred to in paragraph 12 of this Agreement (the "Periodic Payments "'), and I 13 Assignor and MOSSC;0 wish to ethot a "qualified ,.asviguateuer within the naonning and subject to lire conditions of Section 00(c) of the Internal kevenue Cock itf IoSFi, as amended '(the "f ride" % Nosy, therefore, 14 t onsideradon of the foregriing and for other good and valuable consideration, the parties agree as follows: I. Assignment and Amamptionq Release Of Assignor, Assignor hereby assigns, to MOBSCO, and MJSSCO hereby accepts and assumes, alt of Assigitor's liability, to make the Periodic Payments, Eagh Claimant hereby accepts and consents to such assignment by Assignor and assumption by MO$SCf3, Iitfectiva nit the Effective Date, each claimant herbytelca*and. discharges Assignor from all IiAjity to make the Peri"at Payments. 2. Nature of Periodic Pa) 'Rents. The Periodic Faymenty .constitute i, damages (other thaw i punitive th mages); whether by suitor agreement, or ii. compensation andep a workers' compensation act, on account of personal Mary or sickness In a case involving physieai injury or physical sickness, within the meaning of Sections 130(c) and 104(a) of the Code, 3. Extent of MOSSCtp's Liability. MOSSCo's liability to make the Periodic Payments shall be no greater than the liability of Assignor, immediately prior to the Pffective Date. MOSSCO assume$ ntr liability other than the liability to make the Periodi0ayments. MOSSCO's liability to make the Periodic Payments shall be unaffected by any bankruptcy or insolvency of Assignor. 4, Qualified Funding Asset. M05SC0 will fund the Periodic Payments by purchasing from United a "qualified funding assct," as defined in Section 130(4) of the Code, in the form of an annuity contract (the "Annuity ") issued by United and providing for payments corresponding .to the :Periodic Payments. MQSSCO shall be IiPD957 Page 1 rf4 0711 1 I