Federal Trade Commission v. Prime Legal Plans LLC et al

Filing 67

PRELIMINARY INJUNCTION and order continuing asset freeze and other provisions of the Temporary Restraining Order, appointing a permanent receiver, and permitting expedited discovery. Signed by Judge Robert N. Scola, Jr. on 10/12/2012. (rss) (Additional attachment(s) added on 10/12/2012: # 1 Attachment A, # 2 Attachment B, # 3 Attachment C) (wc).

FEDERAL TRADE COMMISSION
FINANCIAL STATEMENT OF CORPORATE DEFENDANT

Instructions:
1.

Complete all items. Enter “None” or "N/A" (“Not Applicable”) where appropriate. If you cannot fully answer a
question, explain why.

2.

The font size within each field will adjust automatically as you type to accommodate longer responses.

3.

In completing this financial statement, “the corporation” refers not only to this corporation but also to each of its
predecessors that are not named defendants in this action.

4.

When an Item asks for information about assets or liabilities “held by the corporation,” include ALL such assets
and liabilities, located within the United States or elsewhere, held by the corporation or held by others for the
benefit of the corporation.

5.

Attach continuation pages as needed. On the financial statement, state next to the Item number that the Item is
being continued. On the continuation page(s), identify the Item number being continued.

6.

Type or print legibly.

7.

An officer of the corporation must sign and date the completed financial statement on the last page and initial
each page in the space provided in the lower right corner.

Penalty for False Information:
Federal law provides that any person may be imprisoned for not more than five years, fined, or both, if such person:
(1) “in any matter within the jurisdiction of any department or agency of the United States knowingly and
willfully falsifies, conceals or covers up by any trick, scheme, or device a material fact, or makes any false,
fictitious or fraudulent statements or representations, or makes or uses any false writing or document knowing the
same to contain any false, fictitious or fraudulent statement or entry” (18 U.S.C. § 1001);
(2) “in any . . . statement under penalty of perjury as permitted under section 1746 of title 28, United States Code,
willfully subscribes as true any material matter which he does not believe to be true” (18 U.S.C. § 1621); or
(3) “in any (. . . statement under penalty of perjury as permitted under section 1746 of title 28, United States
Code) in any proceeding before or ancillary to any court or grand jury of the United States knowingly makes any
false material declaration or makes or uses any other information . . . knowing the same to contain any false
material declaration.” (18 U.S.C. § 1623)
For a felony conviction under the provisions cited above, federal law provides that the fine may be not more than the
greater of (i) $250,000 for an individual or $500,000 for a corporation, or (ii) if the felony results in pecuniary gain to any
person or pecuniary loss to any person other than the defendant, the greater of twice the gross gain or twice the gross loss.
18 U.S.C. § 3571.

Attachment B

BACKGROUND INFORMATION

Item 1.

General Information

Corporation’s Full Name ___________________________________________________________________________
Primary Business Address ______________________________________________________ From (Date) _________
Telephone No. _____________________________ Fax No. _____________________________
E-Mail Address________________________ Internet Home Page________________________
All other current addresses & previous addresses for past five years, including post office boxes and mail drops:
Address____________________________________________________________ From/Until____________________
Address____________________________________________________________ From/Until____________________
Address____________________________________________________________ From/Until____________________
All predecessor companies for past five years:
Name & Address _________________________________________________________ From/Until ______________
Name & Address _________________________________________________________ From/Until ______________
Name & Address _________________________________________________________ From/Until ______________

Item 2.

Legal Information

Federal Taxpayer ID No. _________________________ State & Date of Incorporation _________________________
State Tax ID No. ____________________ State ________________ Profit or Not For Profit _____________________
Corporation’s Present Status: Active ________________ Inactive _______________ Dissolved __________________
If Dissolved: Date dissolved _________________________ By Whom ______________________________________
Reasons _________________________________________________________________________________________
Fiscal Year-End (Mo./Day) ________________ Corporation’s Business Activities _____________________________

Item 3.

Registered Agent

Name of Registered Agent __________________________________________________________________________
Address __________________________________________________________ Telephone No. __________________

Page 2

Attachment B

Initials __________

Item 4.

Principal Stockholders

List all persons and entities that own at least 5% of the corporation’s stock.
% Owned

Name & Address

_________________________________________________________________________________ ______________
_________________________________________________________________________________ ______________
_________________________________________________________________________________ ______________
_________________________________________________________________________________ ______________

Item 5.

Board Members

List all members of the corporation’s Board of Directors.
Name & Address

% Owned

Term (From/Until)

____________________________________________________________________ __________ _________________
____________________________________________________________________ __________ _________________
____________________________________________________________________ __________ _________________
____________________________________________________________________ __________ _________________
____________________________________________________________________ __________ _________________

Item 6.

Officers

List all of the corporation’s officers, including de facto officers (individuals with significant management responsibility
whose titles do not reflect the nature of their positions).
Name & Address

% Owned

_______________________________________________________________________________ ________________
_______________________________________________________________________________ ________________
_______________________________________________________________________________ ________________
_______________________________________________________________________________ ________________
_______________________________________________________________________________ ________________

Page 3

Attachment B

Initials __________

Item 7.

Businesses Related to the Corporation

List all corporations, partnerships, and other business entities in which this corporation has an ownership interest.
Business Activities

Name & Address

% Owned

___________________________________________________________________ ___________________ _________
___________________________________________________________________ ___________________ _________
___________________________________________________________________ ___________________ _________
State which of these businesses, if any, has ever transacted business with the corporation _______________________
________________________________________________________________________________________________

Item 8.

Businesses Related to Individuals

List all corporations, partnerships, and other business entities in which the corporation’s principal stockholders, board
members, or officers (i.e., the individuals listed in Items 4 - 6 above) have an ownership interest.
Business Name & Address

Individual’s Name

Business Activities

% Owned

__________________ __________________________________________________ __________________ ________
__________________ __________________________________________________ __________________ ________
__________________ __________________________________________________ __________________ ________
State which of these businesses, if any, have ever transacted business with the corporation _______________________
________________________________________________________________________________________________

Item 9.

Related Individuals

List all related individuals with whom the corporation has had any business transactions during the three previous fiscal
years and current fiscal year-to-date. A “related individual” is a spouse, sibling, parent, or child of the principal
stockholders, board members, and officers (i.e., the individuals listed in Items 4 - 6 above).
Relationship

Name and Address

Business Activities

_________________________________________________________ _________________ ______________________
_________________________________________________________ _________________ ______________________
_________________________________________________________ _________________ ______________________

Page 4

Attachment B

Initials __________

Item 10.

Outside Accountants

List all outside accountants retained by the corporation during the last three years.
Firm Name

Name

Address

CPA/PA?

____________________ ______________________ ________________________________________ ____________
____________________ ______________________ ________________________________________ ____________
____________________ ______________________ ________________________________________ ____________
____________________ ______________________ ________________________________________ ____________
____________________ ______________________ ________________________________________ ____________

Item 11.

Corporation’s Recordkeeping

List all individuals within the corporation with responsibility for keeping the corporation’s financial books and records for
the last three years.
Position(s) Held

Name, Address, & Telephone Number

____________________________________________________________________________ ___________________
____________________________________________________________________________ ___________________
____________________________________________________________________________ ___________________
____________________________________________________________________________ ___________________

Item 12.

Attorneys

List all attorneys retained by the corporation during the last three years.
Name

Firm Name

Address

____________________ ___________________________ ________________________________________________
____________________ ___________________________ ________________________________________________
____________________ ___________________________ ________________________________________________
____________________ ___________________________ ________________________________________________
____________________ ___________________________ ________________________________________________

Page 5

Attachment B

Initials __________

Item 13.

Pending Lawsuits Filed by the Corporation

List all pending lawsuits that have been filed by the corporation in court or before an administrative agency. (List
lawsuits that resulted in final judgments or settlements in favor of the corporation in Item 25).
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________

Page 6

Attachment B

Initials __________

Item 14.

Current Lawsuits Filed Against the Corporation

List all pending lawsuits that have been filed against the corporation in court or before an administrative agency. (List
lawsuits that resulted in final judgments, settlements, or orders in Items 26 - 27).
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________

Page 7

Attachment B

Initials __________

Item 15.

Bankruptcy Information

List all state insolvency and federal bankruptcy proceedings involving the corporation.
Commencement Date _________________ Termination Date _________________ Docket No. __________________
If State Court: Court & County _______________________ If Federal Court: District __________________________
Disposition ______________________________________________________________________________________

Item 16.

Safe Deposit Boxes

List all safe deposit boxes, located within the United States or elsewhere, held by the corporation, or held by others for the
benefit of the corporation. On a separate page, describe the contents of each box.
Owner’s Name

Name & Address of Depository Institution

Box No.

__________________ ___________________________________________________________________ __________
__________________ ___________________________________________________________________ __________
__________________ ___________________________________________________________________ __________
__________________ ___________________________________________________________________ __________
__________________ ___________________________________________________________________ __________

FINANCIAL INFORMATION
REMINDER: When an Item asks for information about assets or liabilities “held by the corporation,” include
ALL such assets and liabilities, located within the United States or elsewhere, held by the corporation or held by
others for the benefit of the corporation.
Item 17.

Tax Returns

List all federal and state corporate tax returns filed for the last three complete fiscal years. Attach copies of all returns.
Federal/
State/Both

Tax Year

Tax Due
Federal

Tax Paid
Federal

Tax Due
State

Tax Paid
State

Preparer’s Name

___________ __________ $_________ $_________ $__________ $__________ ______________________________
___________ __________ $_________ $_________ $__________ $__________ ______________________________
___________ __________ $_________ $_________ $__________ $__________ ______________________________

Page 8

Attachment B

Initials __________

Item 18.

Financial Statements

List all financial statements that were prepared for the corporation’s last three complete fiscal years and for the current
fiscal year-to-date. Attach copies of all statements, providing audited statements if available.
Year

Balance Sheet

Profit & Loss Statement

Cash Flow Statement Changes in Owner’s Equity Audited?

_________ _____________ ______________________ __________________ _______________________ ________
_________ _____________ ______________________ __________________ _______________________ ________
_________ _____________ ______________________ __________________ _______________________ ________
_________ _____________ ______________________ __________________ _______________________ ________
Item 19.

Financial Summary

For each of the last three complete fiscal years and for the current fiscal year-to-date for which the corporation has not
provided a profit and loss statement in accordance with Item 18 above, provide the following summary financial
information.
Current Year-to-Date

1 Year Ago

2 Years Ago

3 Years Ago

Gross Revenue

$_________________

$_______________

$_______________

$_______________

Expenses

$_________________

$_______________

$_______________

$_______________

Net Profit After Taxes

$_________________

$_______________

$_______________

$_______________

Payables

$_________________

Receivables

$_________________

Item 20.

Cash, Bank, and Money Market Accounts

List cash and all bank and money market accounts, including but not limited to, checking accounts, savings accounts, and
certificates of deposit, held by the corporation. The term “cash” includes currency and uncashed checks.
Cash on Hand $_________________________ Cash Held for the Corporation’s Benefit $_______________________
Current
Balance
_____________________________________ _______________________________ ______________ $___________
Name & Address of Financial Institution

Signator(s) on Account

Account No.

_____________________________________ _______________________________ ______________ $___________
_____________________________________ _______________________________ ______________ $___________
_____________________________________ _______________________________ ______________ $___________

Page 9

Attachment B

Initials __________

Item 21.

Government Obligations and Publicly Traded Securities

List all U.S. Government obligations, including but not limited to, savings bonds, treasury bills, or treasury notes, held by
the corporation. Also list all publicly traded securities, including but not limited to, stocks, stock options, registered and
bearer bonds, state and municipal bonds, and mutual funds, held by the corporation.
Issuer _________________________________ Type of Security/Obligation __________________________________
No. of Units Owned __________ Current Fair Market Value $__________________ Maturity Date _______________
Issuer _________________________________ Type of Security/Obligation __________________________________
No. of Units Owned __________ Current Fair Market Value $__________________ Maturity Date _______________

Item 22.

Real Estate

List all real estate, including leaseholds in excess of five years, held by the corporation.
Type of Property________________________________ Property’s Location__________________________________
Name(s) on Title and Ownership Percentages___________________________________________________________
Current Value $____________________ Loan or Account No. __________________________
Lender’s Name and Address_________________________________________________________________________
Current Balance On First Mortgage $_______________ Monthly Payment $______________
Other Loan(s) (describe)____________________________________________ Current Balance $_________________
Monthly Payment $__________________ Rental Unit?_________________ Monthly Rent Received $_____________

Type of Property________________________________ Property’s Location__________________________________
Name(s) on Title and Ownership Percentages___________________________________________________________
Current Value $____________________ Loan or Account No. __________________________
Lender’s Name and Address_________________________________________________________________________
Current Balance On First Mortgage $_______________ Monthly Payment $______________
Other Loan(s) (describe)____________________________________________ Current Balance $_________________
Monthly Payment $__________________ Rental Unit?_________________ Monthly Rent Received $_____________

Page 10

Attachment B

Initials __________

Item 23.

Other Assets

List all other property, by category, with an estimated value of $2,500 or more, held by the corporation, including but not
limited to, inventory, machinery, equipment, furniture, vehicles, customer lists, computer software, patents, and other
intellectual property.
Property Category

Property Location

Acquisition
Cost

Current
Value

____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________

Item 24.

Trusts and Escrows

List all persons and other entities holding funds or other assets that are in escrow or in trust for the corporation.
Trustee or Escrow Agent’s
Name & Address

Description and Location of Assets

Present Market
Value of Assets

______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________

Page 11

Attachment B

Initials __________

Item 25.

Monetary Judgments and Settlements Owed To the Corporation

List all monetary judgments and settlements, recorded and unrecorded, owed to the corporation.
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________

Item 26.

Monetary Judgments and Settlements Owed By the Corporation

List all monetary judgments and settlements, recorded and unrecorded, owed by the corporation.
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit_______________________________________ Date______________ Amount $______________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________

Page 12

Attachment B

Initials __________

Item 27.

Government Orders and Settlements

List all existing orders and settlements between the corporation and any federal or state government entities.
Name of Agency ___________________________________________ Contact Person __________________________
Address _____________________________________________________________ Telephone No. _______________
Agreement Date ______________ Nature of Agreement __________________________________________________

Item 28.

Credit Cards

List all of the corporation’s credit cards and store charge accounts and the individuals authorized to use them.
Names of Authorized Users and Positions Held

Name of Credit Card or Store

__________________________________________ _____________________________________________________
__________________________________________ _____________________________________________________
__________________________________________ _____________________________________________________
__________________________________________ _____________________________________________________
__________________________________________ _____________________________________________________

Item 29.

Compensation of Employees

List all compensation and other benefits received from the corporation by the five most highly compensated employees,
independent contractors, and consultants (other than those individuals listed in Items 5 and 6 above), for the two previous
fiscal years and current fiscal year-to-date. “Compensation” includes, but is not limited to, salaries, commissions,
consulting fees, bonuses, dividends, distributions, royalties, pensions, and profit sharing plans. “Other benefits” include,
but are not limited to, loans, loan payments, rent, car payments, and insurance premiums, whether paid directly to the
individuals, or paid to others on their behalf.
Name/Position

Current Fiscal
Year-to-Date

1 Year Ago

2 Years Ago

Compensation or
Type of Benefits

_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________

Page 13

Attachment B

Initials __________

Item 30.

Compensation of Board Members and Officers

List all compensation and other benefits received from the corporation by each person listed in Items 5 and 6, for the
current fiscal year-to-date and the two previous fiscal years. “Compensation” includes, but is not limited to, salaries,
commissions, consulting fees, dividends, distributions, royalties, pensions, and profit sharing plans. “Other benefits”
include, but are not limited to, loans, loan payments, rent, car payments, and insurance premiums, whether paid directly to
the individuals, or paid to others on their behalf.
Name/Position

Current Fiscal
Year-to-Date

1 Year Ago

2 Years Ago

Compensation or
Type of Benefits

_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
Item 31.

Transfers of Assets Including Cash and Property

List all transfers of assets over $2,500 made by the corporation, other than in the ordinary course of business, during the
previous three years, by loan, gift, sale, or other transfer.
Transferee’s Name, Address, & Relationship

Property
Transferred

Aggregate
Value

Transfer
Date

Type of Transfer
(e.g., Loan, Gift)

______________________________________ ________________ $____________ __________ _________________

______________________________________ ________________ $____________ __________ _________________

______________________________________ ________________ $____________ __________ _________________

______________________________________ ________________ $____________ __________ _________________

______________________________________ ________________ $____________ __________ _________________

Page 14

Attachment B

Initials __________

Item 32.

Documents Attached to the Financial Statement

List all documents that are being submitted with the financial statement.
Item No. Document
Relates To

Description of Document

___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________

I am submitting this financial statement with the understanding that it may affect action by the Federal Trade
Commission or a federal court. I have used my best efforts to obtain the information requested in this statement. The
responses I have provided to the items above are true and contain all the requested facts and information of which I have
notice or knowledge. I have provided all requested documents in my custody, possession, or control. I know of the
penalties for false statements under 18 U.S.C. § 1001, 18 U.S.C. § 1621, and 18 U.S.C. § 1623 (five years imprisonment
and/or fines). I certify under penalty of perjury under the laws of the United States that the foregoing is true and correct.
Executed on:
______________________________
(Date)

_____________________________________________________
Signature

_____________________________________________________
Corporate Position

Page 15

Attachment B

Initials __________