Free Notice of Removal - District Court of Delaware - Delaware


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Date: December 31, 1969
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State: Delaware
Category: District Court of Delaware
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Case 1:05-cv-00713-SLR Document 1-3 Filed O9/30/2005 Page 1 0f 4
EXHIBIT "B"

Case 1:05-cv-00713-SLR Document 1-3 Filed O9/30/2005 Page 2 of 4
IN THE UNITED STATE DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
PAUL WEIK, as administrator of
the estate of CARL WEIK :
Plaintiff, CASE NO.:
V.
LIFE INSURANCE COMPANY OF
NORTH AMERICA, LEGIONNAIRE :
INSURANCE TRUST, AND :
ASSOCIATION GROUP INSURANCE :
ADMINISTRATOR, :
Defendants,
DECLARATION OF RITA McMULLEN
Pursuant to 28 U.S.C. § 1746, I, Rita McMullen, make this declaration of my personal
knowledge, information and belief, and declare that:
l. I am employed by the law firm of Margolis Edelstein and am authorized to make
this declaration on its behalf in support of removal of the above captioned lawsuit from the
Superior Court for New Castle County to this district court. I have reviewed a true and correct
copy of the claim file prepared by Life Insurance Company of North America in making this
declarationfll
2. The subject matter of the Complaint in this lawsuit is Plaintiffs demand for
accidental death insurance benefits under a policy of group insurance issued by Life Insurance
Company of North America, administered by Association Group Insurance Administrators and

Case 1:05-cv-00713-SLR Document 1-3 Filed O9/30/2005 Page 3 of 4
sponsored by the Legionnaire Insurance Trust.
3. The Complaint omits any allegation of Plaintiffs domicile, however, Plaintiff is
a resident of the State of Delaware.
fl. Plaintiff has admitted under oath that his present domicile is 1123 Powderhorn
Drive, Newark, Delaware 19713 in a Preference Beneficiary’s Affidavit that he submitted to
LINA with regard to Carl Weil<’s death. A copy ofthe Preference Beneficiaty’s Affidavit is
attached to this Declaration as Exhibit One.
5. Plaintiff has further admitted that his present domicile is 1 123 Powclerhorn Drive,
Newark, Delaware 19713 in the claim form that he submitted to LINA with regard to Carl
Weil<’s death. A copy of the claim form is attached to this Declaration as Exhibit Two.
6. Plaintiffs present domicile is recorded in the Certificate of Death for Carl Weik
as 1123 Powderhorn Drive, Newark, Delaware 19713. A copy ofthe Certificate of Death is
attached to this Declaration as Exhibit Three.
7. During his life, insured Carl Weik was a resident of Delaware, and maintained his
domicile at 13 Capano Drive, Apt. C4, Newark, DE 19702-1853. See Exhibits Two and Three.
8. Defendant Life Insurance Company of North America is a Pennsylvania
corporation with its principal place of business at 1610 Chestnut Street, Philadelphia, PA 19103.
9. Defendant Legionnaire Insurance Trust is a not—for-profit trust, organized and
maintained under Internal Revenue Code § 501 (c) (19), to which numerous Departments (state
organizations) of The American Legion have joined, and has its situs in Washington, D.C.
10. Association Group Insurance Administrators ("AGIA") is a California corporation
with its principal place of business at 1155 Eugenia Place, Carpinteria, CA USA 93013. By way
of clarification, the correct name of this defendant is A.G.I.A., Inc

Case 1:05-cv-00713-SLR Document 1-3 Filed O9/30/2005 Page 4 of 4
ll. The Complaint omits any allegation ofthe amount of insurance benefits in
controversy; however, the amount in controversy is $76,000, exclusive of interest and costs.
12. I declare under penalty of perjury that the foregoing is true and correct.
Dated: September 29, 2005 {gf { iz
RITA McMULLEN