Free Motion for Miscellaneous Relief - District Court of Connecticut - Connecticut


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Date: May 29, 2008
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State: Connecticut
Category: District Court of Connecticut
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Must be Postmarked No Later Than July 7, 2008

Case 3:02-cv-02133-EBB

Annuity and Life Re (Holdings), Ltd. Securities Litigation c/o The Garden City Group, Inc. Claims Administrator P.O. Box 9254 *P-ANR$F-POC/1* Dublin, OH 43017-4654 1-800-298-3208

Document 270-6

Filed 05/29/2008

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ANR

PART I: CLAIMANT IDENTIFICATION: Claim Number:

PROOF OF CLAIM AND RELEASE

Control Number:

Name:

WRITE ANY NAME AND ADDRESS CORRECTIONS BELOW OR IF THERE IS NO PREPRINTED DATA TO THE LEFT, YOU MUST PROVIDE YOUR FULL NAME AND ADDRESS HERE:

You must fill in the last four digits of your Social Security Number/Taxpayer ID Number if box is blank:

IF THE ABOVE AREA IS BLANK, YOU MUST ENTER YOUR FULL NAME AND ADDRESS HERE

Address:

City: State/Country: Zip Code:

Daytime Telephone Number: Evening Telephone Number:

( (

) )

-

IF YOU PURCHASED OR OTHERWISE ACQUIRED THE SECURITIES OF ANNUITY AND LIFE RE (HOLDINGS), LTD. ("ANR") DURING THE PERIOD BETWEEN MARCH 15, 2000 AND NOVEMBER 19, 2002, INCLUSIVE ("CLASS PERIOD"), AND WERE DAMAGED THEREBY, YOU ARE A "CLASS MEMBER" AND YOU MAY BE ENTITLED TO SHARE IN THE SETTLEMENT PROCEEDS. Excluded from the Class are the Defendants, their officers, directors, and partners at all relevant times, members of their immediate families and their legal representatives, heirs, successors or assigns, and any entity in which Defendants have or had a controlling interest. For purposes of this Settlement, the term "controlling interest" shall include any interest of 10% or more of the common stock of any entity.

Email Address:

UNLESS YOU HAVE PREVIOUSLY SUBMITTED AN ACCEPTABLE PROOF OF CLAIM IN CONNECTION WITH THE PRIOR SETTLEMENT, YOU MUST COMPLETE AND SIGN THIS PROOF OF CLAIM AND MAIL IT BY FIRST CLASS MAIL, POSTMARKED NO LATER THAN JULY 7, 2008 TO THE FOLLOWING ADDRESS: Annuity and Life Re (Holdings), Ltd. Securities Litigation c/o The Garden City Group, Inc. Claims Administrator P.O. Box 9254 Dublin, OH 43017-4654

IF YOU ARE A CLASS MEMBER, AND YOU HAVE NOT PREVIOUSLY SUBMITTED AN ACCEPTABLE PROOF OF CLAIM IN CONNECTION WITH THE PRIOR SETTLEMENT, YOU MUST COMPLETE AND SUBMIT THIS FORM IN ORDER TO BE ELIGIBLE FOR ANY SETTLEMENT BENEFITS. IF YOU HAVE ALREADY SUBMITTED AN ACCEPTABLE PROOF OF CLAIM IN CONNECTION WITH THE PRIOR SETTLEMENT, THEN THERE IS NO NEED TO DO SO AGAIN.

YOUR FAILURE TO SUBMIT YOUR CLAIM BY JULY 7, 2008 WILL SUBJECT YOUR CLAIM TO REJECTION AND PRECLUDE YOUR RECEIVING ANY MONEY IN CONNECTION WITH THE SETTLEMENT OF THIS LITIGATION. DO NOT MAIL OR DELIVER YOUR CLAIM TO THE COURT OR TO ANY OF THE PARTIES OR THEIR COUNSEL AS ANY SUCH CLAIM WILL BE DEEMED NOT TO HAVE BEEN SUBMITTED. SUBMIT YOUR CLAIM ONLY TO THE CLAIMS ADMINISTRATOR.

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6. I understand that the information contained in this Proof of Claim is subject to such verification as the Claims Administrator may request or as the Court may direct, and I agree to cooperate in any such verification. (The information requested herein is designed to provide the minimum amount of information necessary to process most simple claims. The Claims Administrator may request additional information as required to efficiently and reliably calculate your Recognized Claim. In some cases the Claims Administrator may condition acceptance of the claim based upon the production of additional information, including, where applicable, information concerning transactions in any derivatives of the subject securities such as options.) 7. Upon the occurrence of the Effective Date my signature hereto will constitute a full and complete release, remise and discharge by me and my heirs, executors, administrators, predecessors, successors, and assigns (or, if I am submitting this Proof of Claim on behalf of a corporation, a partnership, estate or one or more other persons, by it, him, her or them, and by its, his, her or their heirs, executors, administrators, predecessors, successors, and assigns) of each of the "Released Parties" of all "Settled Claims," as defined in the KPMG Settlement Notice.

5. I have enclosed photocopies of the stockbroker's confirmation slips, stockbroker's statements, or other documents evidencing each purchase, acquisition, sale or retention of ANR securities listed below in support of my claim. (IF ANY SUCH DOCUMENTS ARE NOT IN YOUR POSSESSION, PLEASE OBTAIN A COPY OR EQUIVALENT DOCUMENTS FROM YOUR BROKER BECAUSE THESE DOCUMENTS ARE NECESSARY TO PROVE AND PROCESS YOUR CLAIM.)

4. I have set forth where requested below all relevant information with respect to each purchase or acquisition of ANR securities during the Class Period, and each sale, if any, of such securities. I agree to furnish additional information (including transactions in other ANR securities) to the Claims Administrator to support this claim if requested to do so.

3. I consent to the jurisdiction of the Court with respect to all questions concerning the validity of this Proof of Claim. I understand and agree that my claim may be subject to investigation and discovery under the Federal Rules of Civil Procedure, provided that such investigation and discovery shall be limited to my status as a Class Member and the validity and amount of my claim. No discovery shall be allowed on the merits of the Action or Settlement in connection with processing of the Proofs of Claim.

2. By submitting this Proof of Claim, I state that I believe in good faith that I am a Class Member as defined above and in the Notice of Proposed Settlement of Class Action with Remaining Defendant KPMG Bermuda, Motion for Attorneys' Fees and Settlement Fairness Hearing (the "KPMG Settlement Notice"), or am acting for such person; that I am not a Defendant in the Action or anyone excluded from the Class; that I have read and understand the KPMG Settlement Notice; that I believe that I am entitled to receive a share of the Net Settlement Fund; that I elect to participate in the proposed Settlement described in the KPMG Settlement Notice; and that I have not filed a request for exclusion. (If you are acting in a representative capacity on behalf of a Class Member (e.g., as an executor, administrator, trustee, or other representative), you must submit evidence of your current authority to act on behalf of that Class Member. Such evidence would include, forexample, letters testamentary, letters of administration, or a copy of the trust documents.)

1. I affirm that I purchased or otherwise acquired the securities of Annuity and Life Re (Holdings), Ltd. ("ANR") during the period between March 15, 2000 and November 19, 2002, inclusive, and was damaged thereby.

CLAIMANT'S STATEMENT

NOTE: Separate Proofs of Claim should be submitted for each separate legal entity (e.g., a claim from Joint Owners should not include separate transactions of just one of the Joint Owners, an Individual should not combine his or her IRA transactions with transactions made solely in the Individual's name). Conversely, a single Proof of Claim should be submitted on behalf of one legal entity including all transactions made by that entity no matter how many separate accounts that entity has (e.g., a Corporation with multiple brokerage accounts should include all transactions made in ANR securities during the Class Period on one Proof of Claim, no matter how many accounts the transactions were made in.)

*P-ANR$F-POC/2*

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8. NOTICE REGARDING ELECTRONIC FILES: Certain claimants with large numbers of transactions may request to, or may be requested to, submit information regarding their transactions in electronic files. All Claimants MUST submit a manually signed paper Proof of Claim form listing all their transactions whether or not they also submit electronic copies. If you wish to file your claim electronically, you must contact the Claims Administrator at 1-800-298-3208 or visit their website at www.gardencitygroup.com to obtain the required file layout. No electronic files will be considered to have been properly submitted unless the Claims Administrator issues to the Claimant a written acknowledgment of receipt and acceptance of electronically submitted data.

Case 3:02-cv-02133-EBB
PART II:

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Separately list each of your purchases/acqusitions or sales of ANR common stock below. Photocopy this page if more space is needed. Be sure to include your name and the last four digits of your Social Security number or Tax ID number on any additional sheets. The date of purchase, acquisition or sale is the "trade" or "contract" date, and not the "settlement" or "payment" date.

SCHEDULE OF TRANSACTIONS IN ANR COMMON STOCK

*P-ANR$F-POC/3*

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1.

2.

Date(s) of Purchase (List Chronologically) (Month/Day/Year)

PURCHASES/ACQUISITIONS: Please list all purchases of ANR common stock during the period between March 15, 2000 and November 19, 2002, inclusive. (NOTE: If you acquired your ANR common stock during this period other than by an open market purchase, please provide a complete description of the terms of the acquisition on a separate page) (each purchase or acquisition must be documented):
Number of Shares of Common Stock Purchased Purchase Price Per Share of Common Stock Aggregate Cost (including commissions, taxes, or other fees)

BEGINNING HOLDINGS: Number of shares of ANR common stock held at the close of business on March 14, 2000. (If none write "zero" or "0") (If other than zero, each sale must be documented):

/ / / /
3.

/ / / /

$ $ $ $

. . . .

$ $ $ $

. . . .

Date(s) of Sale (List Chronologically) (Month/Day/Year)

SALES: Please list all sales of ANR common stock during the period between March 15, 2000 and November 19, 2002, inclusive. (If none write "zero" or "0") (If other than zero, each sale must be documented):
Number of Shares of Common Stock Sold Sale Price Per Share of Common Stock Amount Received (net of commissions, transfer taxes, or other fees)

/ / / /
4.

/ / / /

$ $ $ $

. . . .

$ $ $ $

. . . .

IF YOU NEED ADDITIONAL SPACE TO LIST YOUR TRANSACTIONS YOU MUST PHOTOCOPY THIS PAGE AND CHECK THIS BOX IF YOU DO NOT CHECK THIS BOX THESE ADDITIONAL PAGES WILL NOT BE REVIEWED

UNSOLD HOLDINGS: Number of shares of ANR common stock held at the close of business on November 19, 2002. (If none write "zero" or "0") (If other than zero, must be documented):

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*P-ANR$F-POC/4*

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A Proof of Claim received by the Claims Administrator shall be deemed to have been submitted when posted, if mailed by July 7, 2008, and if a postmark is indicated on the envelope and it is mailed first class, and addressed in accordance with the above instructions. In all other cases, a Proof of Claim shall be deemed to have been submitted when actually received by the Claims Administrator.

You should be aware that it will take a significant amount of time to process fully all of the Proofs of Claim and to administer the Settlement. This work will be completed as promptly as time permits, given the need to investigate and tabulate each Proof of Claim. Please notify the Claims Administrator of any change of address . UNDER THE PENALTIES OF PERJURY, I (WE) CERTIFY THAT ALL OF THE INFORMATION I (WE) PROVIDED ON THIS PROOF OF CLAIM FORM IS TRUE, CORRECT AND COMPLETE. Signature of Claimant (If this claim is being made on behalf of Joint Claimants, then each must sign) ______________________________________ (Signature) ______________________________________ (Signature) ______________________________________ (Capacity of person(s) signing, e.g. beneficial purchaser(s), executor, administrator, trustee, etc.)

Date: ________________

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REMINDER CHECKLIST 1. Please sign the Certification Section of the Proof of Claim and Release form. 3. Please remember to attach supporting documents. 2. If this claim is made on behalf of joint claimants, then both must sign.

8. Do not use highlighter on the Proof of Claim and Release form or supporting documentation. THIS PROOF OF CLAIM MUST BE POSTMARKED NO LATER THAN JULY 7, 2008 AND MUST BE MAILED TO: Annuity and Life Re (Holdings), Ltd. Securities Litigation c/o The Garden City Group, Inc. Claims Administrator P.O. Box 9254 Dublin, OH 43017-4654

7. If you move, please send us your new address.

6. The Claims Administrator will acknowledge receipt of your Proof of Claim and Release by mail, within 30 days. Your claim is not deemed filed until you receive an acknowledgment postcard. If you do not receive an acknowledgment postcard within 30 days, please call the Claims Administrator toll free at 1-800-298-3208.

5. Keep a copy of your Proof of Claim and Release form and all documentation submitted for your records.

4. DO NOT SEND ORIGINALS OF ANY SUPPORTING DOCUMENTS.

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EXHIBIT B

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EXHIBIT C

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EXHIBIT D

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