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Home My WebLink About98-04539 ~ \l ~ ~ ~ ~ ~ "). ). ~ ~. \," ~ ll: ~ ~ ~ t ~ " , . .:'l . ... <::.J. Q'-. C"l) Vj, ~ , 0..- ~ . ~ "- b- ",' j::.': 6~J7 1.1.... _ c--,. ;":; ~.'. --.,.... It..; Of.. W]/': -I" 0.:'.,: F:: ll, o '" <,:;-' " :'>'.' ~. '. ;...~; , ('.~ 1:1 ~~ _,h ,- ::~) 6 C.'C Q') .'>--. -..,.( ~ --...... ~ '-.Y -L -..J... ,"' ~ c~ ~ V q I}- \../} --.j /0 \ --3 'V \) )] ~ In D C; ~ 0.i '~ -J. r:d. '< ~ '0 '&R. , I I I I-< C- O> ES ... (IJ III ci<~ ~i .t::;g Ul -.g,~ 1>-1 en ~: ::l ::l 'tl = ~~ 00 I O{!) c: .... .-I: .E!.-I III ~ en '" e f ,.-1, .fJM ~ ;g "'o-l ~I (IJ.-I '" .- ,.-I' ~ I '0 3"'>;o-l , CJ I 1-<" 8 s "': .fJ.-I I 'tl~S": e ~ [!;] ~~ i~ ~ c:!l p.. M --: 011 g eLf) Lf)1 <1J -OM """ gJ.a'tl tr.l ,.-II . ~ U O>o-l "'" I' 01 &j'~ oJ t: 1>-1 -.-I ~ .- 00' H '~01 4-l I. "': I-< ..:: r::: ...lJ....l..Qf'-O , ><O.fJZ ~I'.-I~ .-I: (IJ~OenMZ , ~,~ ~ ~ ~ Ill..-I .t:: '.-IN I rLo.-l '.-I , Q, .fJ I-< I . , I-< ~I (IJ enl-<'-o ~ !ii..:~Ul gj ""'Ill ..-1 1 .fJ ~ 0 &J o-l . O1COU ul Ul p.. .-H " a. Scratched right cheek, requiring which has totally resolved and left no scar. b. A gouge injury to the minor's top no stitches and which healed sa tisfactorily, but a minor scar. c. After the incident, the minor was treated at and released from Carlisle Hospital. Thereafter, the minor had three or four follow up visits with Kaye M. Riolo, M. D. (plastic surgeon) the last of which was a six month recheck in February 1998. Dr. Riolo observed the healing of the inj ury to the lip and performed no, nor recommended any additional treatment. 5. The minor's claims for pain and suffering and personal injuries and medical bills total approximately $400. 6. Liability in connection wi th said incident has been no sutures, lip, requiring which has left disputed. 7. That for the purposes of avoiding the expenses and uncertainty of litigation, the parties have agreed upon a settlement and comprise in full discharge of the claim of Peti tioner, Steven Brewbaker as parent and natural guardian of Hayley Irene Brewbaker, a minor P13intiff, in the sum of $1,600. A copy of the proposed Release in this case is attached hereto as Exhibit "An. 8. That your Petitioner approves the proposed settlement because he considers it to be fair and reasonable in that he believes that it adequately compensates the minor for the injuries she sustained and the expenses incurred thereby and he does further approve the proposed distribution contained in the form of the Order attached hereto. 9. The undersigned counsel is not charging the Petitioner or the minor for any representation with respect to this matter. 10. No more follow up medical appointments have been scheduled; the minor has fully recovered from her injuries; and BREWBAKER and ERIE INSURANCE EXCHANGE, or their heirs, executors, administrators, successors or assigns, or which in any manner have arisen or might arise as a result of that certain dog bite incident which occurred on September 26, 1997, at or about 84 Fairview Street, Carlisle, Cumberland County, Pennsylvania, which is the subject of the above lawsuit. I further certify, state, acknowledge, warrant, and declare that each and every person, attorney, carrier, entity or association which claims to have a lien on the proceeds of this settlement arising out of this incident, lawsuit, or litigation, is aware of this Release and its terms and I understand that said released parties hereunder are relying expressly upon this unconditional express warranty in making payment hereunder. I, STEVEN BREWBAKER, as Parent and Natural Guardian of HAYLEY IRENE BREWBAKER, a minor, understand that the said KENNETH BREWBAKER and ESTA BREWBAKER and ERIE INSURANCE EXCHANGE, by reason of agreeing to this compromised payment, neither admit nor deny liability of any sort and that the same KENNETH BREWBAKER and ESTA BREWBAKER and ERIE INSURANCE EXCHANGE made no promise or inducement to do or omit to do any act or thing not herein set forth and I further understand that this Release is made as a compromise to avoid expense and terminate all controversy and/or claim of whatsoever nature, know or unknown, including any future problems which may result to the said HAYLEY IRENE BREWBAKER, a minor, which in any way is growing or connected with the above- mentioned accident, casualty or event. 2 I, STEVEN BREWBAKER, as Parent and Natural Guardian of HAYLEY IRENE BREWBAKER, a minor, hereby agree to dismiss with prejudice or otherwise terminate of record, the above-noted action heretofore instituted on behalf of HAYLEY IRENE BREWBAKER, a minor, against KENNETH BREWBAKER and ESTA BREWBAKER and ERIE INSURANCE EXCHANGE, in the Court of Common Pleas of Cumberland County, Pennsylvania. I, STEVEN BREWBAKER, as Parent and Natural Guardian of HAYLEY IRENE BREWBAKER, a minor, do hereby expressly stipulate and agree, in consideration of the aforesaid payment, to indemnify and hold forever harmless the said KENNETH BREWBAKER and ESTA BREWBAKER and ERIE INSURANCE EXCHANGE, and their successors, assigns, heirs, executors and administrators, against loss from any and all further claims, demand and actions in law or in equity that may hereafter at any time be made or brought by the said minor, or by anyone who claims an action on behalf of said minor, for the purpose of enforcing a further claim for damages on account of the injuries sustained as a result of the aforesaid accident, and the said STEVEN BREWBAKER, as Parent and Natural Guardian of HAYLEY IRENE BREWBAKER, a minor, hereby waives any and all rights of exemption, both as to real and personal property, to which she may be entitled under the law of this or any other state as against such claim for reimbursement or indemnity. 3 ,~. OCT 1 2 199~ HAYLEY IRENE BREWBAKER, a Minor, by and through her Parent and Natural Guardian, STEVEN BREWBAKEH, Petitioner/Plaintiff IN TilE COURT OF' COMMON PLEAS or CUMBERLAND COUNTY, PENNSYLVANfA v, NO. IY - ~J.3Q .. . \ /7 (1.<... {Let. KENNETH BREWBAKER and ESTA BREH8A!~Ei1, Respondents/Defendants ORDER AND NOW,' chis /3 hi. day of (DCT",)". . 1998, upc.-, consideratior. ct the annexed Petition for Leave to Comproi11i se r, ~llnor' s Action, it is ordered that the settlemer.t of the abolle." captioned action for the gross sum of $1,600,00 is appro~ed. IT IS F'URTHER ORDERED, that the settlement proceeds shall be distributed as follows: Provided that upon receipt thereof, Steven Bre'.-Jbaker shall promptly deposit the minor's funds in an interest-bearing account, money market account or certificate of deposit at a federally insured depository, entitled in the name of the minor, subject to the express restriction which shall be noted upon the records of the depository and on the passbook or certificate, that without further Order of the Orphan's Court Division, no withdral-Ials of principle or interest shall be made until the minor attains the age of eighteen (18) years, \'Ihich event will occur on December 29, 2012, at which time the depository shall, upon Order of the former minor, and without ..' i ,: , ,\ the necessity of an accounting or further Order of the Orphan's Court Division, pay the funds then on deposit on a restricted account to the former minor and promptly file proof of such payment; with the Clerk of Orphan's Court Division. r As evidence of compliance wi th this Order, there shall be filed within ten (IO) days of the date hereof with the Clerk of the Orphan's Coure Division a sworn acknc.v:ledgrn'2nt by an authorized official of the depository that a balance of the money as herewith allotted to the minor legatee has been deposited in the form of a savings investment entitled as aforesaid, subject to ~he restrictions on withdrawals hereinbefore lmposed and that said restrictions have been noted on the bank's records and in the passbook or on ehe certificate as directed. IT IS FURTHER ORDERED, that upon filing this Order, Plaintiff is directed to execute the Release in ehe form ateached hereto as Exhibi t "A", and to execu te a Pra<:cipe for Discontinuance and Order that the Civil Docket in this matter may be marked settled, discontinued and ended. IT IS FURTHER ORDERED, that counsel shall file a copy of this Order with the Clerk of the Orphan's Court Division and that said Clerk shall assign a file number and establish a file captioned "IN RE: Hayley Irene Brewbaker, a Minor". IT IS FURTHER ORDERED that the Affidavit of Deposit and the Affidavit of Payment inquired by this Order, as well as any Petitions for invasion of the minor's restricted account, shall be 2 @ :::.;: c-J C.." C''': "'" i- . uJ 9: (.~ ~2(~. :-:: LI.-," ~4 !-k- ~::: C}C1 ~);~:' LlP-' :=::tl_ c.~ L:.... .~; \.\.1 r= c.: u_ C.:l (~ 0'\ \ ~ . ~ I "', UQ ~ \l'- '-?, - 1.1) - <i ...... y -:) ~ " . " d 11;, <:-' r r ,.... ;5~~ , ) ~... ;~~ .~~~ (n {:!~~ U;!I;JJ ,.L.~.l.. -5 () HAYLEY IRENE BREWBAKER, aMi nor, by and through her Parent and Natural Guardian, JODY BREWBAKER, Petitioner/Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNA. : NO, 98-4539 Civil v, KENNETH BREWBAKER and EST A BREWBAKER, Respondents/Defendants '.,.,..."".),.:....i.:::..;:PRAEC1PE.TO,.FILE..CERTiFICATJll.()F..DE~OSITREClJ;IPT.,. !'f:1;':j::m..i;:;.:.i:m:iijJjJjSuAijrT(j"Co~i;(jiIDJiJJl()F..(jCTOBERii3;'199S:",.'R ..;~;.;,:.;.;. " ~.:';:;:r:.;::::;:;::::':;:;: ;";,,,;,,;~""" ;:(ti:;j::t:~,t::: .,.;.:.;.;-:.:.;.'.;.;.;.; ;:;,:^:::,.: .'...... .:.;.:.:.,,:.,,::,:.:.,' Please file the Certificate of Deposit Receipt under the docket number 98-4539 Civil. Respectfully submitted, THOMAS, THOMAS & HAFER, LLP ;;2~i~~ Attorney I.D, # 72671 305 North Front Street p, 0, Box 999 Harrisburg, P A 17108-0999 (717255-7629 Date: February 9, 2000 :85736,1 WI S BANKERS IA'avil1J.! Our Mark. , i%~vi.ty vfrW February 17.2000 Prothonary Officc I Court Housc Square Carlisle, PA 17013 To whom it may concern: I am supplying you with information on Hayley Ircnc Brewbnb.r ~... 10/131998. A 48 month certifieat/\ "'"" .-- H me EquilY Loan you will fintl " .-" ' Harris SavingS Bank II dOSO~vOd vacalioni Loan, c ~s caT or a we. Ha.rrls Equ ty Jrec t. N . e lmprovemenl"neh~dde~ potential wIth 0. ca. . Horn home 5 I BANKE.RS. DiSCOvor your ." " our "lllr\!.. ApplY Today! 1,1"",'1110: n28"'02 0441 ~2S'jO(lH507. ...0 O::l-17~2I}CIQ t2L " 1 'OJ 19 At\'r ,. ^ .0 .. _ N J ,-,\~ CO CASH DEPO'" 11, U^ cerlain . Commercial CodO. . ns 01 t"e un,'onTl . to 11'10 proVISIO MomborFD1C I deposit aro SUb,leC\c Bank. poliCY, oeeivcd or T\II according EIPT d other Hornfi r \ s In avallabll S '{OUR RE.C Ctlec\( an biect \0 de oy TH\S , depOsits arO SU TEL.OO,,8,ga I-lards Savings Bank Beauforf Filrms Office, Beaufort farms Pia:.., 20li Lillglcstowl1 Road, HarrhlHlrg, Pennsylvania 17110 717/65Z-0900 . 717/652-5.109 fax. www.harrissil\'ingshank.com HAYLEY IRENE BREWBAKER, a Minor, by and through hcr Parcnt and Natural Guardian, JODY BREWBAKER, Petitioncr/Plaintiff : IN THE COURT or COMMON PLEAS OF : CUMBERLAND COUNTY, PENNA. : NO, 98-4539 Civil v, KENNETH BREWBAKER and ESTA BREWBAKER, Respondents/Defendants ,'.-.'.'., ,-,--.".'., :;;:::~::'::;-.:;'X: ',,','. '"..,,, '...',.., .."...,' .'.'PRA.C 'TO" S CO T " ........ ,.'. ,..,.. .., ...., ...., ....,.. '..'EJPE'DI NINUE.........., ...., :':::'::'::::;"':::':""'::':':"::::::'::::::::::':'::'::::;:::',';:,,:::.:. .:,:.-....'.:-: ,:::::'.',.<.,.,.,"...-.:.-:; ,., ;:,,;.:,::::.:.:::.'.... . . ... ... .. ..... ... TO THE PROTHONOTARY: Please mark thc above matter settled, discontinued and ended, Respectfully submitted, THOMAS, THOMAS & HAFER, LLP By: ~. /2-:n .J?l M, Popilocl( Esquire J\ttorney I.D, # 72671 305 North Front Strect p, 0, Box 999 Harrisburg, P A 17108-0999 (717255-7629 Date: February 17, 2000 :86638,1