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Home My WebLink About01-0123 FX JASMIN GOLDEN, a minor, by ROBYN GOLDEN, parent and natural guardian and ROBYN GOLDEN in her own right 689 Cumberland Pointe Circle Mechanicsburg, P A 17055 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA No. 01-):2 '3 200~ Civil Action - (Xi Law ( ) Equity RAY G. SNYDER and KATHY], SNYDER, Individually and as Husband and Wife 138 Linda Drive Mechallicsburg, PA 17055 versus and EDGEW A TER CHILDREN'S SERVICES. a Subsidiary of Northwestern Human Services; EDGEWATER PSYCHIATRIC CENTER, a Subsidiary of Northwestern Human Services; and NORTHWESTERN HUMAN SERVICES 2001 North Front Street Harrisburg, P A ] 71 02 Plaintiff(s) & Address( es) Defendant(s) & Address(es) PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY: Please issue '\Vfit of summons in the above-captioned action. Writ of Summons shall be issued and forwarded to ( ) Attorney (X) Sheriff Richard B. Druby, Esquire Nestico & Droby, L.L.P, 840 East Chocolate A venue Hershey, PA 17033 717-533-5406 /- Supreme Court ID No, 61904 Date: d'? /0 I I I WRIT OF SUMMONS TO THE ABOVE NAMED DEFENDANT(S): YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTlFF(S) HASIHA VE COMMENCED AN ACTION AGAINST YOU. G~c:tA-; l:? ed' J~ < Prothonotary Date: Q~ ?,;2rn; I by qu; u tJ "h" (f'u Deputy ( ) Check here if reverse is issued for additional information ~ ~ e, d \0 \' .,.. >J] ,. \~ M ~ ~ >;: c_~ i' ;~~<. ." f': t~'"":": C'! :-::'1: c:' J-:l 53 -;:.""'" J <::"' ~~ -.. '-c\ -.. <> :J : ~~ " ~. ?:: z 5~ (..)2 '" ~~~ 52 ~~~ -~Lt.: '.:20- =5 o <;.....: N C-- .=:J ! -,... c..:" 'Z-:.'~ -, o JASMIN GOLDEN, a minor, by ROBYN GOLDEN, parent and natural guardian And ROBYN GOLDEN in her own right, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plain tiffs v. NO. 2001-00123 P RAY G. SNYDER and KATHY J. SNYDER, Individually and as Husband and wife; and EDGEWATER CHILDREN'S SERVICES, Defendants CIVIL ACTION-LAW JURY TRIAL DEMANDED ORDER AND NOW, this Z 't" day of r>1"'1 , 2002 on consideration of the foregoing petition, it is ORDERED that the settlement and compromise of this action for the gross sum of $15,000.00 is approved. Petitioner, Robyn Golden, is hereby appointed trustee and custodian of the net settlement proceeds. Counsel fees and expenses are also approved as set forth below. This distribution is directed as follows: 1. To be paid to petitioner, Robyn Golden, parent of minor plaintiff, and to be placed in a federally insured account for the purposes of maintaining the funds in said account until Jasmin Golden attains her eighteenth (18th) birthday on July 30, 2005. The account is to be marked "Not to be withdrawn until minor plaintiff reaches her majority or without the order of a court of competent jurisdiction"--$10,866.95 2. To Richard B. Druby, Esquire, for counsel fees--$ 3,750.00 3. To Richard B. Druby, Esquire, for costs-- $ 383.05 r;i' :" L~~~q.:i~:j~~:2~'~~)TI-\RY ~"I1"" 2' ,', 1..-, l" -j'j - .. ",- ,. I' ,;;,. .. 1 ~ -; " l ., ~ _ CUJvJ8EhLAi\!!) COUNTY FENNSYLVN-JIA -. , - , Petitioner, Robyn Golden, shall be permitted, only after first obtaining Court approval, to invade first the interest and then the principal of the settlement proceeds for the reasonable needs of Jasmin Golden. BY THE COURT! --/ . f-l ;:Jt.... J. L~a ~:br, tR~ <t ~a.Thr S.s~dCR. [d5e.wo....\eR c..\\\\X"R.e.~:S Service.::, L II P3~C.~io-.\.f"'\C Ce.....h" \ It \e.R..( PtL\.mo...( ~e.tl..~\C~ DOR;rfllAYe.S . , JASMIN GOLDEN, a minor, by ROBYN GOLDEN, parent and natural guardian And ROBYN GOLDEN in her own right, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs v. NO. 2001-00123 P RAY G. SNYDER and KATHY J. SNYDER, Individually and as Husband and wife; and EDGEWATER CHILDREN'S SERVICES, Defendants CML ACTION-LAW JURY TRIAL DEMANDED PETITION FOR LEAVE TO COMPROMISE MINOR'S ACTION Pursuant to Pa. R.C.P. No. 2039, RobynGolden, the parent and natural guardian of minor Jasmin Golden, by her attorneys, Nestico & Druby, LLP, petitions this Court to enter an order permitting settlement in compromise of this action, and in support avers the following: 1. Robyn Golden is the parent and natural guardian of minor-plaintiff Jasmin Golden, who was bom on July 30, 1987, and who is presently 14 years of age. 2. Minor-plaintiff was injured on the weekend of January 9, 1999, at the home of Defendants, Ray and Kathy Snyder, when the Snyder's dog had bitten Plaintiff on the face. 3. The minor-plaintiff received several lacerations to the face. All but one wound healed on its own. The remaining wound of 1.4 cm required surgical excision of the scar tissue. That excision was done on March 15,2000. 4. A copy of the medical report of the treating physician, Robert E. Wolf, M.D., a plastic surgeon, is attached as Exhibit "A". 5. Petitioner has incurred $1,069.00 in medical expenses from Leber & Wolf Plastic Surgery for treatment of the minor-plaintiff. The insurance carrier for Defendant Snyders tendered its $1000.00 in medical payments coverage to Petitioner. 6. Counsel was retained by the petitioner to represent the minor-plaintiff on a contingent fee basis. A copy of the fee agreement is attached as Exhibit "B". In prosecuting this action on behalf of minor-plaintiff, counsel has incurred the following expenses: Xeroxing costs $ 15.47 Medical records $ 18.00 Filing Fees $ 45.50 Report of Dr. Wolfe $160.00 Service Fees $144.08 Total $383.05 7. Petitioner seeks approval of the settlement on behalf of minor-plaintiff in the amount of $ 15,000.00 negotiated with Defendant Snyders, because she believes that it represents a full and fair settlement of the case, equal to or greater than that which may be obtained should the matter be fully litigated. Petitioner has decided not to continue litigation against the remaining Defendant. Therefore, Petitioner intends to file a Praecipe to Discontinue this action as to all Defendants upon Court approval of this Settlement and receipt of the settlement funds from the Snyders' insurance company. 8. Petitioner approves of the proposed settlement because she considers it fair and reasonable and it adequately compensates minor-plaintiff for the injuries sustained and expenses incurred. 9. Petitioner, upon receipt of the funds, will place the funds into a federally insured account which will be marked "Not to be withdrawn until minor plaintiff reaches her majority or without the order of a court of competent jurisdiction." 10. Petitioner desires to be named as custodian of her daughter's account. 11. Petitioner desires to have the right to invade her daughter's account prior to her daughter's attaining the age of eighteen (18) if it is necessary to do so for the benefit of her daughter, subject to prior Court approval. 12. Petitioner further approves the proposed distribution contained in the form Order attached. WHEREFORE, petitioner requests that this Court enter an order approving the settlement and compromise, allowing counsel fees and ordering distribution as set forth in the attached order. Date: s-;Ja;j? itted, , , LEBER & WOLF PLASTIC SURGERY, LTD DAVID C. LEBER. M.D.. F.A.C.S. ROBERT E. WOLF, M.D., FAC.S. PLASTIC AND RECONSTRUCTIVE SURGERY 2807 NORTH FRONT ST. HARRISBURG, PA 17110-1222 April 22, 2002 PHONE: (717) 233-4691 FAX: (717) 233~8836 Richard Druby, Esq 840 East Chocolate Ave Hershey, P A 17033 RE: Jasmin Golden Dear Attorney Druby: This is the letter you indicated was necessary regarding update on Jasmin Golden who first presented to me in March of 1999 for evaluation of dog bites on her face, which were sustained on January 10, 1999. At the time of her first visit the scars were still healing and had a palpable natural healing ridge at which time we instructed her on massage therapy to these scars and she followed up two months later on May 28, 1999. At that visit, the scars had shown improvement with softening of the healing ridge and we continued with conservative management. She was once again seen on August 20, 1999 when it was noted that all of the scars had healed exceptionally well except for one in particular in the mid-portion of her right cheek. It was felt that surgical revision of this scar was the only means to improve its appearance therefore this surgery was performed on March 15, 2000 as an in-office surgical procedure. The sutures were removed on March 24, 2000 and she was instructed on re-application of steri-strips to improve wound healing. She was once again seen on May 19,2000 where she was noted to have marked decrease hyperemia within the scar tissue and the scar was quite soft. At that point no further intervention was warranted and she was asked to follow-up in the fall ofthe year 2000, however we have not seen Jasmin since her last visit on May 19,2000. o .' SM MEMBER AMERICAN SOCIETY OF PL6.ST1C SURGEONS, INC. Richard Druby, Esq. Page 2 April 22, 2002 RE: Jasmin Golden I hope this summarizes the treatment and care that she received from our office and if any further information is necessary, please do not hesitate to contact me. With best regards, I am, Sincerely, . I / ...---~____ ---:)' \. . / ' ,r././ - . ,;:/'~_:,''-'''v'''''./;:O, --.." - ------- --- Robert E. Wolf, M. D. REW/mm . . Stephen J. Herceg, M.D., F.A.C.S. David C. Leber, M.D., F.A.C.S. Robert E. Wolf, M.D. PATIENT PROGRESS. NOTES . ~ . I Name (. 4--7?t?71 i ~~?Z/ ; / Ii Birthdate Fr' ~ 3{) /<67 Account No. 117 ';).:l,. J , HERCEG & LEBER PLASTIC SURGERY, LTD. 2101 North Front Street, Building #4 Harrisburg, PA 17110 DATE PROBLEM ~- 7,' ~rl } k..r:"h / c. ...., ) /" / ~ :> \/ / .Y1 \,......, ..s~"'" J ~J~ 1/ L,'; y/ .c,/s .s-)"'j / ,./ -, /;' "". /- /C" A",<-r j~.,/ tA-<"J/ / " /1 1<./;/ ;::V,h/ ~ ......, c,-, -/ j, s ".{ r'-' '" j., " c. .:e-- ;;/. -"> / ~-c'JA"./- 1.1;)"3/'11 .....J v-- c..... 4; iJ ~$.. "7"iv' v' (1 . ,..., ..s 0 ""' J ). (;/ ~~). ':%- h <> '~._ ~....7~. 7~ / 04,.. - '// ')r _~~ :s /,'.),/,.< Ah,/,.,J , ,~ ,')..p. r!/: ""..r/ ;lv/ .J,c-/l / .6~..>~' '<1:..~..r: c,~~"r.,., / ox,,'?;:'..., ,- -de: ~h('/ /(/// "".J r......li~...,( J" I ~ ).... ~ V"~v'J/ <7 ;y, .~,-') ,.,: <>h-, .. ,~ ~ ;-.-- r /~..J ~ /A/:. ~V"::; ./' . Page (~ . ~i;l/;>7U-n ,~ , . ,if. " .- _ " ~"'?'''t..1 DATE PROBLEM 3; ~()O C,. :;,","::."7 c;.:~ / ~"l / Yr-,.--.-. .J,_ . .{.../C"',.,.....,J ,-L C/ '/;"'/:::'~'),Y if.< 5 ('"',..1 c' c:/i f.~""J V' k- rA",""! ~ 5. !.-/',' ~...(,."",(.~,.,-.) / lU.,--~ ~~ B6.../o( / c-' ~ ---",J ;,0. ";!; ...., /,J ,./ -/ .. ,-,,_..., I"-~~ /..,.... ~.,~. s-/- . . .. /~ .. ,/',1<, ._, / -:--;.'\1 i/ ------., ~;:- ;.(j -- / 5j,(y/ou. Aa<'-'<... ~ c.fL/~)~ ,.~ ;1W~,-/CH Clyk-r-,.-=</- Jk>/ '_~' 'F CJ3 2J (j zr V- u U .. ..... II' ~1~/tloJI~r' ('tL/7~c./).d 4y7/?~ /&s c~ ~&-- 5/;11:: II /)~ _, ~_ // ::Z;-5..~ - 'C " J~Y/ u_-J 4/' r' ., IL .. .... mn~1 'J h"..z/oo II ?./. /Ie/I- ; /1 / /--.ll" II J AC /? ,"t: ~/"'r. ~, ,/" ___ / h /.-< J.",L ),r.,/,., J ""r,7 '-) ~ ~/'~J':: /" , ~/ --' ;J,r.7\ ~ " , -~.-/ ":;',.'" I / 17c. ,> , ".- ----- ~ ........~~t./l.-.........~""O / AIL- CONTINGENT FEE AGREEMENT I, Robin Golden, individually and as parent and natural guardian of Jasmin Golden, retain and authorize the law firm of Metzger, Wickersham, Knauss & Erb, P .C., to do whatever they deem necessary or desirable in order to represent me in all claims for compensation and reimbursement for personal injuries, wage loss, and economic and other damages resulting from a dog bite incident on January 11, 1999. 1. Attornev's Fees: The fee of the attorneys shall be contingent as follows: (a) Thirty-three and one-third percent (33 1/3 %) of gross recovery; (b) SHOULD THERE BE NO RECOVERY BY SUIT OR SETTLEMENT, SAID ATTORNEYS DO HAVE NO CLAIM AGAINST ME OF ANY KIND FOR LEGAL SERVICES RENDERED. 2. ExoensesofLitigation: Actual expenses incurred on the business of the client shall be bome by the client and my attorney shall be reimbursed out of the balance, after deduction of attorneys fees, of any recovery for all legal expenses incurred in the prosecution of this claim which have not already been paid by me. I do hereby agree to pay all expenses incurred by my attorney in the preparation and presentation of this case and do understand that these expenses include, but may not be limited to, costs of medical reports and records, stenographic expenses connected with depositions, expert witness fees, photocopying charges, and mileage charges connected ""ith the rendering of legal services. I understand that I am responsible for payment of these expenses regardless of the eventual outcome of the case and further understand that if my attorney deems it necessary, I may be asked to advance these costs prior to the incurring of any such expenses or the scheduling of any deposition. - 1 - Document # 149368 3. I hereby further agree that my attorney may charge me reasonable additional compensation if it is necessary to try the case more than once, if the case is appealed, or if proceedings in other courts are necessary because of the change of circumstance of a party or for other reasons. 4. I hereby further agree that my attorney is hereby authorized to bring suit or to settle and compromise the claim, to execute all documents pertaining thereto, and to do all lawful acts requisite for effecting the claim on my behalf. 5. I further authorize my attorney to payout of any proceeds of settlement or trial any unpaid medical bills for treatments or services made necessary by the injuries sustained in this accident. 6. I agree that my attorney accepts this employment on the condition that he will investigate this claim, and if it appears to be a recoverable claim, he will proceed to handle the claim; but if, after investigation, the claim does not appear to be recoverable, said attorney shall then have the right to rescind this Agreement. 7. I hereby further agree that if I decide to terminate this authority before any settlement is offered or any award is obtained, I specifically agree that the firm shall be entitled to reasonable compensation for all work done on the case up to that point. I agree that reasonable compensation for Richard B. Druby, Esquire, or any other attorney involved in the handling of this case, shall be One Hundred Twenty-five ($125.00) Dollars per hour, or such higherrate as shall constitute his standard billing rate at the time that the work is performed. 8. I agree that my attorney may withdraw from this case at any time after reasonable notice to me, and I agree to keep him advised of my whereabouts at all times and to cooperate at all times in the preparation and trial of this case, to appear upon reasonable notice for depositions and court appearances, and to comply with all reasonable requests made of me in connection with the preparation and presentation of this case. -2- Document #149368 'II IN WIlNESS WHEREOF, I have signed below on this ~ day of JUJ-{,c.I... 1999. ,A Mtfn /S4- CLIENT: Rob n Golden } METZGER, WICKERSHAM, KNAUSS & ERB, P.c. . c'"\. / l;\,. , :IJ ATTORNEY: Riehar // -3- Document#149368 . ,. . "~ . VERIFICATION I, Robyn Golden, verify that the statements made in the foregoing document are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. 94904 relating to unsworn falsification to authorities. Date: 1-/- 1'1-0 v C1Jd~ ,~L RO"byn Gol~en f2 >- L0 ;::: a: ,::; :z u..l~~,! C"") ~~ L= L)-s.::; L)~ c:.:: ~-'_ "'- ."::-:; :=i ~,;) t:~ ~ c 0 ~~~~ 0,:-", ('-..I L~';~ 'LZ -~ >- :JJW . """ U.)C'...:... i=: ::z:. ~ t ~._ "" :::> 0 = U . . SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2001-00123 P " COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND GOLDEN ROBYN ET AL VS SNYDER RAY G ET AL R. Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT , to wit: EDGEWATER CHILDREN'S SERVICES SUB. OF NORTHWESTERN HUMAN SVC but was unable to locate Them in his bailiwick. He therefore deputized the sheriff of DAUPHIN County, Pennsylvania, to serve the within WRIT OF SUMMONS On January 22nd , 2001 , this office was in receipt of the attached return from DAUPHIN Sheriff's Costs: Docketing Out of County Surcharge Dep. Dauphin Co 6.00 9.00 10.00 37.50 .00 62.50 01/22/2001 NESTICO & DRUBY ~~~~ R. Thomas Kline Sheriff of Cumberland County Sworn and subscribed to before me this j",,;:I- day Of.J~ ';;'...01 A.D. ~ "-'- Q '),.,";f,. , . . prothonotary~ SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2001-00123 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND GOLDEN ROBYN ET AL VS SNYDER RAY G ET AL R. Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT , to wit: EDGEWATER PSYCHIATRIC CENTER SUB OF NORTHWESTERN HUMAN SVCS but was unable to locate Them in his bailiwick. He therefore deputized the sheriff of DAUPHIN County, Pennsylvania, to serve the within WRIT OF SUMMONS On January 22nd , 2001 , this office was in receipt of the attached return from DAUPHIN Sheriff's Costs: Docketing Out of County Surcharge 6.00 .00 10.00 .00 .00 16.00 01/22/2001 NESTICO & DRUBY ~ -;::::/ -~==----- ~~ R. -Thomas Kline Sheriff of Cumberland County Sworn and subscribed to before me thi s /.,;.- day of l....Jx.u ' r ;21H:J1 A.D. '-, { J''=7tLC:~' ~ I Prothonotary' SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2001-00123 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND GOLDEN ROBYN ET AL VS SNYDER RAY G ET AL R. Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT , to wit: NORTHWESTERN HUMAN SERVICES but was unable to locate Them in his bailiwick. He therefore deputized the sheriff of DAUPHIN County, Pennsylvania, to serve the within WRIT OF SUMMONS On January 22nd , 2001 , this office was in receipt of the attached return from DAUPHIN Sheriff's Costs: Docketing Out of County Surcharge 6.00 .00 10.00 .00 .00 16.00 01/22/2001 NESTICO & DRUBY ~-- -= .O/~~ R Thomas Kline ~ Sheriff of Cumberland County Sworn and subscribed to before me this J",)/- "-" day ofJ.d'''.7 oZ6-<J I A . D . c-~'". c: n'W?0 ~ 1/ Prothonotary' SHERIFF'S RETURN - REGULAR CASE NO: 2001-00123 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND GOLDEN ROBYN ET AL VS SNYDER RAY G ET AL CPL. MICHAEL BARRICK , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within WRIT OF SUMMONS was served upon SNYDER RAY G the DEFENDANT , at 0016:33 HOURS, on the 17th day of January 2001 at 138 LINDA DRIVE MECK~ICSBURG, PA 17055 by handing to KATHY SNYDER a true and attested copy of WRIT OF SUMMONS together with and at the same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge 18.00 5.58 .00 10.00 .00 33.58 ;;~~~t:~ R. Thomas Kline o ,~. '".--F. 01/22/2001 NESTICO & DRUB Sworn and Subscribed to before By: me this /4 day of 3.J,..,. . : ~J ckz, I A. D. ( L " 0 /J1dk<_o{.Pp<f , P1;othonotary SHERIFF'S RETURN - REGULAR CASE NO: 2001-00123 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND GOLDEN ROBYN ET AL VS SNYDER RAY G ET AL CPL. MICHAEL BARRICK Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within WRIT OF SUMMONS was served upon SNYDER KATHY J the DEFENDANT , at 0016:33 HOURS, on the 17th day of January 2001 at 138 LINDA DRIVE MECHANICSBURG, PA 17055 by handing to KATHY SNYDER a true and attested copy of WRIT OF SUMMONS together with and at the same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge 6.00 .00 .00 10.00 .00 16.00 So Answers: ~~ :P"<~" R. Thomas Kline 01/22/2001 NESTICO & DRUBY Sworn and Subscribed to before By: ..../. me this j.o.:r day of 3-d-. .. <, i' c2cr) ! A. D . q /; ,- . . 4.~ ' ~JO (1 /ud.l"." -=r r othonotary @ffir~ of tlyc ~1rc:r-iff William T. Tully Solicitor Ralph G. McAllister Chief Deputy Mary Jane Snyder Real Estate Deputy Michael W. Rinehart Assistant Chief Deputy Dauphin CoWlty Harrisburg, Pennsylvania 17101 ph: (717) 255-2660 fax: (717) 255-2889 Jack Lotwick Sheriff Commonwealth of Pennsylvania GOLDEN JASMIN vs County of Dauphin EDGEWATER CHILDREN'S SERVICES Sheriff's Return No. 0111-T - -2001 OTHER COUNTY NO. 01-123 AND NOW: January 16, 2001 at 1:25PM served the within SUMMONS upon EDGEWATER CHILDREN'S SERVICES A SUB OF NORTHWESTERN HUMAN SERVICES to TINA CONDE, ADMIN ASST. by personally handing 1 true attested copy(ies) of the original SUMMONS and making known to him/her the contents thereof at 2001 N. FRONT ST. HBG, PA 171D2-0000 Sworn and subscribed to ?f~ Deputy before me this 17TH day of JANUARY, 2001 ~ C!-. AaWw) PROTHONOTARY By Sheriff's Costs: $37.50 PD 01/11/2001 RCPT NO 1.451.91 MLYNEK @ffb:~ llf Ut.e ~4.e:r-iff William T. Tully Solicitor Ralph G. McAllister Chief Deputy Michael W. Rinehart Assistant Chief Deputy Mary Jane Snyder Real Estate Deputy Dauphin County Harrisburg, Pennsylvania 17101 ph: (717) 255-2660 fax: (717) 255-2889 Jack Lotwick Sheriff Commonwealth of Pennsylvania GOLDEN JASMIN vs County of Dauphin EDGEWATER CHILDREN'S SERVICES Sheriff's Return No. 0111-T - -2001 OTHER CDUNTY NO. 01-123 AND NOW: January 16, 2001 at 1:25PM served the within SUMMONS upon EDGEWATER PSYCHIATRIC A SUB OF NORTHWESTERN to TINA CONDE, ADMIN. CENTER HUMAN SERVICES ASST. by personally handing 1 true attested copy(ies) of the original SUMMONS and making known to him/her the contents thereof at 2001 N. FRONT ST. HBG, PA 17102-0000 Sworn and subscribed to Jf~ before me this 17TH day of JANUARY, 2001 ~C!-.M . .. PROTHON6TARY~~ By Sheriff's Costs: $37.50 PO 01/11/2001 RC?T NO 1.l!z.'01.9i MLYNEK @ffir~ of tq~ ~1re~iff William T. Tully Solicitor Ralph G. McAllister Chief Deputy Michael W. Rinehart Assistant Chief Deputy Mary Jane Snyder Rea! Estate Deputy Dauphin County Harrisburg, Peunsylvania 17101 ph: (717) 255-2660 fax: (717) 255-2889 Jack Lotwick Sheriff Commonwealth of Pennsylvania GOLDEN JASMIN County of Dauphin vs : EDGEWATER CHILDREN'S SERVICES Sheriff's Return No. 0111-T - -2001 OTHER COUNTY NO. 01-123 AND NOW: January 16, 2001 at 1:25PM served the within SUMMONS upon NORTHWESTERN HUMAN SERVICES by personally handing to TINA CONDE, ADMIN. ASST. 1 true attested copy (ies) of the original SUMMONS and making known to him/her the contents thereof at 2001 N. FRONT ST. HBG, PA 17102-0000 Sworn and subscribed to So Answers, IR~ ::71;:5A~ Deputy Sheriff before me this 17TH day of JANUARY, 2001 &-dw,u C!-. Q~J J PROTHON!TARY Sheriff's Costs: $37.50 PD 01/11/2001 RCPT NO ~4.51.9i MLYNEK Iu The Court of Common Pleas of Cumberland COU][]}ty, Pennsylvania Jasmin Golden. et. al. VS. Ray G. Snyder. et. al. Serve: Edgewater Children's S b ~~iceOl_f23ucivil of Northwestern Human Svcs. Now, 1/9/01 ,200 (j , I, SHERlFF OF CU1vIBERLAND CO~'TY, PA, do hereby deputize the Sheriff of Dauphin County to execute this Writ, this deputation being made at the request and risk of the Plaintiff. . .. ~~~~#. SheriffofC",-nberi2I1d County, PA Affid.avit of Sernce Now, ,20 , at o'clock M. served the within upon at by handing to a copy of the original and made Imown to the contents thereof. So answers, Sheriff of Cou."ty, P A Sworn .and subscribed before rue this _ day of .70 ,-- COSTS SERvlCE MILEAGE A.FFIDA VIT $ $ In Tbe Court of Common Pleas of CumlJedand COulllrty, Pe 1lltllsylvania Jasmin Golden, et. al. VS~ Ray G. Snyder, et. al. Serve: Edgewater psychiatric C~nter S NO. 01-123 Civil a sub. of Northwestern Human vcs Now, 1/9/01 ,200<1\), I; SHERIFF OF CUMBERLAND COUNTY, PA, do hereby deputize the Sheriff of Dauphin County to execute this Writ, this deputation being made at t.'1e request and risk of the Plaintiff. . . ... ~~~~~ I. 7~ Sheriff of Cumberland Coun.;;y, PA Affidavit of Service Now, ')0 . ,...... -,at o'clock M, served the within upon at . by hfu"1ding to a copy of the original and made Imown to tbe contents thereof. So answers, Sheriff of County, P A Sworn and subscribed before rnethis_ day of ,20_ COSTS SERVICE MILEAGE AFFIDA ViT $ $ bi. The Court of Common Pleas of Cumberland Orllmty, Pennsylvania Jasmin Golden. et. al. VS. Ray G. Snyder, et. a1.. Serve: Northwestern Human Services No. 01-123 Civil Now, 1/9/01 ,20 <0 If) ,I, SHERIFF OF CUMBERLAND COUNTY, PA, do hereby deputize the Sheriff of Dauphin County to exeoute this Writ, this deputation being made at the request and risk of the Plaintiff. ~ ,/-4' ..' ~~~$ Sheriff of Cumberland County, PA Affidavit of Service Now, ,20 , at 0' clock M. served the within upon at by handing to copy of the original a and made brown to the contents thereof. So answers, Sheriff of County, PA Sworn and subscribed before me this _ day of ; 20_ COSTS SERVICE lvITLEAGE AFFIDAVIT $ $