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IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
In re:
Estate of Stuart A. Bingham, Jr.
CIVIL ACTION - LAW
NO. 10 - 4S9 a-'v; I Term
PETITION FOR APPROVAL AND SETTLEMENT OF
WRONGFUL DEATH AND SURVIVAL ACTIONS
NOW COMES Petitioner, Stuart A. Bingham, Sr., by and through Christopher J.
Marzzacco, Esquire, of Colgan Marzzacco, LLC, his Attorney, and as Administrator of
the Estate of Stuart A. Bingham, Jr., deceased, and hereby respectfully sets forth the
following:
1. Stuart A. Bingham, Sr., is the natural parent of the decedent and was
appointed Administrator of the Estate of the decedent by Letters of Administration
dated August 27, 2009. (See Exhibit "A").
2. The Decedent was a resident of Cumberland County, Pennsylvania.
3. Richard W. Jones, Respondent, is the driver and owner of the automobile
which struck Decedent's vehicle and resulted in the death of Stuart A. Bingham, Jr.
4. The insurance companies involved herein are Nationwide Insurance
Company (the third-party carrier) and State Farm Insurance Company (Decedent's first-
party insurance carrier). Said companies are duly registered corporations which
conduct business, including the issuance of automobile insurance policies, within the
Commonwealth of Pennsylvania.
$ga.oo Po A7TY
0011 30!85
a3L. 5a?
5. The Administrator's address for purposes of this petition is 130 West
Church Street, Suite 100, Dillsburg, Pennsylvania 17019.
6. Respondent is represented by his insurance company, Nationwide.
Nationwide's address for the purpose of this petition is P.O. Box 10405, NESRO Class
Claims, Des Moines, IA 50306-9475.
7. On or about August 2, 2009, at approximately 5:43 PM, Respondent was
driving a 2002 Ford Ranger bearing Pennsylvania registration plate number 130RFA,
on Wertzville Road (SR 0944), at the intersection with Center Street (SR 1015) in
Enola, East Pennsboro Township, Cumberland County, Pennsylvania, while driving
under the influence of alcohol. Respondent drove through a red light, striking
Decedent's vehicle as Decedent was lawfully crossing through the intersection. (See
the police accident report attached hereto as Exhibit "B").
8. As a result of the above-referenced collision, Decedent died from multiple
blunt-force trauma. (See Certificate of Death attached hereto as Exhibit "C").
9. Petitioner was twenty-two (22) years of age at the time of the collision and
his date of birth was March 27, 1987.
10. The Decedent was survived by his parents, Stuart A. Bingham, Sr., and
Renee Bingham.
11. At the time of the accident, the Decedent did not have a lawful Last Will
and Testament.
12. The following is a list of the names and addresses of all possible
beneficiaries to this action:
a. Stuart A. Bingham, Sr., 3588 Golfview Drive, Mechanicsburg, PA 17050.
b. Renee Bingham, 4156 Kittatiny Drive, Mechanicsburg, PA 17050.
13. Respondent's automobile insurance policy through Nationwide provided
$100,000.00 of coverage for bodily injury and/or death.
14. The third-party, Nationwide Insurance, has been represented by Tyler
Hauck, a claims adjustor for said entity with offices in Harrisburg, Pennsylvania.
15. Stuart A. Bingham, Sr., as Administrator of the Estate of Stuart A.
Bingham, Jr., has accepted a settlement offer of full policy limits of $100,000.00 made
by Nationwide Insurance for the release of its insured, Richard W. Jones. (See Exhibit
«D„
16. Prior to his death, Decedent resided with his father, Stuart A. Bingham,
Sr., and was covered by an automobile insurance policy underwritten by State Farm.
After reviewing said policy and all underinsured refusal forms, undersigned counsel
confirmed that said policy did not provide underinsured motorist coverage.
17. Counsel has done an extensive investigation and has determined that all
applicable automobile liability and other insurance policies have been identified and
reviewed. Moreover, reasonable investigation has also determined that no other
defendants exist in this claim.
18. Attached as Exhibit "E" is a release of all claims to be executed by Stuart
A. Bingham, Sr., Administrator of the Estate, which releases Richard W. Jones and
Nationwide Insurance Company.
19. Petitioner's counsel respectfully requests that this Honorable Court enter
the proposed Order approving the settlement and distributing counsel fees, expenses
and placing the proceeds of the Estate in escrow for future distribution through the
Estate administration.
20. The enclosed billing statement (attached as Exhibit "F") shows that
undersigned counsel has incurred the following expenses for which reimbursement is
sought:
Accident Report Fee $ 15.00
Postage $ 47.98
Notary Fees $ 5.00
Court Filing Fee $ 92.00
Investigation Fee $ 1,520.00
TOTAL
$ 1,679.98
21. Counsel requests attorney's fees in the amount of $30,000.00
representing thirty (30%) percent of the gross proceeds of the settlement. (See Exhibit
«G„
22. The estate administration is being handled separately by David W.
Reager, Esquire, of Reager & Adler, PC, in Camp Hill, Pennsylvania.
23. As a result of the aforementioned automobile collision, the Estate has
incurred the following expenses:
Funeral costs: $6,727.22
Crypt expense: $2,050.00
Mausoleum: $ 495.00
Pastor: 200.00
TOTAL: $9,472.22
24. All medical expenses were paid by State Farm. No outstanding medical
bills exist.
WHEREFORE, Petitioner requests that he be permitted to enter into a
settlement as described above and that the Court enter an Order of Distribution as
follows:
(a) Pennsylvania Wrongful Death Statute, 42 Pa. C.S.A. Section 8301: $ 28,400.00
(b) Pennsylvania Survival Act; 42 Pa. C.S.A. Section 8302: $39,920.02
(c) Colgan Marzzacco Counsel Fees $30,000.00
(d) Colgan Marzzacco (Costs) 1,679.98
$100,000.00
25. The Department of Revenue has been contacted regarding the allocation
of the proceeds to the estate. The Department has approved the above-referenced
allocation, for estate tax purposes. (See Exhibit "H").
26. Stuart A. Bingham, Sr., Administrator of the Estate, believes it is in the
best interest of the Estate to accept the aforementioned settlement offer as all potential
insurance proceeds have been identified and policy limits have been tendered.
27. All actual damages of the Estate caused by the aforementioned
automobile collision have been accounted for in this Petition. Any other estate debts
will be paid via the separate administration thereof.
28. It is believed and, therefore, averred that representatives from Nationwide
Insurance Company do not object to this Honorable Court approving the instant Petition
without a formal hearing.
29. Approving the instant Petition without a hearing would prevent the
Decedent's family from painful testimony and provide closure in this tragic case.
WHEREFORE, the Petitioner respectfully requests the following:
That this Court authorize and empower the Petitioner to settle the above-
captioned matter on behalf of the Estate of Stuart A. Bingham, Jr., as set forth in the
proposed Order of Court and Release.
2. That the Court approve the payment of the sum identified in this Petition
and Release as fully set forth in the attached document.
Respectfully submitted,
COLGAN MARZZACCO, LLC
y
by: Chri t her J. arzza o, Esquire
ID No.: 78262
130 West Church Street
Suite 100
Dillsburg, PA 17019
(717) 502-5000
VERIFICATION
The undersigned, Stuart A. Bingham, Sr., verify that the statements made in this
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. §4904, relating to unsworn falsification to authorities.
Respectfully submitted,
Stuart A. Bingham, Sr.
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
In re:
Estate of Stuart A. Bingham, Jr.
CIVIL ACTION - LAW
NO.
CERTIFICATE OF SERVICE
I, Christopher J. Marzzacco, Esquire, hereby certify that I am this / 7 day of
January, 2010, serving a copy of the foregoing document upon the person(s) and in the
manner indicated below, which service satisfies the requirements of the Pennsylvania
Rules of Civil Procedure, by first-class mail delivery, to:
Tyler Hauck
Nationwide Insurance Co.
P.O. Box 10405
NESRO Class Claims
Des Moines, IA 50306-9475
Respectfully submitted,
COLGAN MARZZACCO, LLC
by: Chris o er J. Marzzacco, Esquire
ID No.: 78262
130 West Church Street, Suite 100
Dillsburg, PA 17019
(717) 502-5000
Exhibit it A"
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I,
SHORT CERTIFICATE
I STRASBAUGH
U Register for the Probate of Wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 27th day of August, Two Thousand and Nine,
Letters of ADMINISTRATION
in common form were granted by the Register of
said County, on the
estate of STUART A BINGHAM JR late of EAST PENNSBORO TOWNSHIP
Oat, Middle, Last)
in said county, deceased, to STUART A BINGHAM SR
(First, Middle, Last)
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 27th day of August
Two Thousand and Nine.
File No.
PA File No.
Date of Death
S.S. #
2009- 00805
21- 09- 0805
810212009
178-72-9467
C" t'vk'
- C?--
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
Exhibit It B"
Prn* CRS w4119845
_J POLICE C RASH POPENNSYLVANIA
{II{? IIN INII I III{
case Closed Reportable Crash W0119845
AA 500 1 a Ygs 0 No 0 Yes Q No 1
Page 1 of 9
Crash Number
Incident Number Police Agency Patrol Zone
2009080032 21101 E2
A env
Name P
i
t I
y
rec
nc
nvestigation DAM (MM-DD-YYYY)
East Pennsboro Township ENOLA 08 m 02 a 2009
t Dispatch Time (mil) Arrival Time (mil) Investigator Badge Number
8 1743 1744 DENELLE E. CRAUL 1626
Reviewer Bad a Number Approval Date (MM-DD-YYYY)
Coun
unty Name Municipality Munici ali Dav of
p
1 umberland 11101 ast Pennsboro Township 0 Sun Q Thu
C
e Crash Date (MM-DD-YYYY) Crash Time (mi! No of Units le Injured Killed' •i{ > 00 0 Mon Q Fri
08 02 2009 1743 2 3 1 1 ? O
p Wed Q Unk
Workzone meSlbiCoSemcpGOn 29) 0 Yes No Relaatteld?s O Yes No School OAe Q Yes 0 No N.=,r0 Yes 0 No
t /nt"action Tvne Q 4 Way Intersection Q 'Y' Intersection Q Multi-Leg
Q Off Ra
mp Q Railroad Crossing
0 Midblock Traffic Circle/ Intersection
"
"
00
7
Intersection O Round About 0 On Ramp Q Crossover 0 Other
e
Sea Ov?r
la??
Route Hum
ment (Optional) Travel Lanes ?mk O Nth
`
0944 02 35 House Number (if a 1'Kable)
0
O South
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l Street Name Street Ending 0 East
o For Mid-block crashes only. use
l H
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N
b
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us O West
WERTZVILLE PETI
O O U
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a
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um
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P
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e n
nown lied in
fled in if using this option
Route
0 Interstate Turnpike Turnpike State County Local Road Private Other/
(Not Turnpike) 0 (EasUWest) 0 Spur - Highway 0 Road O or Street
0 Road 0 Unknown
$ _
Route Number nt (Optional) Travel Lanes Speed Link Q North ~
1015 02 25
?
O South
q LJ
Street Name Street Ending 0 East
I 0 west
ICENTER ST
Q Unknown
g Di 8 0 interstate O Turnpike 0 Turnpike - State 0 County 0 Local Road O Private O Other/
(Not Turnpike) (EastANest) Spur Kighway Road or Street Road Unknown
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i _ Intersect! Rt Hum Or Mile Post Or 7nt Marker
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for BOTH • ?
Landmarks
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This Option Intersecting Rt Hum Or Mile Post Or Segment Marker
C
0 North
Distance From Crash
S
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1
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Or Intersectin Street Name
9 St Endin
0 East
o
o
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etween
0 West 7 and
Landmark 2)
Degrees Minutes Seconds Degrees Minutes Seconds
Latitude: Longitude:
Traffic [onbw Devine O Yield Sign Q Police Officer or
0 Not Applicable Traffic Signal 0 Active Crossing 0 Flagman Other Type TCD
O No Controls O Device Improperly Functioning Emergency
O Preemptive
t- Flashing Traffic Controls ls
O Signal O Stop Sign O Passive RR Unknown
Crossing Controls O Signal
0 Device Not . Device Functioning 0 Unknown
Functioning Properly
(aW_Gk=d Of "Not Applicable", skip rest of the Lane Closure section) {NaL O North O East Q North and South 0 All
v Q Not Applicable O Partially Fully O Unknown AkUdW
Q South O West (N,S,E,W)
O East and West
c
c ? UYesnknown No O
Q Et
0 < 30 Min. Q 30.60 Min. 0 1-3 hrs Q 3-6 hrs Q 6-9 hrs 0 > 9 hours 0 Unknown
Q1348d
9
FORM a AA4500 (17/02)
PENNDOT COPY
http://www.dot6. state.pa.uslcrsappIPrintlmageslXmIFiles/20090775 5820090809122004204.... 8/9/2009
Pr;,lt CRS WO, 119845
_ 1 POLICE CRASH TING FORM OF PENNSYLVANIA
Papa:
AA 500 2 POlke Use Only .LL_j.
W0119845
Page 2 of 9
Crash Number 7
c Motor Vehicle in Hit & Run Vehicle Q Illegally Parked Q Le l Parked
TYAe Transport O 9a ti Q Non -Motorized
Commercial Vehicle
ro ?,
UnJt Pedestrian on Skates, Disabled From
Q Pedestrian Q
O Train Q Phantom Vehicle
Q No
Q Yes No
in Wheelchair, etc
Previous Crash (If Yes, Complete Form C)
(!f 'Pedestrian' or 'Pedestrian on Skates, in Wheelchair, etc', Com lete Form M, Section 28)
Unit No First Name MI Date of Birth (MM-DD-YYYY)
O1
I RICHARD W? 04 21 1957
Delete? Last Name Tel hone Number
Q
JONES 5187013408
1
Address / C' / State Zip
157 S ENOLA DR, APT A ENOLA PA 17025
Driver License Number State Gass
102BB8556
C
AlcoMMMas Suspected Driver or Pedestrian Physical Condition
1 No Q Illegal Drugs Q Medication
Q CD Use al Drug
Q Q Q Fatigue Q Medication
Q Alcohol 0 Alcohol and Drugs Q Unknown Had Been
O Sick Q Asleep Q Unknown
D
rinkin
p Alcohol Test Type
Q Test Not Given Q Breath Q Other
lMrmary Vehre Code VafsUOn Charged?
-e, a Blood Q Urine Q T wif HOMICIDE BY VEHICLE Yes O No
C
y
Alcohol Test Results
Q Test Refused Unknown
Results Driver Operated
Presence 1=Driver 3=Driver Fled Scene
- Test Given,
M
i
d R
C
t
t
lt Vehicle 4=Hit and Run
1
na
on
am
e
esu
s
. 2=No Driver 9=Unknown
OwnenDriver 00=Not Applicable 02=Private Vehicle Not 04=State Police Vehicle 07=Municipal Police Veh 09=Federal Gov Veh
01=Private Vehicle Owned/ Owned/Leased by Driver 05=PENNDOT Vehicle 08=Other Municipal 98=Other
01
Leased by Driver 03=Rented Vehicle 06--Other State Gov Veh Government Vehicle 99=Unknown
Same as Owner First Name Owner Last Name or Business Name Of Pedestrian, ski this Section)
Driver Q
I RICHARD W. JONES
Address / C' / State / Zip Vehicle Make *Make Code
1 157 S ENOLA DR, APT A ENOLA PA 17025 Ford 12
VIN Model Year Vehicle Model (see overlay)
I 1FTZR45E42PA36602 2002 RANGER
License Plate Reg. State Est Speed Vehicle Towed Towed B
130RFA 999 W Yes O No MAGARO'S TOWING
Insurance Insurance Company Policy No
°
Un-
a Yes Q No O kn
own ALLIED INSURANCE -J PPGM16242889
Uri Ii T 1=Towing Pass. Veh 4=Mobile/Modular Home 7=Semi-Trailer Tag No Tag Year Tag St
un?t No, of y 2=Towing Truck 5=tamper 8=Other
a ? ?
v Trailing
3=Towin Utility Trailer 6=Full Trailer 9=Unknown
Units: g
y Direction F] *Vehicle Position O1 *Movement 01 *See Soccdal Usage
y
Vehicle Color Vehlde hoe 05=Large Truck 20=Unicycle, Bicycle, 00 12=Commercial
Passenger
06=Yellow
OS 07=Silver 01=Automobile 06-SUV Tricycle
04 02=Motorcycle 07=Van 21=Other Pedalcycle
7 00=Not Applicable Carrier
Fi
V
h 13
01
T
i
08=Gold
01=Blue 09=Brown -
03=Bus 10=Snowmobile 22=Horse & Buggy
04=Small Truck 11 =Farm Equip 23=Horse & Rider =
re
e
=
ax
02=Ambulance 21=Tractor Trailer
02=Red I O=Orange (!f "02' Complete Form 12=Construction Equip 24-Train 03=Police 22=Twin Trailer
08=Other Emergency 23=Triple Trailer
03=White 11=Purple
04=Green 12=Other M, Section 26) 13=AN 25=Trolley
18=Other 7 Spec Veh 98=Other
Complete
'20" or "2 1
(x
y Vehicle 31 =Modified Veh
11=Pupil Transport 99=Unknown
05=Black 99=Unknown , M, Section tio 27)
19=Unk. T
pes SpVeh 99=Unknown
form M, S
Initial l?ntlact Point Damage indicator Gradient 3=Downhill Road Allanmeot
12 00=Non-Collision 14=Undercarriage
01-12=Clock Points 15=Towed Unit O=None 2=Functional
1=Minor 3=Disabling 4=Bottom of Hill
1=Level 5-To of Hill 1=Straight
a 2=Curved
9=Unknown 2=Uphill
13=Top 99=Unknown 9=Unknown 9=Unknown
FORM r AA-500 (12112)
PENNDOT COPY
http://www.dot6. state.pa.uslcrsappIPrintlmageslXmIFilesl2009077 55 820090809122004204.... 8/9/2009
Prin± CRS W9119845
R6A
-J POLICE AREPORTING FORM I?II?IIII?I
Page:
AA 500 2 Pala use ooiv 3
W0119845
Page 3 of 9
Crash Number
- Motor Vehicle in O Hit & Run Vehicle 0 Illegally Parked 0 legally Parked Q Non - Motorized
Type Transport Commerdal Vehicle
o ;y Unit Pedestrian on Skates, Disabled From
0 Pedestrian O
0 Train 0 Phantom Vehicle
Q Q Yes 0 No
a in Wheelchair, etc
Previous Crash (If Yes, Complete Form C)
(if 'Pedestrian' or "Pedestrian on Skates, in Wheelchair, etc", Com lete Form M, Section 18)
Unit No First Name MI Date of Birth (MM-DD-YYYY)
02 STUART A? 03 27 1987
Delete? Last Name Telephone Number
-
0 BINGHAM JR.
?
Address 1 Ci / State Zi
° 4156 KITTATINY DR. MECHANICSBURG PA 17050
Driver License Number State class
12842676 PA
s
Alcohol/Drugs Suspected Driver or Pedestrian Physical Condition
No 0 Illegal Drugs 0 Medication Apparently Illegal Drug
Q Fatigue 0 Medication
Normal Q Use
Q Alcohol 0 Alcohol and Drugs 0 Unknown Had Been
O Sick Q Asleep Q Unknown
Drinking
g
p Akolrol Test Tvpe
a Test Not Given 0 Breath 0 Other
Primary Vehiple Code Violation Charged?
' 0 Blood 0 Urine 0 Unknown if O Yes O No
Test Given
Alcohol Test Results 0 Test Refused 0 Unknown
Results Drfver Presence 1=Driver Operated 3=Driver Fled Scene
O Test Given,
l
d R
C
t
i
M Vehicle 4=Hit and Run
E
esu
ts
on
am
nate
. 2=No Driver 9=Unknown
OwnerlDrfver 00=Not Applicable 02=Private Vehicle Not 04=State Police Vehicle 07=Municipal Police Veh 09-Federal Gov Veh
01 =Private Vehicle Owned/ Owned/Leased by Driver 05=PENNDOT Vehicle 08=Other Municipal 98=Other
02
Leased by Driver 03=Rented Vehicle 06=Other State Gov Veh Government Vehicle 99=Unknown
Same Owner First Name Owner Last Name or Business Name Of Pedestrian, ski this Section)
Driver Q STUART A. BINGHAM
Address ! City / State / Zip Vehicle Make *Mak* Code
1 3588 GOLFVIEW DR. MECHANICSBURG PA 17050 Ford 12
VIN Model Year Vehicle Model (see overlay)
1FALP13P7VW233617 111997 ESCORT
License Plate Reg. State Est. Speed Vehicle Towed Towed B
I FWF4763 PA 999 a Yes 0 No MAGARO'S TOWING
Insurance Insurance Company Policy No
Yes p No O Un-
known STATE FARM MUTUAL 1443902-F22-38B
Trailing T 1=Towing Pass, Veh 4=Mobile/Modular Home 7=Semi-Trailer Tag No Tag Year Tag St
Unit T
No.
i of 2=Towing Truck 5=Camper 8=Other
a
El let 1:1
v
v r
a
3=Towing Utility Trailer 6=Full Trailer 9=Unknown
Unit-.
y Direction of N "Vehicle Position 1 -Movement
F
am i 2 -See Special Us,,,
r Overlay
Vehicle Color Vehide Type 05=Large Truck 20=Unicyde, Bicycle, 12=Commercial
Passenger
06=Yellow
03 07=Silver 01=Automobile 06=5UV Tricycle
01 02=Motorcyde 07=Van 21 =Other Pedalcycle 00=Not Applicable Carrier
01=Fire Veh 13=Taxi
08=Gold
01=Blue 09=Brown 03=Bus 10=Snowmobile 22=Horse & Buggy
04=Small Truck I I=Farm Equip 23=Horse & Rider 02=Ambulance 21=Tractor Trailer
02=Red 10=Orange
Of '01', Complete Form 12=Construction Equip 24=Train 03=Police 22=Twin Trailer
08-Other Emergency 23=Triple Trailer
03=White 11=Purple M, Section 26) 13=ATV 25=Trolley Vehicle 31 -Modified Veh
04=Green 12=Other
05=81ack 99=Unknown (if 20' or '11 , Complete 18=Other Type Spec Veh 98=0ther
Form M, Section 27) 19=Unk. Type Spec Veh 99=Unknown t t=pupil Transport 99=Unknown
Initial Imeact Point Damaoe lndtvtor Gradient 3=Downhill Road ARonment
00=Non-Collision 14=Undercarriage
09 01
12
k P
t
T
Cl
i
15
i
d U 0=None 2=Functional
F1 1=Minor 3=Disabling 4=Bottom of Hill
E11=Level 5=Top of Hill 1=Straight
? 2=Curved
-
=
oc
o
n
s
=
owe
n 9
k
U 2=Uphill
13=Top 99=Unknown -
n
nown 9=Unknown 9=Unknown
FORM N AA-SW (12M)
PENNDOT COPY
http://www.dot6. state.pa.uslcrsappIPrintImageslXmIFiles/20090775 5820090809122004204.... 8/9/2009
, rrn . ?" ZS Vrd(jl; '9845 COMM
PENNSYLV -? POUI E®RA FIR PORTING FORFflANIA Page 111001211111 -1 L_J AA 500 3 Police Use Only
W0119845
Page 4 of 9
Crash Number
Person Tyoea
A 1=Driver
2
P Seat i'osibm
D 00=Not A Passenger/Occupant
01
D
i
All V
hi
l Safely Egyjpnfent One:
E oD=None Used ! Not Applicable G O=Not Applicable
h
l
=
assenger
7=Pedestrian =
r
ver -
e
c
es
02=Front Seat Middle Position 01=S
ou
der Belt Used 1--Not Ejected
02=Lap Belt Used 2=Totally Ejected
8=Other
9=Unknown 03=Front Seat Right Side
04=Second Row - Left Side Or 03=Lap And Shoulder Belt Used 3=Partially Ejected
04=Child Safety Seat Used 9=Unknown
Motorcycle Passenger 05=Motorcycle Helmet Used
05=Second Row - Middle Position 06--Bicycle Helmet Used H &eam Path:
d
F?=Female
B 06=Secon
Row - Right Side
07=Third Row Or Greater - I O=Safery Belt Used Improperly
11 =Child Safety Seat Used Improperly O=Not Ejected / Not Applicable
1 Th
h S
D
i
d
O
a M=Male
U =Unknown Left Side
08=Third Row Or Greater - roug
e
oor
pen
ng
i
12=Helmet Used Im ropedy
90=Restraint Used, YpT e Unknown 2=Through Side Window
n Middle Position
09=Third Row Or Greater - 99=Unknown 3=Through Windshield
4=Through Back Door
o
c-
d
njuly Severity;
Right Side
10=Steeper Section of Truckcab 5=Through Back Door Tail to Openin
g
Roof Openin g Sunroof/
F 00=None /Not Applicable 6--Through Top Down)
e
® C 0--Not Injured
1=Killed 11=1n Other Enclosed
Passenger Or Cargo Area 01-Front Air Bag Deployed (For This Seat) 7=Through Roof Opening (Convertible
02=Side Air Bag Deployed (For This Seat) Up)
Top
2=Major injury
3=Moderate 12=In Open Area
(Back Of Pickup, Etc.) 03=Other Type Air
Bag De
oyed 9=Unknown
04=Multiple Air Bags Deplpk>yed
Injury
4=Minor Injury
8=Injury, Unk 13=Trailing Unit
14=Riding On Vehicle Exterior
1 S=Bus Passenger 05=Motorcycle Eye Protection
06=Bicyclist Wearing Elbow/Knee/Pads Extrication
10=Air Bag Not Deployed, Switch on ( 0 Applicable
Severity
9=Unknown if 98=Other
99=Unknown 11=Air Bag Not Deployed, Switch Off 1=Not Extricated
12=Air Bag Not Deployed, 2=Extricated By Mechanical Means
Injury Unk Switch 3=Freed By Non - Mechanical Means
13=Air Bag RemSetU oved?Prior To Crash) 8=Other
19=Unknown If Air Bag Deployed 9=Unknown
99=Unknown
EMS Agency: EAST PENNSBORO EMS Medkal Facility: HOLY SPIRIT HOSPITAL
Unit No Person No
O1 O1 Delete? Date of Birth (MM-DD-YYYY) A B C D E F G H I
p ?- 21 - 1957 110 1 O1 99 Ol 000
Name / Address / Phone EMS Transport
C1 same as JONES RICHARD W 157 S ENOLA DR, APT A ENOLA PA 17025 51
Operator ' O Yes 0 No
Unit No Person No
02 01 Delete? Date of Birth (MM-DD-YYYY) A B C D E F G H I
p 03 - 27 - 1987
I 1
? M? 1 J01 03 O 1 0? Iq
IT]
Name / Address / Phone
EMS T
t
ranspor
0 same as BINGHAM JR., STUART A 4156 KITTATINY DR. MECHANICSBURG P
Operator O Yes i No
Unit No Person No
02 02 Delete? Date of Birth (MM-DD-YYYY) A B C D E F G H I
p 02 - 28 -11988 EJF? 71 03 99 O1 0 0I 0?
Name I Address / Phone EARS Transport
Oprerator EMRICK, KELLI L 109 BOYER ST PO BOX 417 SUMMERDALE PA 17 0 Yes O No
Unit No Person No
as Date of Birth (MM-DD-YYYY) A B C D E F G H I
?o-cam- ?oaooooa?
Name / Address / Phone EMS Transport
Same as
Operator
O Yes O No
Unit No Person No Delete? Date of Birth (MM-DD-YYYY) A B C D E F G H I
Name / Address / Phone
EMS Transport
Same as
Operator O Yes O No
Unit No Person No
L-? Delete? Date of Birth (MM-DD-YYYY) AA }} 8 C D E F G H I
O -?-LJ???FT?
Name / Address / Phone
EMS Transport
Same as
Operator F_ I O Yes (::)No
FORM R AA-5W (17102)
PENNDOT COPY
http: //www.dot6. state.pa.uslersappIPrintImageslXmIFilesl200907755820090809122004204.... 8/9/2009
Print CRS W01 19845
COMMONWEALTH OF POLICE CRASH IREPORTING?FORM ?Wlf? Page 110 1111
AA 500 Poke Use Only
W0119845
Page 5 of 9
Crash Number 7
Crash Description O=Non-Coftion 2=Head On 4=Angle "idmwlpe 8--Hft Pedestrian
(OPPe Direction)
R
E
R
5
c ear
= a
1=
ear
nd 3= to
(Same
- (Backing) girection) 7--M Fixed Object 9--Oftr/Unknown
c Relation fo RoadWav 1 1=0n Travel lanes 3=Median 5--Outside Tmffieway 7-6ore (Ramp Intersection)
?- 2-Shoulder 4=Road8ide 6=ln Paridng Lane 9=Unknown
- g
'
o
n 1=Daylight 3=Da Street 5=08111M 8.iher
g
v ' W&
2=Street Lioghts 4=Dusk Roadway
_
---- -- --
- - - - - -
Weather Conditions 1' jiorm.0 3=Sleet (Hail) 5=Fog -7=Sleet 5 Fog - 9--Unknown
2=Rain 44oow 6=FWn $ Fog a=Other
-
= O=Dty 2 , Mud, Dirt, 4=Slush Woe Patches -- t.Other -
Road Surface Conditions Standing
0 7=Water
? 1=Wet 3=Snow Covered 5=1oe or Moving
Harts Event L/R Most' Uti Pole Number Harmfa/ Events (Harm Event) 30--Hit Fence Or Wail
1 02 ? 01=Hit Unit 1 31=Hit Building
it 2 32=Hit Culvert
02
Hn U
Unit No =
n
03=Hit Unit 3 33=Hit Bridge Pier Or Abutment
O 1 2 F-1 O 04=Hit Unit 4 34=HR BParapet ri End
05=Hn Unit 5 35=Hit Bri dge Red
06=Hit Other Traffic Unit 36=Hit Boulder Or Obstacle
Put
PleaseEvents fn 3 ? O 07=Hit Deer On Roadway
08--Hit Other Anmal 37=flit Impact Attenuator
Sequential 09=Collision With Other Non 38=Hit Fire Hydrant
Fixed Object 39=Hit Roadway Equipment
Order
4 ? O 11=Struck By Unit 1 40=Hit Mail Box
2 41=:Hit Traffic Island
12
k B
i
U
y
n
=5tnx
t
13=Struck By Unit 3 42=Hit Snow Bank
Harm Event L/R Most7 Utility Pole Number 14=Struck By Unit 4 43=Hit Temporary Construction
rrier
B
C
c
' 11 a
15=Struck 8 Unit 5
11 Struck By Other Traffic Unit 48=Hit Other Fixed Object
'
49=Hit Unknown Fixed Ob
ect
21
Hi
T
Sh
bb
O
iv
u Unit No =
ree
r
ru
ery
t
j
22=Flit Embankment 50-OvertumrRo110ver
s
N
02 2 0 Z3=Hn Utility Pole 51=Struck By Thrown Or Falling
n Object
Hn Traffic Si
24-
Please Put
3 O g
-
25=Hit Guard Rail 52=Pot Holes Or Other
26-HO Guard Rail End Pavement Irregularities
2 Curb 53=lack n
Events in
Sequential
Order
2"k Concrete Or 54=fire In Vehicle
r n
u
anal Barrier
'
?
4 O
Harmf
l
ch Harmful Event
99-Unknown
29=Hit
First Unit No Harm Event Afort Unit No Harm Event Driver Action (D) 17=Careless Or Illegal
- f
ul in POTPO 1 02 ven in m O 1 02 00=No Contributing Acton Backing On Roadway
01=Driver Was Distracted 18=Driving On The Wrong
rash?ra
Do not rWeat this inion- ion on "Kkipk page
V 02=Driving Using Hand Held Phone Side Of Road
03=Driving Using Hands Free Phone 19=Making Improper
Envkonmental /ROadwav
00 2 3
1
R
f
E 04--Making Illegal U-Turn Entrance To Highway
05?mproper/Careless Turning 20=Makkty Improper Exit
hwa
Lane From Hi
m Wron
06
Tu
F
actors (
)
A
Poem" g
y
g
=
rning
ro
07=Proceeding W/O 21=Careless Par%g/Unparking
00=None 11=Sli Road Conditions (ice/Snow)
pery
01=WIndy Conditions 12=Su Lance On Roadway
02=Sudden Weather Conditions 13-Potholes Clearance After Stop 22=Over/Under
08=Running Stop Sign Compensation At Curve
mg Red h g
nn
03=Other Weather Conditions 14=Broken Or Cracked Pavement t?ailure To Respond To 24
Too Fast For C
nditions
D
04--Deer In Roadway 15=TCD Obstructed =
o
Other Traffic Control Device 25=Failure To Maintain Proper Speed
05=Obstacle On Roadway 16=Soft Shoulder Or Shoulder Drop Off
06=Other Animal In Roadway 28=Other Roadway Factor i 1=Tai mg 26=Driver Fleeing Police (Poll Chase)
12=Sudden SlowingiStopping 27=Driver Inexperienced
Q 07=Glare 29=Other Environmental Factor
08=Work Zone Related 99-Unknown 13=Illegally Stopped On Road 28=Failure To Use Specialized Equip
14_=Careless Passing Or Lane 92-Affected By Physical Condition
e
Chan
Possible Vehide Failures (I0 12 Wipers g
15 =Passing In No Passing Zone 98=Other Improper Driving Actions
99=Unknown
00=None 06-Exhaust 13=Driver Seating/Control
01=Tires 07=Headlights 14=Body, Doors, Hood, Etc t6=Driving The Wrong Way On
1•Way Street
CA 15=Trailer Hitch
02=Brake System OB=Other Lights
03=Steering System 09=Other lights 16=Wheel
Unit
.
O 1 1 09 2 3 4
04=Suspension 10=Hom 17=Airbags
0S=Power Train 11=Mirrors 18=Traiier Overloaded
c 19=U o/Shifted
Unit Trailer ailer Load
No 01 1 00 2 20=Improper Towing Unit
No 02 9 00 2 3 4
21=Obstructed Windshield
Usk 99-Unknown
02 t 00 2
No PodIestrian Action (P) 03=Working
04=Pushin Vehicle
00=None 9
roachin
Or Leavin
Vehicle
05=A
pp
g
g
01=Entering Or Crossing At
Specified Location 06=Working On Vehicle
lodketed Prime Factor Unit No Factor Code
.prep = this inrorrnation on 01 09 02=Walking, Running, Jogging, gg=0thering
Or Playing 99=Unknown
E/ R V D P Unit No 0] Unit No 02
O O 0 O If EIR is the Prime Factor
Type, leave Unit No blank
FOAM • AA-500 (12ft)
PEPIPIDOT COPY
http://www.dot6.state.pa.uslcrsappIPrintlmageslXmIFiles/20090775 5 820090809122004204.... 8/9/2009
Pn*nt CRS WO, ' 9845
POLICE 1 :RASH REPORTING FORMANIA Page '? ???III
M 5005 RdFce Use Only 6
W0119845
Page 6 of 9
Crash Number
0
MCQUISTON, STEPH 316 S ENOLA DR ENOLA PA 17025 7177322159
Z RYAN, WILLIAM 114 WAYNE AVE ENOLA PA 17025 7177323763
I Narrative and additional witnesses: Accident Investigation Nott kation Issued? 0 Property Damage O 1
z
w
On August 2, 2009 at 1743 hours, officers from East Pennsboro Township Police Department were dispatched
to a crash on Wertzville Road at Center Street. Upon arrival, Officer Epting located a male, standing next to the
truck (Unit 1), identified as Jones, the driver of Unit 1. Unit 1's front, passenger side tire was shredded off to the
rim. Officer Epting then observed a male, identified as Stuart A. Bingham, Jr., still in the driver's seat of the
sedan (Unit 2). Bingham was not breathing or moving, no first aid was attempted due to EMS personnel being
on scene. It was later determined that the driver of Unit 2, Bingham was deceased and the Cumberland County
Corner was requested to the scene. Kelli Emrick was then located next to Unit 2, and advised she was a
passenger in Unit 2. Emrick explained that they were waiting at the traffic light on Center Street at the
intersection with Wertzville Road. Their traffic light then turned green, and they entered the intersection. Unit 1
was travelling east on Wertzville Road and did not stop, impacting with the driver's side of Unit 2. Officer Epting
then returned to speak with the driver of Unit 1, Jones. Jones advised that his traffic light was green. Officer
Epting's observations, he was determined to be DUI of alcohol and drugs and was transported to Harrisburg
Hospital for legal blood. Officer Diehl then spoke with wittnesses. A witness, Timothy McOuiston,
FORM N AA-M (IMM
PENNDOT COPY
http://wwNv.dot6. state.pa.uslcrsappIPrintImageslXmIFiles/20090775 5820090809122004204.... 8/9/2009
;'Tint CRS WO; 19845
CC RQ®%MMALVt11 OF PENN5YLVANOA II INIIIIIIII
MACE CRASH QtEPGKMG FORM ?9e O New
W0119845
AA 500 N rd ce use oar O amwi
c w tkm
x
Page 7 of 9
Narrative and additional witnesses:
advised he was the first vehicle behind the striking vehicle. He stated the traffic signal turned to a steady
red indication for Unit 1 who failed to stop, striking Unit 2. Stephanie McQuiston who was with her
husband, Timothy, in the first vehicle behind Unit 1, observed a tire lying in the roadway in the area of
Wertzville Road and Technology Drive in Hampden Township. As they continued to follow Unit 1, she
continued to see chunks of tire along the road. When they arrived in the area of Wertzville Road and
Southmont Drive, she realized that Unit 1 was the vehicle leaving all of the tire debris behind. When the
approached the intersection of Wertzville Road and Center Street, she observed the traffic light turn to red.
She then said out loud, 'That truck is not going to stop!" Officer Diehl then spoke with William Ryan. Ryan
advised he was the first vehicle behind Unit 2 on Center Street. He advised upon approach of the traffic
light for Center Street, it was red. Both he and Unit 2 had stopped at the traffic light. When the light turned
to green, Unit 2 pulled into the intersection being struck by Unit 1. Sarah Steigerwalt was the front seat
passenger in Ryan's vehicle. She advised they were stopped at the red light on Center Street. When the
light turned green, Unit 2 proceeded into the intersection and was struck by Unit 1 on the driver's
side.
t
it,
9
FORE/ f AAiBODI ?
PENNOOT COPY
http://www.dot6. state.pa.uslcrsappIPrintlmageslXmIFilesl200907755820090809122004204.... 8/9/2009
Prtip± CRS W01119845
Page 8 of 9
-? FOUCE MASN IRtMUM M ?$ff I?lat4 Page 0 Now 11111111111111 Crloh NuffdM
AA 500 F r°M" teOnly W0119845
[_ 0 Co on
14oac1 S?xfaae Teller =-
Q Brick or Block
p Dirt
SpeW BOA
O military
O Other Federal Sites
24 (_) Concrete O Gravel or Q Other ? No Special
Ju
isdi
ti Q Indian Reservation O Other
IN Blacktop Q Unknown r
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on
O National Park
O""? O Unknown
Please complete Unit Information for om* unit involved in a fob/ crash. Do not repeat the information in the fields above on multiple pages.
Unit ft
[)? Prkxh le inroad Psbet
O Non-Collision
O
0
12
1 1
O
Q
Restriction 10 02 O
D fp s s
O Com
lied With Not a Pennsylvania
D
i O
Top
p
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PASUICtIOM mplied With
O No Restrictions( O Co
Not A
licable r
ver
Q Compc?an e
Undercarriage
09
O
0
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03 O
4
7
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.
0 6
Dd erEndsrsdnent Required -
O a Not
: Pennsylvania
O Unknown O
O
O
Complied With Dr
O Required - Non O Unknown Am@Mp ce A/aneuner
_
25 O None Required Compliance
O Compliance No Avoidance
O Maneuver
Eraki Other O Other Avoidance
Compliance Unkno wn Maneuver
G??
O Not Required for
Unk If CDL or
O Braking - Skid
Marks Evident Steen Evidence
or Driver Q "g " Stated O Inconclusive
Vehicle Class CDL Required
No Valld License
O for Class Not a Pennsylvania
Driver Braking - No Skid
O Ma
Driver
dew 0 5Bn9 O Unknown
O E
O Not Licensed
O Valid License for
O Unknown s, tated
v
Class Under RA* b?dlator
Ong Test Type
0 Blood
O Other
- No Underride or Underride, No
Override,
O Compartment O
O None Q Urine O Unknown if Test Override Vehicle
intrusion
Garen U
d
id U
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Om Test llera is - fUb
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5 a
Amphetamines
F I F1 n
err
e,
Q Compartment
Intrusion n
n
nown
err
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O Compartment O Underride or
Intrusion Unknown Override
1 ° No Drug Reported 6 =PCP
2 = Mari uana
3 = Cocaine 9 = Unknown Test
? ?
Erg use
Not in Emer
enc
Q Lights Flashing O Si Both Lights and
4 = Opiates
Results g
y
Use
O Siren Sounding Q Unknown
Unit No
02
1 Prick h"Dad point
O Non-Collision O
O
12
1
0
O
Restrictions P
l 1 02 O
Driver Ratilrkdoru O Complied With ennsy
vania
O D irot a O Top
N Re arictiosl
O Restriction Not
O Complied With Unknown
OCompliance
O Undercarriage 09 03 Q
Applicable
0
=apta
-
O Towed Unit
O 08
04O
U
n 07 05
weent
En O Required - O Not a Pennsylvania Q Unknown 06
O O O
LIM n Complied With Driver
Q Required - Non
Compliance O Unknown AvoMam Maneuver
n x 0 None Required
O Required - Compliance No Avoidance
Maneuver
O Braking -Other O Other Avoidance
Compliance Unknown Evidence Maneuver
Darth1w ' Not R iced for
O Not e?Gas
Unk if CDL or
O Braking - Skid
Q Marks Evident Steering - Evidence
O inconclusive
Q or Driver Stated
Lanounoe CD
L Required
No Valid License
O for Class Not a Pennsylvania
O Driver Braking - No Skid
O Marks, Driver
?ng Q Unknown
O E
or SB
de
c
Q Not Licensed Valid License for
? G O Unknown Stated t
vi
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e
ass Under hide kickat"
Drug Test TYS+e
O Blood
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' a her
O Compartment O
None O Urine O Unknown if Test Override ehK
Intrusion
Given Underride Underride
Unknown if
Orm Test Riess is - (Up to Fuca Iksu?
[9
F] ,
O Compartment
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O Compartment O Underride or
Intrusion Unknown Override
0 = No Test Given 5 = Amphetamines
1 = No Drug Reported 6 = PCP
2 = Marijuana B - Other
3 = Cocaine 9 = Unknown Test Emeraerecv Use Both Lights and
Q Lights Flashing O Siren
4 = Opiates
Results Not in Emergency
Use
O Siren Sounding O Unknown
PENNDOT COPY
http://www.dot6. state.pa.uslersappIPrintImageslXmIFiles/200907755 820090809122004204.... 8/9/2009
Pr;n` C;ZS WQ; '9845
Page 9 of 9
Crash Number; W0119845
Incident Number: 2009080032
I1
Center Street (SR 1015)
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J IfiC73" 7-0
http://www.dot6. state.pa.uslcrsappIPrintlmageslXmlFiles/200907755 820090809122004204.... 8/9/2009
Exhibit "C"
... -_1 'Fv.kxmq
T his is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with
the Vital Statistics Law of 1953, as amended.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
5145398
No.
a, ee" %
Linda A. Caniglia
State Registrar
OCT 16 2009
Date
105.1" REV 112005 COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF HEALTH a VITAL RECORDS
PEl s 079911
PONAW CORONER'S CERTIFICATE OF DEATH
(See Instructions and examples on reverse)
#32-073 STATE FILE NUMEIER
1.*0olDo wt(Fnl,midde,KV* 2. sex 3.sxwSK"Maaw 4.DWof 094QWm dq,yw)
Stuart A Bingham, Jr. Male 178 - 72 - 8467 August 2, 2009
s.AP(lad30*1 Undw1 Udwk &DWdeaapb,d 7, MOND (04 end*0or 10* OMM eLRVd0eAPckmyab)
22
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March 27, 1987
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Cumberland
East Pennsboro
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mmm,PaabHaA0.) White
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6375 Basehore Road Suite
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EXh?bit
"ID 11
7174125049 nationwide Nationwide Insurance
pa wonw0 2 how-we
ANAdhWROM
N&do wA&AwdWmIMN
T11ae NWXMM
Qn 1bw $W Vkwk IKwaaw
P.O. Box 10405 ' NESAO Class Claims ' Des Moines, IA 50306-9475
December 1, 2009
The Law Offices of Colgan Marzmcco, LLC
130 West Church St
Suite 100
Dillsburg, PA 17019
OUR INSURED : Richard W. Jones
OUR CLAN NUMIBER : 72 14 20 074702 08022009 01
DATE OF LOSS : 08-02-2009
YOUR CLIENT : Estate of Stuart Bingham Jr
Dear Christopher Marzzaoco:
04:57:04 p.m. 12-01-2009 2/4
This letter is to confirm our offer of $100,000.00 in settlement of your clients claim against our insured for
the above accident.
Thank you for your cooperation in this matter and your prompt response.
Sincerely,
Nationwide Agribusiness Insurance Company
Tyler Hauck
Claims Department
(717)651-5436
Any person who knowingly and with intent to defraud any insurance company or other person files an
application for insurance or statement of claim containing any materially false information or conceals for
the purpose of misleading, information concerning any fact material thereto commits a fraudulent
insurance act, which is a crime and subjects such a person to criminal and civil penalties.
Exhibit it E"
7174125049 nationwide Nationwide insurance 04:57:41 p.m. 12-01-2009 4/4
RELEASE OF ALL CLAIMS
CLAIM NUMBER: 72 14 20 074702 08022009 01
FOR AND IN CONSIDERATION OF the payment to m&%w the Sum of ($100,000.00) dollars. and other good and vaiuable
consideration, I/we, being of lawful age, have released and discharged, and by these presents do for myseN/ourselves, my/our heirs,
executors, administrators and assigns, release, acquit and forever discharge Richard W. Janes, Nationwide Insurance Company and
any and all other persons, firms and corporations, whether herein named or referred to or not, of and from any and all past, present and
future acyons, causes of action, claims, demands, damages, coats, loss of services, expenses, compensation, third party actions, suits
at law or in equity, including daims or suits for contribution andlor indemnity, of whatever nature, and all consequential damage on
account of, or in any way growing out of any and all known and unknown personal injuries, death, ardor property damage resulting or
to result from an accident that occurred on or about 08-02.2009 at or near CENTRE/WERTZVILL ENOLA
PA17025CUMBERLAND.
I/we hereby declare and represent that the injuries sustained may be permanent and progressive and that recovery therefrom is
uncertain and indefinite, and in making this release and agreement it Is understood and agreed that Uwe rely wholly upon my/our own
judgment, belief and knowledge of the nature, extent and duration of said injuries, and that Uwe have not been influenced to any extent
whatever in making this release by any representations or statements regarding said injuries, or regarding any other matters, made by
the persons, firms or corporatiom who are hereby released, or by any person or persons representing him or them, or by any physician
or surgeon by him or them employed.
Vwe understand that this settlement is the compromise of a doubtful and disputed claim, and that the payment is not to be construed as
an admission of liability on the part of the persons, firms and corporations hereby released by whom liability is expressly denied.
It is further understood and agreed that I am responsible for the payment of any Ilan or charges against the settlement sum, including
but not limited to Worker's Compensation liens, liens of the Department of Public Welfare or low arising out of any other form of public
assistance. Should any person or entity drake a claim for payment of any liens or charges against the released parties, I hereby agree
to indemnty and hold harmless the released parties, from any and all liens, charges, fees, attorney's fees, cost, interest and other
sums.
It is agreed that distribution of the above sum shall be made as follows: one IUmp sum made payable as the court outlines.
This release contains the ENTIRE AGREEMENT between the parties hereto, and the terms of this release are contractual and not a
more recital.
Uwe further state that I/we have carefuily read the foregoing release and know the contents thereof, and Uwe sign the same as my/our
own tree act.
WITNESS
In the presence of:
Name
Address
Name
Address
State of , County of
hand and seal this _ day of , 20
CAUTIONI READ BEFORE SIGNING
Your Signature (SEAL)
Your Signature
(SEAL)
On this day of , 20 Before me personally appeared
to me known to be the person... described herein, and who executed the foregoing instrument and he/she acknowledged that
he/she voluntarily executed the same.
My tern expires , 20
Notary Public
Any person who knowingly and with intent to defraud any insurance company or other person files an application for
insurance or statement of claim containing any materially false information or conceals for the purpose of misleading,
information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such a
person to criminal and civil penalties.
EXh0 0
t
66f:ll
Colgan Marzzacco, LLC
130 West Church Street
Suite 100
Dillsburg, PA 17019
To:
Stuart A. Bingham, Jr.
417 Delancey Ct.
Mechanicsburg, PA 17055
Statement
Date
1/19/2010
Amount Due Amount Enc.
$1,679.98
Date Transaction Amount Balance
04/30/2009 Balance forward 0.00
09/30/2009 INV # 143. 19.74 19.74
11/25/2009 INV #230. 19.04 38.78
11/25/2009 INV #231. VOID: 0.00 38.78
11/25/2009 INV #233. 5.00 43.78
12/11/2009 INV #239. 1,520.00 1,563.78
12/11/2009 INV #240. 24.20 1,587.98
01/19/2010 INV #250. 92.00 1,679.98
CURRENT 1-30 DAYS PAST 31-60 DAYS PAST 61-90 DAYS PAST OVER 90 DAYS
Amount Due
DUE DUE DUE PAST DUE
92.00 0.00 1,568.24 0.00 19.74 $1,679.98
Colgan Marzzacco, LLC
130 West Church Street
Suite 100
Dillsburg, PA 17019
Bill To
Stuart A. Bingham
3588 Golfview Dr.
Mechanicsburg, PA 17050
Invoice
Date Invoice #
9/30/2009 143
Terms
Date Description Attorney Time Rate Amount
8/20/2009 Cost to obtain accident report
Postage for 3rd Quarter, 2009. Marzzacco 15.00 15.00
4.74
Total $19.74
Colgan Marzzacco, LLC
130 West Church Street
Suite 100
Dillsburg, PA 17019
Bill To
Stuart A. Bingham
3588 Golfview Dr.
Mechanicsburg, PA 17050
Invoice
Date Invoice #
11/25/2009 230
Terms
Date Description Attorney Time Rate Amount
11/9/2009 Postage through conclusion of case Marzzacco 19.04 19.04
Total $19.04
Colgan Marzzacco, LLC
130 West Church Street
Suite 100
Dillsburg, PA 17019
Bill To
Stuart A. Bingham
3588 Golfview Dr.
Mechanicsburg, PA 17050
Invoice
Date Invoice #
1112512009 233
Terms
Date Description Attorney Time Rate Amount
11/25/2009 Notary Fee - Nationwide Release Marzzacco 5.00 5.00
Total $5.00
Colgan Marzzacco, LLC
130 West Church Street
Suite 100
Dillsburg, PA 17019
Bill To
Stuart A. Bingham
3588 Golfview Dr.
Mechanicsburg, PA 17050
Invoice
Date Invoice #
12/11/2009 239
Terms
Date Description Attorney Time Rate Amount
12/10/2009 Investigative work by Applied Forensic Solutions Marzzacco 1,520.00 1,520.00
Total $1,520.00
Colgan Marzzacco, LLC
130 West Church Street
Suite 100
Dillsburg, PA 17019
Bill To
Stuart A. Bingham
3588 Golfview Dr.
Mechanicsburg, PA 17050
Invoice
Date Invoice #
12/11/2009 240
Terms
Date Description Attorney Time Rate Amount
12/11/2009
12/11/2009 Postage (Petition for Approval filing)
Postage (finalization of case) Marzzacco
Marzzacco 19.80
4.40 19.80
4.40
Total $24.20
Colgan Marzzacco, LLC
130 West Church Street
Suite 100
Dillsburg, PA 17019
Bill To
Stuart A. Bingham, Jr.
417 Delancey Ct.
Mechanicsburg, PA 17055
Invoice
Date Invoice #
1/19/2010 250
Terms
Date Description Attorney Time Rate Amount
1/19/2010 Cost to file Petition for Court Approval Marzzacco 92.00 92.00
Total $92.00
ejktilbit
fifiG 11
0 THE LAW OFFICES OF
COLGAN MARZZACCO
LLC
Timothy J. Colgan
Christopher J. Marzzacco
David E. Hershey
Thomas M. Clark
Shawn M. Curry
AUTHORITY TO REPRESENT
ON A CONTINGENT FEE BASIS
I do hereby retain and employ CHRISTOPHER J. MARZZACCO, Esquire, as
my,4ttorpey to represept me in my claim against
firm, or cor ration liable therefor resultin f
or about tW4j,C&,2 , .?
Pennsylvaniaj-
or against any other person,
rom an,gccidenYinci?ent which occurred on
in lam o-- gA J County,
FEE:
IPA
I agree to pay CHRISTOPHER J. MARZ 6?8 from the proceeds of any recovery
by settlement or verdict, as follows: Thirty- ' percent -7 of any amounts recovered
from any available source in this case. The legal fee i `earned" when my Attorney
receives 'a settlement offer from another party or as per the terms contained in the
"Termination" paragraph below. If my Attorney does not make a recovery on my behalf,
I understand that I do not owe him a legal fee.
COSTS:
I understand and agree that all costs in this matter will be advanced by my attorney,
but will remain my responsibility if no recovery is made on my behalf. If a recovery is
made, all advanced costs will be deducted from my portion of said recovery. I hereby
agree that "costs" include, but are not limited to, the costs of investigation, preparation,
research, experts, court costs and other incidentals such as copying, and postage, and if
necessary, my attorney's transportation, accommodation and meal expenses if travel to
another jurisdiction is necessary to pursue my claim.
AUTHORITY TO ACT:
I hereby expressly give my Attorney the authority to execute all checks, releases,
health insurance lien documentation forms, Medicare/Medicaid forms, financial forms,
medical authorizations and all other documents necessary to pursue and settle my claim
or claims, as if I were personally signing the same. In cases of a settlement on my behalf,
upon receipt of a release, my Attorney may sign the same for me, after explanation of the
terms contained therein and request payment from the responsible party or company.
Upon receipt of the settlement check, my Attorney is permitted to sign the same on my
behalf, deduct legal fees, costs, expenses and all lien amounts and to send me a check
via mail. This paragraph is intended to expedite settlement for me and to facilitate
payment of legal fees, costs and expenses once the same have been earned.
130 W. Church Street, Suite 100 • Dillsburg, PA 17019 • P: 717-502-5000 • F: 717-502-5050 • Toll Free: 1-800-615-0115 • www.cmlawl.com
Where Every Client Mailters
Offices in Dilisburg, York, Harrisburg, Scranton Area
TERMINATION:
Should I terminate this contract before payment of an outstanding settlement offer
or verdict is received by my Attorney, I understand that my attorney is entitled to payment
for his time at his hourly rate of $250.00, or 35% of any existing settlement offer negotiated
by him, plus advanced costs, as of that date. I also understand that my attorney may
terminate this contract at any time, if after a reasonable investigation, he determines that
the case lacks merit and would not be successful if litigated. If my Attorney terminates this
contract before a settlement offer is paid, I understand that I do not owe him a legal fee.
Therefore, having read this document and discussed any concerns regarding the
same with my attorney, hereby sign this document and agree to be bound by its terms.
Dated this day of ,
f r., /n
ATTORN LIENT '
[end of document]
Exhibit 11 H"
v-sy pennsylvania
DEPARTMENT OF REVENUE
December 31, 2009
Christopher J. Marzzacco
Law office of Colgan Marzzacco
130 W. Church Street, Suite 100
Dillsburg, PA 17019
Re: Estate of Stuart Bingham, Jr.
File Number 2109-0805
Court of Common Pleas Cumberland County
Dear Mr. Marzzacco:
The Department of Revenue has received the Petition for Approval of Settlement Claim to be
filed on behalf of the above-referenced Estate in regard to a wrongful death and survival action. It has
been forwarded to this Bureau for the Commonwealth's approval of the allocation of the proceeds paid to
settle the actions.
Pursuant to the Petition, the 22 year old decedent died as a result of a motor vehicle accident.
Decedent is survived by his parents.
Please be advised that, based upon these facts and for inheritance tax purposes only, this
Department has no objection to the proposed allocation of the net proceeds of this action, $28,400.00 to
the wrongful death claim and $ 39,3933.52 to the survival claim. Proceeds of a survival action are an
asset included in the decedent's estate and are subject to the imposition of Pennsylvania inheritance tax.
42 Pa.C.S.A. §8302; 72 P.S. §9106, 9107. Costs and fees must be deducted in the same percentages as
the proceeds are allocated. In re Estate of Merryman, 669 A.2d 1059 (Pa. Cmwlth. 1995).
I trust that this letter is a sufficient representation of the Department's position on this matter. As
the Department has no objections to the Petition, an attorney from the Department of Revenue will not be
attending any hearing regarding it. Please contact me if you or the Court has any questions or requires
anything additional from this Bureau.
S14crely,
C-. I vj?zu
$hannon E. Baker
Trust Valuation Specialist
Inheritance Tax Division
Bureau of Individual Taxes
Bureau of Individual Taxes PO Box 280601 1 Harrisburg, PA 17128 1717.783.5824 1 shabaker@state.pa.us
s.
i
FILE
'FE ,..
2010 JAN 25 FK 2: 35
JAN 212010
ri
M1? 1 F.
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
In re:
Estate of Stuart A. Bingham, Jr.
CIVIL ACTION - LAW
NO. 10 - 4SI.. 0'tvit --r?rM
ORDER
AND NOW this day of 20, having reviewed the
enclosed Petition for Approval and Settlement of Wrongful Death and Survival Actions with
concurrences from all parties involved, it is hereby Ordered and decreed that:
1. Petitioner, Stuart A. Bingham, Sr., as Administrator of the Estate, is
authorized and empowered to settle the above-captioned matter on behalf of the Estate
of Stuart A. Bingham, Jr., by accepting the sum of one hundred thousand dollars
($100,000.00) for the claims referenced within said Petition.
2. The amount of one hundred thousand dollars ($100,000.00) is hereby
approved and may be accepted by the representative of the Estate and distributed
•
pursuant to the laws of this Commonwealth as follows:
(a) Pennsylvania Wrongful Death Statute, 42 Pa. C.S.A. Section 8301: $ 28,400.00
(b) Pennsylvania Survival Act; 42 Pa. C.S.A. Section 8302: $39,920.02
(c) Colgan Marzzacco Counsel Fees $30,000.00
(d) Colgan Marzzacco (Costs) $ 1.679.98
$100,000.00
DISTRIBUTION:
? 1'4- ristopher J. Marzzacco, Esquire, 130 W. Church Street, Suite 100, Dillsburg, PA 17019
Shannon E. Baker: Business and Trust Valuation Manager, Inheritance Tax Division, PA Dept.
of Revenue Bureau of Individual Taxes, Department 28061, Harrisburg,
Pennsylvania 17128-0601
Viler Hauck: Nationwide Insurance Company, P.O. Box 10405, NESRO Class Claims,
Des Moines, IA 50306-9475
?? t?ES' M.ci.l
BY THE COURT: