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HomeMy WebLinkAbout04-2784IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION KENNETH L. WHISLER 40 Brandt Lane Newville, PA 17241 Plaintiff V. : FILE NO.: Otf. 2 ? f-t f 646 SHAWN W. WEAVER CIVIL ACTION - LAW 61 S. High Street Newville, PA 17241 Defendants PRAECIPE FOR ISSUANCE OF A WRIT OF SUMMONS TO THE PROTHONOTARY: Kindly issue a Writ of Summons in the above-captioned action. Respectfully submitted, ABOM & KUTucAKIs, LLP 4^ Dxn;, 71' 'Y Michael T. Traxler, Esquire 36 S. Hanover Street Carlisle, PA 17013 (717) 249-0900 Attorney for Plaintiff ID No. 90961 WRIT OF SUMMONS TO: Shawn W. Weaver 61 S. High Street Newville, PA 17241 You are notified that Kenneth L. \v hiller has commenced an action against you. Date i 2'." sCC?jr?„- Prothonotary Depu rothonotary QN V v 1` J. 4"0 t C? ra 0 co t. c.: _ir SHERIFF'S RETURN - REGULAR CASE NO: 2004-02784 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND WHISLER KENNETH L VS WEAVER SHAWN W LARRY ZEIGLER , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within WRIT OF SUMMONS was served upon WEAVER SHAWN W the DEFENDANT at 1115:00 HOURS, on the 21st day of June , 2004 at CUMBERLAND CO SHERIFF'S OFFICE ONE COURTHOUSE SQUARE CARLISLE, PA 17013 SHAWN W. WEAVER by handing to a true and attested copy of WRIT OF SUMMONS together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing 18.00 Service .00 Affidavit .00 Surcharge 10.00 .00 28.00 Sworn and Subscribed to before By me this day of i? .. ,, ?2,ot?q A.D. P othonotary So Answers: R. Thomas Kline 06/21/2 ABOM & KENNETH L. WHISLER, Plaintiff VS. SHAWN WEAVER, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 04-2784 - CIVIL CIVIL ACTION - LAW PRAECIPE FOR A RULE TO FILE COMPLAINT TO THE PROTHONOTARY: Please issue a Rule upon the Plaintiff to file a Complaint within twenty (20) days or suffer a judgment of non pros. TO THE PLAINTIFF: RULE A Rule is hereby issued upon you to file a Complaint within twenty (20) days of service of this Rule or suffer a judgment of non pros. DATED: ' (o P otary KENN L. WHISLER, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA VS. : NO. 04-2784 - CIVIL WEAVER, CIVIL ACTION - LAW Defendant PRAECIPE FOR WITHDRAWAL OF APPEARANCE TO PROTHONOTARY: Please withdraw the undersigned's appearance on behalf of the Defendant, Weaver, with regard to the above-captioned matter. Respectfully submitted, NEALON GOVER & PERRY Date: By: l e G. ore, Esquire I.D. 5321 NEALON GOVER & PERRY 2411 North Front Street Harrisburg, PA 17110 717/232-9900 CERTIFICATE OF SERVICE NOW, this e day of July, 2006, 1 hereby certify that I have served the Praecipe for Withdrawal of Appearance on the following by depositing a true and copy of same in the United States mail, postage prepaid, addressed to: Michael T. Traxler, Esquire ABOM & KUTULAKIS 36 South Hanover Street Carlisle, PA 17013 S"n ore, Esquire ey KEN L. WHISLER, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA VS. : NO. 04-2784 - CIVIL WEAVER, CIVIL ACTION - LAW Defendant PRAECIPE FOR ENTRY OF APPEARANCE TO E PROTHONOTARY: Please enter the undersigned's appearance on behalf of the Defendant, S Weaver, with regard to the above-captioned matter. Respectfully submitted, NEALON GOVER & PERRY By: Date: Je ni Henley Allen, Esquire I.D. : 84311 LL ON GOVER & PERRY 2411 North Front Street Harrisburg, PA 17110 717/232-9900 CERTIFICATE OF SERVICE AND NOW, this 1 ?]'-day of July, 2006, 1 hereby certify that I have served the Praecipe for Entry of Appearance on the following by depositing a true and copy of same in the United States mail, postage prepaid, addressed to: Michael T. Traxler, Esquire ABOM & KUTULAKIS 36 South Hanover Street Carlisle, PA 17013 Allen, Esquire KENNETH L. WHISLER : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY Plaintiff, : PENNSYLVANIA V. CIVIL DOCKET NO.: 04-2784 SHAWN W. WEAVER Defendant. JURY TRIAL DEMANDED NOTICE TO DEFEND You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the court, your defenses or objections to the claims set forth against you. You are warned that if you fail to do so, the case may proceed without you and a judgment may be entered against you by the court without further notice, for any money claimed in the Complaint or for any other claim for relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Lawyer Referral Service Bedford Street, Carlisle, Pennsylvania 17013 (717) 249-3166 NOTICA Le han demandado a usted edn la corte. Si usted quiere defenderse de estas demandas expurestas en las paginas signiuentes, usted tiene veinte (2) dias de plazo al partir de la fecha de la demanda u la notificacian. Usted debe presentar una apriencia escrita o en persona o por abogado y archivar en la corte enforma escrita sus defenses o sus objeciones a las demandas en contra de su persona. Sea avisdo que si usted no se defiende, la corte tomara medidas y piede enrrar una orden contra used sin previo aviso o notificacion y por cualquier queja o alivio que es pedido en 14 peticion de demanda,. Usted puede perder dinero o sus propiedades o otros derecho? importantes para usted. LLEVE ESTA DEMANDA A UN ABOGADO INM$DIATEMENTE. Si no tiene abogadi o si no tiene el dinero suficiente de pagar tal servicio, vaya en persona o llame por telefono a la oficina cuya direccion se encuentra escrita abajo para averiguar donde se puede conseguir asistencia legal. Cumberland County Lawyer Referra Service Bedford Street, Carlisle, Pennsylvani 17013 (717) 249-3166 r KENNETH L. WHISLER : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY Plaintiff, : PENNSYLVANIA V. SHAWN W. WEAVER CIVIL DOCKET NO.: 04-2784 Defendant. : JURY TRIAL DEMANDED COMPLAINT AND NOW, this 1()"" day of August 2006, comes the Plaintiff, Kenneth L. Whisler by and through his attorney, Jason P. Kutulakis, Esquire of ABOM & KUTULAKIS, L.L.P., and files this Complaint against the Defendant, Shawn W. Weaver as follows: 1. Plaintiff Kenneth L Whisler (hereinafter "Whisler"), is an adult individual residing at 40 Brandt Lane, Newville, Cumberland County, Pennsylvania 17241. 2. Defendant Shawn W. Weaver (hereinafter "Weaver"), is an adult individual residing at 61 S. High Street, Newville, Cumberland County, Pennsylvania 17241. 3. Defendant Weaver's operator's license number is 24852384. 4. On or about June 18, 2002, at approximately 10:30 a.m. Plaintiff Whisler was operating an automobile in Cumberland County, Pennsylvania 5. Plaintiff Whisler was operating his vehicle as it traveled westbound on SR 641. 6. Plaintiffs vehicle had fully operational taillights, brakelights, and turn signals. 7. Defendant Weaver was operating his vehicle as it traveled westbound on SR 641. 8. It is believed and therefore averred that Defendant Weaver was the owner of the vehicle he was operating at the time of this accident- 2 9. An unknown vehicle was traveling some distance in front of Plaintiff Whisler's vehicle as he traveled on SR 641. 10. The vehicle Defendant Weaver was operating was traveling some distance behind Plaintiff Whisler's vehicle as the two vehicles traveled westbound on SR 641. 11. An unknown vehicle, traveling in front of Plaintiff Whisler, prepared to make a left turn from SR 641 to Mountain Rock Road. 12. In preparation for that turn, the unknown vehicle reduced in speed and eventually stopped. 13. In observance of the unknown vehicle slowing down and eventually stopping on SR 641, Plaintiff Whisler safely reduced the speed of his vehicle and eventually stopped behind the unknown vehicle. 14. Plaintiff Whisler's vehicle remained stopped behind the unknown vehicle waiting to turn left onto Mountain Rock Road. 15. Plaintiff Whisler came to a full, legal stop in observance of the unknown vehicle preparing to make a left turn that had also stopped. 16. At the same time and location, as Defendant Weaver's vehicle continued to drive westbound on SR 641, it began to approach the intersection at Mountain Rock Road. 17. At the same time and location, Defendant Weaver's vehicle approached the area in the road occupied by Plaintiff Whisler as it sat ?ehind the unknown vehicle. !I III 18. As Defendant Weaver operated his vehicle, he caused the front end of his vehicle to violently collide with the rear end of the vehicle being operated by Plaintiff Whisler. 19. Defendant Weaver was operating his vehicle in a negligent manner, so as to cause the front end of his vehicle to violently collide with the rear end of the vehicle being operated by Plaintiff Whisler. 20. Defendant Weaver was operating his vehicle in a careless manner, so as to cause the front end of his vehicle to violently collide with the rear end of the vehicle being operated by Plaintiff Whisler. 21. Defendant Weaver was operating his vehicle in a recklessly indifferent manner, so as to cause the front end of his vehicle to violently collide with the rear end of the vehicle being operated by Plaintiff Whisler. 22. Prior to impact, the Defendant failed to engage his vehicle's braking system. 23. The Defendant's car collided into Plaintiff s vehicle without braking whatsoever. 24. Following the collision, at 11:10 a.m., the Defendant told Pennsylvania State Police Trooper Chad F. Sydnor, that "I looked back at my daughter who was in the back seat. When I looked up, the car in front of me was stopped. I hit the car." (Attached Exhibit A at p. 8.) 25. The accident was directly and proximately caused by Defendant Weaver's negligent, careless, and recklessly indifferent behaviot which breached the Defendant's duty to operate his vehicle in a careful manner, and such negligent, careless, and recklessly indifferent behavior consistedlof the following: (a) operating Defendant Weaver's automobile at a high and excessive rate of speed under the circumstances; (b) failing to maintain Defendant Weaver's automobile under proper and adequate control; (c) failing to keep a proper lookout for the automobile being operated by Plaintiff Whisler which was legally stopped in observance of a vehicle stopped ahead; (d) operating his motor vehicle with no warning of approach or intended direction; (e) failing to have his motor vehicle under the proper control so as to stop said vehicle within the assured clear distance ahead; (f) failing to use due care under the circumstances; (g) failing to notice the Plaintiffs motor vehicle; (h) failing to take evasive action in order to avoid impacting with Plaintiff s vehicle; (i) failing to apply his brakes in sufficient time to avoid striking Plaintiff Whisler's stationary vehicle; 0) operating his automobile in such a manner as to collide with the rear of the automobile being operated by Plaintiff Whisler, which was legally stopped; (k) operating his automobile without due regard for the rights, safety, well being, and position of Plaintiff Whisler under the aforesaid circumstances; (1) operating his automobile in violation of the ordinances of Cumberland County and the statutes of the Commonwealth of Pennsylvania pertaining to the operation of motor vehicles on the public highways; (m) failing to maintain visual contact with the road in front of his vehicle, including a failure to maintain his attention and exercise of due care towards those automobiles directly in the path of his own. (n) such other acts of negligence, carelessness and recklessness as may be determined through the process of discovery and/or at trial. 26. At all times material hereto, Plaintiff Whisler acted with due care and was not contributorily negligent. 27. As a direct and proximate result of the collision and Defendant Weaver's careless conduct, Plaintiff Whisler was injured. 28. As a direct and proximate result of the collision and Defendant Weaver's negligent conduct, Plaintiff Whisler was injured. 29. As a direct and proximate result of the collision and Defendant Weaver's recklessly indifferent conduct, Plaintiff Whisler was injured. 30. Defendant's failure to operate a vehicle at such a speed which would permit the driver to bring his vehicle to a stop within the assured clear distance ahead is a violation of 75 Pa. C.S.A. § 3361. 31. Pennsylvania State Tropper Chad F. Sydnor charged Defendant Weaver with violating 75 Pa. C.S.A.§ 3361, because of Defendant Weaver's failure to operate his vehicle at such a speed which would permit Defendant Weaver to bring his vehicle to a stop within the assured clear distance ahead and thus avoid colliding with Plaintiff Whisler. 32. On 6/27/02, Defendant pled guilty to this violation of 75 Pa. C.S.A.§ 3361. (Attached Exhibit B.) 6 33. Defendant's conduct and plea of guilty to 75 Pa. C.S.A. § 3361, failure to maintain as assured clear distance, constitute Negligence Per Se. 34. As a direct and proximate result of the aforesaid collision, Plaintiff Whisler has suffered serious and permanent injuries, including but not limited to the following: a. Strain and sprain of the muscles, tendons, ligaments and other soft tissue at or about the cervical spine. b. Neck pain with left radicular-type symptoms in the left- upper extremities. C. Numbness and tingling that radiates in'the spinal cervical area down his arm to mainly the middle two fingers of his left hand. d. Chronic denervation changes at the Abductor Pollicis Brevis e. Prolonged left Median Distal Motor Laltency. f. Prolonged left Median Sensory Latency g. Aggravation of and post-traumatic progression beyond that which would have occurred absent the trauma from this collision. h. Post-traumatic left carpal tunnel syndrome. i. Decreased range of motion for left-upper extremities. j. Contusions. k. Severe headaches. 35. As a direct and proximate result of the aforesaid injuries, Plaintiff Whisler has undergone and in the fixture will undergo great pain and suffering for which damages are claimed. 36. As a direct and proximate result of the aforesaid injuries, Plaintiff Whisler has suffered and may continue to suffer a loss of earn i gs for which damages are claimed. 37. As a direct and proximate result of the aforesaid injuries, Plaintiff Whisler has and/or may in the future incur a loss of earning capacity for which damages are claimed. 38. As a further result of the aforesaid injuries, Plaintiff Wbisler has sustained a permanent dimunition of his ability to enjoy life and life's pleasures for which damages are claimed. 39. As a direct and proximate result of the aforesaid dollision, Plaintiff Whisler sustained damages due to his personal, physical injuries, pain and suffering, inconvenience, discomfort, and loss of life's pleasures, all of which are continuing into the future, and which Plaintiff Whisler believes will result in some permanent disability, for which damages are claimed. 40. As a direct and proximate result of the collision and Defendant Weaver's careless, negligent and recklessly indifferent conduct, Plaintiff Whisler has incurred, and in the future will perpetually incur, reasonable and necessary rehabilitative costs and expenses for medical treatment and physical therapy due to a likely permanent physical disability in an 41. As a further result of the aforesaid injuries, may hereinafter incur financial expenses and losses recoverable under the limitations and exclusions Vehicle Financial Responsibility Law for which not yet ascertained. iff Whisler has incurred or iich exceed sums Pennsylvania Motor Res are claimed. 42. Plaintiff Whisler was the named insured on a policy of insurance issued to him by the Erie Insurance Group bearing policy numbler Q09 2940006 which was in effect on the date of the above-referenced collision.) Plaintiff selected the full tort option regarding that policy. A copy of the declaration page of said policy is attached hereto and incorporated by reference herein as Exhibit C.) Therefore Plaintiff Whisler remains eligible to claim compensation for non-economic loss and economic loss sustained in this collision pursuant to applicable tort law. 43. Plaintiff Whisler sustained a serious bodily caused him a serious impairment of bodily function. remains eligible to claim compensation for sustained in this collision pursuant to applicable tort in this collision which has Plaintiff Whisler loss and economic loss 44. As a direct and proximate result of the collision and Defendant Weaver's careless, negligent and recklessly indifferent conduct, Plaintiff Whisler's automobile was damaged to Plaintiff Wbisler's detri ent and financial loss 45. Plaintiff Whisler and his own insurance carrier h ve incurred costs of repairing the damage caused by Defendant in this collision. 46. As a direct and proximate result of this collision, Plaintiff Whisler has been unable to follow his usual occupation, and Plaintiff W hisler believes that he will likely be permanently unable to resume this occupati n, whereby he has lost the income which would have come to him through this employment. 47. As a direct and proximate result of this collision, Plaintiff Whisler has sustained said injuries and disability, and by reason o these injuries and disability, Plaintiff Whisler was compelled to, and di employ a substitute drill- operator to perform Plaintiff Whisler's duties. Employing this substitute drill- operator caused Plaintiff Whisler to incur additional would have otherwise not been incurred had able to operate the drill. 48. Additionally, since the substitute drill-operator h has been unable to find another suitable replacement, Whisler and, his well-drilling business have been unal inability to operate the drill has prevented Plaintiff W obtaining multiple drilling contracts, and as a result substantial losses. 49. As a direct and proximate cause of this collision, never be able to operate a water drill again, causing liabilities that been physically resigned, Plaintiff Whisler as such Plaintiff to operate this drill. This from pursuing and has incurred Whisler will likely to incur permanent damage to his earning capacity. 50. Plaintiff Whisler also demands such other damages that the court finds just at trial. 51. Plaintiff Whisler has made a demand for compensation of the aforesaid injuries and losses, which Defendant Weaver has failed and refused and still refuses to pay. 10 WHEREFORE, Plaintiff Whisler demands judgment against Defendant Weaver in an amount in excess of the mandatory arbitration limit toge?her with the cost of suit, interest, and delayed damages as allowed by law. ABOM & KUTUJAMS, L.L.P. P. Supreme Court I #8041 36 South Hanover Street Carlisle, PA 17013 (717) 249-0900 Attorney for 11 VERIFICATION Kenneth L. Whisler, being duly sworn according to law deposes and says that he is the Plaintiff, and that the facts set forth in the foregoing Complaint are true and correct to the best of his information and belief. Kenneth L. Whisler 12 "1'?' cin,h Numtxa COMMONWEALTH OF PENNSYLVANIA 001645- `1 POLICE CRASH REPORTING FORM ,e, New P0425867 Case Closed Change! AA 45 1 1 o Page: ) Yes Canlinualtion Inuderlt Number Police Agency Patrol Zone N c z- 1 Z'!o S 19 9 _i G N o 2 p Agency Name Precinct _ Invesd 'on Date (MM-DD•YYYY) Ddpat(I, Time ?Arnva Time (mill/ InvestlEalor Badge Number 1 _? 3 q f `F i 6' 2 F--f v % 411 no F S%lbyw• o S 0 ° Reviewer Bad it Number al Date (MM-DD-YYYY) - --~ - -_._ J 3 PIDP?f -;iF? County.,, County Name .___.__ Munki I' fty Municipality Name lTa of ' r 4v Sun a Cash OPte IMM bD p,6 YYYY) <µ *rC Crash Time (MHNar No of "eeUnits Nol of 'q I'sojels +- a ?No O ma p#? q In aced No Killed f > BB, 0 Mon p --- I ( : -- -,- mplete (4l Tun Q; ._8} es.(o7o2?', "--1- ty O 2 CO?yJ ) D O AA43 ).UWedp 'I o G-I- j._ i Reportable Crash Noti(y Niyhavay Maintenance School Bus Related S" Zone Refaced PeonDOT Property dp Yes No Yes d& No (1 Vas lopNo Yes 0No Q Yes IcaliNo „y .Unit-Number Motor vehicle in G Hit 6 Run Vehicle 0 Illegal) Parked Q Legally Parked Q Non . Motorized; -' Delete? Transport Unit' Pedestrian on Skates, from •w Pedestrian in Wheelchair, etc Prevlou crash ram O Phantom Vehkle; Owner Last Name (I/ Pedesrian, skip to Form AA 45 3 1) N I Tel one Numbu u t A V F a j f?] ,n116-`? CaNm.nf is _ _ _? Yahida Address city State Zi Q Yale ; o L'b1 5 NiGB St' -- ?'NE4v tLLF ?® 112?i) ?No +. v9N Modal Yeu Vehicle Make• (M Yes, Complete' ° 1 f 5 it ?. 1 8 L iF ?„ + y tS 4 9' 915 5 1 8 1 2 Form AA es C 1). - - -- L cenw Plate Reg. State Travel Speed 't c w -Refer to Ust on Z' S 1 3 l .1 C l 0 a? '1 $ Back of Overlay Q i -Lj [=S Insurance Insurance Company Policy No Insurance Company Photo- 41111111 Yes No Un 1 r y'? known Au STl,cf JL?, 9854411 I1?111L_ Vehicif. Towed Towed To Towed By Tow Agency Photo •?ymyi Yes AM No Unit Number 41b Motor Vehicle in r-) Hit 6 Run Vehicle d Bekoly Parked O teg ily Perked CD Non -?- Delete? h6pe Transport C:) Yet Pedestrian ? Pedestran an Skaes, 0 prDisabled evious From ? Train CCD) Phantom VeMdr - - in wlieelchak, etc Prevbus gash Owner Last Name in Pedestria?itto Form AA 4S 3 1) Fl M, Telephone Number . I fl- 4H r_ 5 .`_ 'W eI 4 C D R X L l ? coimt.rclatJLJ -j vhrd. Address S ZI yK ?{ 31e6 l Ca FEEN Sta ctaG as NrtLrY:tLkf Qp tl'Ly) ?Mo VIN -? Model Yeu Vehicle Make' (N Yes, Can 1 __ GTD J ;G _ 3 1. L? 5. j. ?. I ._1_`'r 4 6 2 a t F& FomK AA 45 C s _ License ate Re . State Travel !-?-? Speed *Rd w to List on Insurance Z 1 ' 3T? P A Q Bads of Overlay Insurance Company Poo lliicy No Insurance Company Photo Yes No Ir L known[ ?i/ 7y'Za Vehicle Towed Towed To Towed By Tow Agency Phone Ves No I -? co"M n AP as :qi Orl PENNDOT COPY f, 1O' Crash N...i.w COMMONWEALTH NIA POLICE CRASH REPORTING FORM ,s New P0425867 Ch AA 45 2 1 001646 Page: 'L ange) i Continuation Unit th.,mb.•r r rli r m ! ¢ OJ.L 1U1 T Le 9f U l!! Y er Veh Passrn wer 1 T S=Cam er e 6=frailer Tag No -"?-"" - - Tag ? Tag St t "-? Number g I - o Year a e O Q of Trai ling 1=toning imck : 3=Towing Vniity frailer 7-Semi-Trailer a=Oth Other ,? Tag No Tag r-----t Tag [?. Units. Year State L 4=Mobile or Modular Nome 9=11nknown Vs b. rre Cgp! O 3 Vehicle Tvoe 0 y N( Rim o a t2=COmmerdai i 01 Pn,,- r 1 Pr,; 08.6old 01.Automobile I I.Farsn Equip 22.HOM and BUM 23-Hone and Rider I. +Trte 09=8rown 02=Motorcycle 12=Construction Equip 24-Train 04=Green 10=Orange j 0"us 1B=Other Type Special Vah i l 25=Trolley =Black 11=Purple 104=Small Truck Vis t 19=Unknown Type Specia 06=yellow 12=01her 05=Large Truck 20=Unicycle, Bicycle, Tricycle 98=01hat 07=Silver 10=Snowmobile 99=Unknown 21=Other Pedalcyda 990UeklWwn l E )22iv(.lmpart POir-II y) 2 J R?1g! mdicaror F] Vebfcie Role L 0 12 11 01 - - I O=None 1=Minor (Driveable) 0=Non•CoRhi0n 0 70 "02 00-Non-Collision 2=FUndional taSWking s 091 303 Y../ 04 08 13-To P 1aJlndercatriage ` (Moderate Damage, May Not be Driveable) b)i ere - Oi ise 3 r 2=Struck 3309th Striking and Struck ! sa ng v = 07 --' OS 15=T,wed Unit Not Driveable) 06- 6 0 99=Unknown i ) Q>sn hen of `-?; hteyemenr I I 07=Entering a Parked 14.1srkinq Up . Position 15-changing lanes 01=-Going Straight 08=7rymg to Avoid Animal, or Merging N=UCr`1• 02=51owinglStnppmg in lane Ped, Object, Veh, etc 16-Negotiating 5, 5."!h 93.=Stopped in irnffic lane 09 -Turning Right on Red Curve - Right',. E=Las; 04=PacunglClVertakmg Veb 10=Turning Right 17=11egotiatMg W-JN?si 11=7urning Left on Red Curve - left U: Un: ..own 05=1 caving a Parked Position 12=Turning Left 98-Other 0b. Parked 13=MOkmg a U-Turn 99-Unknown ft lance Esnerganty e P4 t W Pa p pp pp g6 (Cu b tL r ) nee i Turn Lee* OB.Left of TaHkwa Lam O9eRiakt of TrafRcw TUm Lam 10. tam rection Ilesheukler Right W Tom lane 12aShtwkW 4h N Forward 13.OM Um Road ing lam 91.OUm smmg TraHk Low MUnknown ,Frays 3.0ownhiU 1 4.5aglBotiom of H t=level Roadway S.CmWop of Hill 2=1.1phIB 9=Unknown Bllad?t %straight 2=Curved 9=Unknown Unit Number nq it S=Camper T 1 nnUl 1Oiing"Si I V h l - c ?( II T T ,? Tag No e Tow ' t zTowinq Passenger e 6=Aai er Number _ Yew i State O 'L Q' 2,TOwing Truck 7=5emi-Trailer of Tradtn 3=Towin9 Utility Trailer 8=Other ?- T T 'D Tag No ::: Units: k Ye ar F 5 nown 4=Mobile or Modular Nome 9=Un - .- V J .L! (.+de! y, t o Type o 4 `' i l 0 1 JAM I ?' .L J u=eanmerc a D7 Red 1 08=Gold 01 =Amomobiie 11=Farm Equip 22 LIlmse and Buggy 00%Not Applkabla 01=Fi V k Pastarugrr UnW` 13aTaa) 03=Wh11- 09=Brown 02=Motorcyde 12.Construillon Equip re e 23=Hone and Rider 02=Ambulance 24=Tram 21aTrsROr TnRer 04.: Gran 05-Black ID-Orang» u=bus 18=Other Type ,Pedal Veit 03=Pditt 11=Purple 6d=5mal1 truck 19=Unknown Type Special Veh 25=Trolley D8=Ol6er Emergency 22=Twin baOar 23.11`riple Trailer 062 YOGI 12 -Omer 05=large Truck 20- Unicycle, Bicycle, Tricycle 98=Other Vehicle 31a1slOdified Veh 1 01-5,:,•'r 99, Unknown 10=5nowmohlle 21=Other Pedalcyde 99=Unknown 11=Pupil Transport 9%Unkrwvm Tqt{Z ImPdrC %9i^_f -', Dm,•9vs4Ctatst 1 I ?r(e.BP(! " ' ?lbl[M PoSffloll O N li b l _00 .?, ?. 1 ot Appi ca i e - ' I1 to - 07 =Minor (Drivesbla) . 02 DC -NomCulbsion ?2=Functional O=Hondollision 01=RW La (Curb) t=StriUn 02.111'yyfit Turn Lam 9 Z% i O1=Leff of Tatfjcwsye' f 03= Um 09.RhhtO e - --itll (Moderate Damage, t3-T,p 2=Struck 04=Beh Tum Lam loan V Lkm May Not be Driveable) ! 3=80th Striking 0S6 -Dkedbn II-Shoulder Ri0llt "`- _ . to=tlnderrarna9a 04 3=Disabling (Severe • 15=Toned Unit mar Tum Um and Struck 06= her forward 12.Shouldw L$ 13.One lam Road G7 0: 05 1 Not Driveable) 99=Unknown ov kq lam i 91.OthaF 9=Unknown 0T ng Trom I" 99sunkmm o r ctlgn el - 07=Entering a Parked Mev<ment i _? 14=Backing Up Gradient 3=Daw" ?. 0 4 , Position 15.Changing Lanes 4Saq/8ottom of Hug,•, 4 SW 08=Trying to Avoid Animal, or Merging leLeval Roadway 014 Ding Straight I - SuCresMop of Hill N Norm Ped, Object. Veh, etc 16=Negotiating tli Smwmgrstnppmy in lane 2-Uphill 9=Unknown 5 S rah t t 09=turning flight on Red Curve • Right (li St npnd in Traffic lane sting 10=1urnin Right 17zlilegol: ------ i 1 S h g ring/Overtaking Veh Od P d(19ONCO1 I J1 tra g = t t . n . 11=Turning Leh on Red Curve Curve -Leh o 05 a Park:rd Pr.nion 12=Turning Left 98=Other 2=Curved Uu=P+•s,•d 13=MaWny a a U- Turn 99=Unknown ? l 9=Unknown NA 13? Crash Number COMMONWEALTH OF PENNSYLVANIA POLICE CRASH REPORTING FORM 410 New P0425867 AA 45 3 1 001647 Page; 3 Continuation Unit Nomoer Last Name dr- address License Number 2 L4 $;5 2r 3 S y? Alcoho40ruos Suspected 46 No i? Illegal Drugs Alcohol._ C-) Alcohol and On Akerhol Test Tvce + lrst Not Given l- i Breath Blood L-) Urine 1 O Medication O Unknown Other (-? Unknown If Alcohol rest Resu is - Test Refused C Unknovm ) , - Test Given. Results - ----- -' Contaminated Results Driver or Pedestrian Physical Condition Q apparently - -, Illegal Drug `J Fatigue ._J Medication Y O No Pedestrian Signal D ? ice);-,n?-y3?z ,late Zip 5-51-i-1--t-ii Al A?I e NUante Number Is wbksawn J_nJ driver It not kneed sea mam' •s O Not at Intersection Pedestrian location In Roadway p Feet o 4 10 off Road its p Marked 61 11111=74 Q Not In Roadway > Oki R oood anaCtlon • No O Ga t le CD Median . sw a s G Island O ottWde to n CoioisldwNksfIon G Shoulder O T?'ded Patl O Driveway Access O Sidewalk O Unknown and mark if they were Normal Be n H ---- Use ' sul I loves C e -- a ( sick Asleep ! Unknown i I___. _J I r O Yes C _ _ Owner,Vrive< 00=Not Applicable 03=Rented vehicle U--Other Municipal Driver Presence Cam- 01=Private Vehicle owned/ 04=State Police Vehicle Government Vehicle 1=Driver Operated 3e0river Fled Leased by Driver 05=PennDOT Vehicle 09=Federal Gov Vehkle 98 th Vehicle 4=Nb and Run 10 02=Private Vehicle Not 06=Other State Gov Vehicle er =0 2=NO Driver 9-Unknown - Owned,Leased by Driver OT=Municipal Police Vehicle 99=Unknown Unit Number Last Name _ ll__?TT?i 11 ,I'l fiMt 1 TeeprlOM NDTMr _ M S IS-. ` ,M1 l..1 _-l.__1__. = J I »-?na;-y)93 P AdadrescZ e -^ ------- __ _ ----' cry-- state Z' yQF•_ ..tu _ __ ---,LN?,evrl.uE Pp 1 4 License Number _ State Hlkenu Number unknown a Z s -- driver is not Ncensed see mane Alcoho6Drug5 Suspected g Pedestrian Siorul of Sane of Crash 42 No -' Illegal Drugs Medication " G No Pedestrian Signal C:) Not at lintersiection o Alcohol Alcohol and Drugs Unknown O Pedestrian Sigel ... .. __ .. 3 -_-._ AI<ohoi rest rope pedestrian loratpon 4 10 feel -• o CJ In Roadway O OR NOW e ift Test Not riven _.1 Breath Other O Marked Crosswalks Unknown if at Intersection G Not In Roadway (D > 10 Pose ,. Blood Urine ?--' Test Given r: O At Intersection • No O MadWn Crosswalks O OutsideTraffk r Alcohol Test Results O Wand is NorWntersection O SharedPathsl+ 'rest Refused C) Unknown G Results Crosswalks G Shoulder Traib .t i 0 - Test Given, r- '. ------ contaminated Rewh5 ?., Driveway Access J Sidewalk O Unknown Dncer or Pedestrian Physical Condition Vehicle Code List any ands Coda their r this haver has ?7?rq? svlti Violatloni r Appalently Illegal Drug - vrolated and mark N the were charged. G Fatigue J Medication u Normal --' use > Had Been - I O Yes ?i - Drinkmcl ._' Sick Asleep CJ Unknown O Yes O' O.vne.•Ur r 00=Not Aapliwble 03=Rented Vehicle 08=01ther Municipal Driver Pawnee Cuc?e 01=Private Vehicle Owned; 04=State Police Vehicle Government Vehicle ( ? 1=Driver Operated 3=Driver Fled Sane Leased by Driver 05=PennDOT Vehicle 09=Federal Gov Vehicle FFFI JI Vehicle 4=Hit and Run C 1 02=Private Vehicle Not 06=Other Stale Gov Vehicle 98=00her 2sNo Driver 9=Unknown Owned: Leased by Driver 07=Municipal Police Vehicle 99=Unknown ' NIA :(.rash rdun ?4" J COMMONWEALTH OF PENNSYLVANIA ry ?+ POLICE CRASH REPORTING FORM 4F New p 1" 04258 67 AA 454 i 00164$ Change/ Pa - -? continuation 1?( Saett-On e 5 a -os cn y 4 P p G O=Nofnpplicable D U - stAPis enrieu Occupant E 0=None Used/Not Ap licable !!! Ejection; H P. ss-mng,.• 0_or:rcr A,+Venicies 01-Shoulder Belt Used 1=Not Ejected 7-P.dest•,a- 02=, ont Seat Middle Position 02sLap Belt Used 2=Totally Ejected ?- -r 03- •ont Seat Right Side 03sLap And Shoulder Belt Used 3=Partially Ejected 04='.ecund Row-Left Side Or 04-Child Safety Seat Used g=Unknown Motorcycle Passenger 05--Motorcyck HelmatUsed, 05-Second Row• Middle Position 06=111cycle helmet Used 06 ',ecnnd ROw - Right Side tOsSafe W10" Path: ty Belt Used improperly H ge?E1laid/Not Ap lies tl+ F =Female 07=third Row Or Greater- 21aChlk Sataty SSMUsad lrWoperly s7 K 12=Helmet Used 11 1:Thsough Side Door BM=male Left Side pr 2=ThroughSide Wind oW U=Lnknown 08=Third Row Or Greater- 90=Restraint Used, Type Unknown 3=Through WisdshkId ' Middle Position 99=Unknown 4m7itrOlsgh Badt Door 09= Third Row Or Greaten - I Right Side S.Through Back DOorTallga Se%ly Eg tRT1 =Through Roof Opening lSu :n/.,ry Sevrr+ty: 10=Sleeper Section Of Truckcab F GI.Fr ntAk toyerabla 6Convertblello Down) Cn=Notlnjured 11-In Other Enclosed OtfrOn Ak toyed lFaThis Seat) 7=Through Roof OpMIng IC i=Kdled Passenger Or Cargo Area 02=SMe Aireag ad 00't This seat) Top Up) Z 1.lajorlnjury 12=In Open Area 03=0fherTy=1 DaapplOyed - 9=Unknown 3 Moderate (Back of Pickup, Etc.) 04=Multipkf ployed - Injury 13=Trailing Unit 0S=Mototevde Eye hotactftm fl 4cMlnorinjury 14=Riding On Vehicle Exterior 06.8 If Wearing Elbow/Kneer Er 9=Unknown 15-Bus Passenger Other Pads I,1 Extricated o 98=Other 10=Air BagNot Deployed, Switch On 99=Unknown 11=AirBagNot0eployeCL SWkchOff 2-ExtrkatedByMechanical M10iq ovedUrTocrash) Air Bag Deployed ..,_ •.-.__. e:.,i. ruu_nn_vvvv+ O R f n F F G H_"t = DeVetei 7:r ] 1 [Kili! t -1 M 1 1 L 51-01 '=J[cc>;] 'G nm AJJrea l 1`iwno -__ . -. ` ,'' FMSTI? e 5ll?wu IsrEe.v?A. _... I Oval, ;. r No Person No Date of Birth (MM DD YYYY) A B C D E Delete) 19 -W] r F G H w X-5 ne: Address: Phone EMSTrantrpol4t Oy s ®Mo i R F_66La.A wf_4.vfCA. e ) ,, I No Person Nci z. Date of Birth [MM-DV- YYYY) / ?? A ? ;B C D E Drlen•r . ,l5 -'1 - ? yM-?CSf6 I??f?l? ° c? F G H - . i ix 1 aao r - _ _ ne Address/Phone EMS VaMpOR ;- .NV@.TII W14.rSLFItF___ --- -- Ores •No _ r_t. , cNv Person No Dateof B+rth(M_M-DD-YYYY) A 8 C D E3 Delete? 1 lCj ..^j Z ? E"J E ? J 715 F G H i- K'u If Z ' re i Address / Phone 1 _ _ j t E O D Y s )f ; 179 l,E 1'ls'11 lfl aL Q 6- Y 556 R?vm/ Iip O . 7 r PB.MDY L t gl p ? ?rr D en ens No Prson No Date of Birth (MM•DD-YYYY) A 8 C D '. E Delete? + F G H I T Phon EMS Tr O Yes 0 No 0 No Person No Delete? Date of Birth (MM DD-YYYY) A B C D E F G H 1 D El e ! Address Phone a EMSTrartsport .'' Oyes ONO y i° n,..:, r,+.1 ,.. ileA I N Crash Number _ COMMONWEALTH OF PENNSYLVANIA D ?J POLICE CRASH REPORTING FORM do New P0425867 ?' - --- AA 45 5 1 043 Page: .5, r- change 1. _ T_ ?. __1_T_1_? C Inte•rsecnon Tip- - _ .. ^Y' interSMVOn _. Off Ramp Spe lal location 0 M,dW oc< Traffic Circle/ 4' Not Applicable O Bridge O Cross Over Related Crossover a Wo; tr.trsr;.oon -" Round About - 0 Underpass ? O Tunnel O Driveway/Parking to n -T• 11: I;ecuon .-::) Multi-Leg r Railroad Crossing -- ` Intersection O Ramp O Toll Booth O Ramp & Bridge " - L; Other On Ramp (if 'Ramp' is indict Please see manual) O Unknown ' Complete the Principal Road Section for all type of crashes. For crashes at intersections, enter Infor mation In the Intersecting Road Section the G Section. it you have a midbloc ( crash, you should enter information in the "Distance from landmark Section, the GPS Section, or the House Nianber Section in the Principal Road area. n eapty Route Number Segment (Optional) Travel Lanes Speed Limit O Month House Number (H applic" is o -, r--'--. - - Y'! I F li ? !Y f? I 11 L y South ? y A I - _ O Fatt Street E nding Street Name [ ICI -I? m West r.? 0 a I?J O Unknown .' Roue Signing - < -? Interstate Turnpike -? Turnpike 0 State O County O Local ' Road O Private O Otherl Spur Highway Road ors _ (Not Turnpike) (East/Werst) - t Rood unknown o County Route Number Segment (Optional) Travel Lanes Speed Limit Y " •O North r i O Soul m -- - ?!- ` Street Ending Scree ? t Name East O it O w _ a 0Unknown __. ._ 1 e.. Route Signinq v c v interstate Turnpike Turnpike ?- State ;J County O L ' ° (Rood O Private O Other/ Spur - Highway Road or g (Nut Turnpike) IEast/WesU Street Road Unknown ` Intersecting Rt Num Or Mile Post Or Segment Marker _.. - - D North C ? Fred E C ?. J ..._. South V _ _ St Ending O East - Or Intersecting Street Name ? [ ?? Pin3;a T V Enter OWesl Or Mle I-f--7 T--l Information for BOTN v. 4 landmarks intersecting Rt Num Or Male Post Or Segment Marker F u If using O North Distance From Gash ,kt. Thu Option O South Scene to landmark g (For Crash between ;t. w Or Intersecting Street Name St Ending O East - Landmark 1 and O West Landmark 2) m Degrees Minutes Seconds Degrees Minutes '.. Seconds'. . - lon itude: tit d L g F u e a ?3 6 5 yp f 'g I 3 G 1L? 01 : .. Traffic Control Device Passive RR Stop Sign TCD FuMtlonina p - Crossing Controls m Not Applicable ,-- Yield Sign Police Officer or ; s dP No Controls C) Devka Functioning O Emergincy Improperly Preens tlve ? Hashing Traffic - flagman . ?. - Signal --, Active RR Crossing --, Other Type TCD Controls - O Device Not O Device Functioning O Unknown Functioning Properly - Traffic Signal Unknown Type of Work Zone (it 'Not a Work Zone', skip rest of Wort Zone section) Work Zone (Mart all tha apply) 0 O Not a Work Zone -- - --- - ------- ? Lane Closure ? Work on Shoulder ? Haggler Cmod 3^, ; Work Zone logtron .J r Construction Transition Area k B f 1 W Road Closed with ? or me" E] [3 NtterndtteM or Oilier .` or - ore st e Maintenance IJ Activity Area Zone Wanting Sign Detour Ck. ksod work g Utility Company Advance Warning 0 Termination Area Work Zone m1 Wqkers O Yes O No O Link Other Area r-1 Other mit sr* M FrH' Lahti Closed (If -Not Applicable', skip rest of the Lane Closure section) ; 0 Not Applicable (J Partially Fully C.1) Unknown Traffic Detoured O Yes O No i .ne Cloture Dirxrvnn - Estimated Lime hosed 1-3 hours O 9 12 ho rs d' D 0 North - ". East _ i North and South O < 30 Minutes . u - _ 3.6 hours O > 12 houn Ymth West East and West 30.60 Minutes 6-9 hours O Unknown "AM. ii Ji at.mi PENNDOT COPY ;?liLtMWEALTH OF oath N,rnbcr -F POLICE RASH REPORTING PENNSYLVANIA OW New P0425867 ? C AA 45 6 1 00JLp$0 / Change/ " r ?? r Y CD Continuation ! r- (idion-Codivou 2. Head on 4=Angle 6=SideswiQe B= it Pedestrian (Backing) (Same erection 7=Nit hired Object 9=0ther/Unknown 1=0n Travel Lanes 3=Median 5=Outside Trail y 7=Gore (Ramp Intersection ; ) -?- 2=Shoulder 4=Roadside 6=1n Parking lane 9=Unknown - 1=Daylight 3=Dark - Street S=Dawn 1- -? ` B=Other ' ? ? ? 1=Dark - No Lights 6=0ark • Unkntswn r Street Lights 4=Dusk Roadwa U hLin =. Weather C_ndhons 1=No Adverse ) I Conditions 3=Sleet (Hail) S=Fog - , 7=Sleet & Fog 9 Unknown i r r 2=Rain 4=Snow 6=Rain B Fog 8=0ther m3 y u 1 O=Dry 2-Sand, Mud, Dirt 4=Slush 6-ke Patches 8-OUroj +y' 8getLSud:,ss_Cvnl lynx OI oil 1=Wet 5=lee , 7=Water - Stand' ....1 3=Snow Cover ed ) or Mond Harm Event LIN Most? Wilily Pole Number - , 30=Nit Fence Or Well ?. G 1 r 0 1-1= D 01=HIt Un t 31=141t BuUding " Unit NO -' - O2=Hh Unit 2 . 32eHh CulveR "" 03=111h Unit 3 33=Hit Bid" Pler Or Abutment O ) 2 - 04-Hit Unit 4 Hh 5 34=Hit Parapet End ' = 0 Unit 5 06=Hit Other Traffic Unit 35=141t Sri dge all 36=14It Boulder Or Obst da'.. Please Put r -- E '--' .I --T-r--'r 07=11h Deer 09 Hit Oth r Ani l On Roadway - 37 it I ` vens: m 3 f - e ma =H mpad Attenuatt# . s .err r, r..rr I - - 09=Collision With Other n 38=H11; Fire Hydrant O d , - I fixed Object 39-Hh Roadway Equipment- . a f 11=Struck By Unit.1 40aHlt Mail Box " .. ., - .... 1 .? __. 12=Struck By UNt 2 Ali-M Traffic Island 13=Struck 8 Unit 3 42 Hit S B k S o 4 Harm Event L/R .... Most' Utility Pole Number .. .. _ -. , __ 14=Struck By Unit 4 5 Nt 15= truck By US = now an 43=Hh Temporary Construction kr Barf ? ® a 16=Struck By Other Traf , Unit 48=Hit Other Fixed Object e 21= it T O Sh bb ' i , uric No ... ._.. i _. r e r ru ery . 49=Hit Unknown F xed Objed _ 22= it Embattlement 50=Overtum/Ra9 Over a Z 23=1le Utility Pole S1=Struck By Thrown Or Falling - ? 2 ? 24=Hit Traffic Sign Object -,- 25=Hit Guard Rail 52 Pat Holes Or Other Please Pur - - . i' -- ( 26=Hit Guard Rail End Pavement Irregularities - Events 'n 3, ? 27=Hit Curb 53=Jacknife 'equenw; ... - .- .. _....__ .._ :. _._ _, 28=11it Concrete Or 54=Fire In Vehicle Order - - - - ---- Longitudinal Barrier 58=Other Non-CoUldon y 29=Hit Ditch 99=Unknown Harmful Event - - '--" LgjYBJ'y(1j.(L/R) L=Left 4-Right O=Other U=Unknown ' &5,f Una No Harm , U" U n Fvent M-OA Unit No Harm Event 1 1 1 u Tful Dryer Action (D) 16=DrivThe Wrong Way J u . O EYCLtb ) ? (ftg grin tr 2 O z Event rn h r ? -- --- i 00 No Contributing Action 01 -Driver Was Distracted I. ay Street On 17=CCa areless Illegal Backing On n Roadway ` +, " r •+? '• r " Hand Held Phone 18=Sides On The Wrong g H D , 03 -Driving Using Side of Road and Hands Fr eR Phone - €nv+PgLnv:lld:'.?4@A+ P_gjnntx.- f rsT9rL (Ern! 1 0 i T p 2 3 a _. '-"_? 04 Makin Illegal U-Turn 9 05=Improper/Careless Turnig 19=Making Improper Entrance to Highway .r u et vd,nd Conditons Y 02 do M '• C d t 11=sIm a Road Conditions 0cMSnowl Pry On R t ad t2 5 h 0 um It= d Wrong 06aTumiein W/O A 20=Making Improper Exlt N From ighwa r . r r eat r on on 93 Ot' c ??;4er Conditiors anw wav u s o - 13=Potholes Clearance fter Sto P 08=Running Stop Si n P=Careless Parhuq/Unpacking ' ^.. Oe r in Roadway 14=Broken Or Cracked Pavement g 09=Running Red Light r + Ok stack On Roadway G6-01,rar ri,l in Roadway 15=TCD Obstructed 16=5oft Shou4Jer Or Shoulder Drup Off Compensation 10=Failure To Re Other TraNic Control Devlice 23=Speeding 24 i i T D F F C i 07_61arn 2'-:_oi.;r z°rc Related 28=0ther RnadwaY Factor 99=Onknown 11=Tailgating 12=Sudden Slowin9/StoPPm = r v ng oo ast or ong ondit 15=Failure To Maintain Proper Speed 26 i D Fl i P li >'h; e F.i :1Lrg?(V) F P.,JJdt? Y 12=Wipers 13=I1legally Stopped On Roa 14=Careless Passin Ot Lan = r ver ee o ng ce (Police chase) i _ tin Nonc 06=Exh 07 z1"' 0%: H^ aust 13=Driver Seating/Control Daorz .,dG hts to-bud Mood Etc ' e Change 9 P 27=Dr ver Inexperienced 28=Failure To Use Specialized Equip . , , q ? Ol -Wake sy-oc•m 08:5,gnal lights 15=Tray er hitch 15= assing In No Passing 20 a 98=Other Im ro r DriV Pe HsB Attiors P 0 5eg System 09=0ther Lightss 16=Wheels Oct 5L,sDer 10=Horn 17=Airbags Nat I? 1 I ?,? I t _?''''') ( '- J 13 W 4 m L 2? I ll?? ! 05=Vc+wcr T,, v,; it=Mir rors 18=Trailer Overloaded -- .. _ . rt ^> j 1 0 •J 19=Unsecure/Shifted 1 Trailer Load 20 I T i ?---? No it C? 'Z 1 II^-?_? 3 m 4 m i 2 = mproper ow ng J_ 21=06strucled Windshield C?O Z 1 - --O 2"---_-. 99=Unknown P.gdg2,Vian Action (P) 03=Working r,o - 00=None 04=Pushing Vehicle - - -'- 01=Entering Or Crossing At 05=Approaching Or Leaving Vehicle __ - jn ,c rf d Pars, Fdttlor Unit No ra,.c_t- _or .r- . _ Code Specified Location 02=Walking. Running, Joggin 06=Playing Or Working On Vehicle i" , 07=Standing :.. n ' ^+^ Un .0 ' Playing. Or Cycling 98=Other FR V U P i 'R r9 the n l if th Pre Unit No i Ol' 1 Unit No q I ?1 t © it f an p No blank Tv p, e t_LI % ---_-- ' COMMONWEALTH OF PENNSYLVANIA crash Number POLICE CRASH REPORTING FORM New P0425867 Change/ -? Continuation AA 45 7 1 Page: 001Cr ?J1 (] Delete Page 4 roe 'COMONWEALTH OF PEN 0 POICEE CRASH REPORTING FORMANiA New P0425867 Change/ c--- AA 45 8 1 J $. Delete Pagh PYdc - ernerye•?cy transport, witness, dnd other information here. N is not required to restate information from the form. F=sce, ding EMS agency. HOVE Medical Facility: Ulf witness t ` q Address: Phone: won• .:2. Address: Phone: P Nan attte f -?*^Qtt?,_??_`"?_.?OFtiP??s PvuF'p i?1Etti ?1rellrel - T1,;S??r-%4z lft- rosi icc0 1>0A=N1r 1o ter ._ -. -- 'JQl4A<of.-1.-1 wAY_ twc'?a?s?.4rS1? ?? Z_ Avo S_c.A_LfD_ Y..__?c?ok<_p' gLIkJA? ??+y 1?AoGu x.t i1,4 nAcV S Q,r \,•\? _T L??k?Ep UQ 711Q ,o of F^?. w AS S f?QQ??Q,__'L H=r MBE ot'1\Ff? K-?s_ 00 E?cvb _L L A5 I1Fi.?it?t..E? T1 vG? Aa?o .S_rp c E L __ 1 .t>5_._ s' T?QQ??i E_ 113u? A.r?M? ._. SP "1?1 S rs?v?0 t'-a ATM '?fNA^?nSA F w PENNOOT COPY COMMONWEALTH OF PENNSYLVANIA TRAFFiC CITATION wdG zlre.SN . 4. D~ NI. p p Sz 313 `f .,., ••, , S. C.P.L 7, D. *B, I 9 ea o P ? P f r ®. al.M.llw wN W W 15 AV a2 4D. pMMan1 Abrew ( awfzb Cpls7 11. VM.A?NV 12.R Yr. 1S S MN IO. Ma? 15.j1q? 19g v ????? i A OnO 1 vV l [T. VM. Rep. IM. I8. Rp. Yr. 10. SWe 2°. MaM" 21. Typ e 22. Com C3 PA p.D ,A A"me A, Ler14r Nemv A AW. ?Same Y DNxWnI ?Nd A;pi 24. CNwp 28. VEHICLE CODE ? Meeamvn SAW LNIIM [3 Dllvwa Reaupel M be LMeneea ? CaMeef DM00 TITLE ]S ? SIM St.6 YMM Sl Pa ? RpWMbn A CeAlpeale d Tale RpuIM 28. sue SEC. Or AS VeWM el Sete SPesE ? ur A was ? T.ftz.lol s,,Aaw FINE ? o,.Iw d vaaaa am. g CMMSb d wa,M ? D"n Mlle OWMa, PrMMp M Sup MOO a RF ad onM E] " l// F /fo-ct) 23. Nawre d Off. ? RAOw ? CMCMI ? AO.V. 3a ? SpeeKp MPH alaaee MPH ? ESP ? Va. ? ONer 50 L . ? Coamw VaN]M MMWI VMM ? Opwwsa V wi. RM SuepmEe .Mad ? OpaMel LE aginaaO VMi I. qq a e ? Waal. S] Pe. Cob RM. 4B CFP $ ? FW . SM. PgME nE? FAS\_Ya - SC S V6\ r Fit- ay,5A6? o:s,rnv Mm -z, ,. rS1[ VtE\1 v.G a - At S 4 N b 7l? RD 7.zo . 37 . Rpb 39. Tep.dpM.LXy p. M„W. d Tlewl As yl \a.114S T, 9 glow w (to ncr r - 31 N 9 E 41.20 1 f D 4243. Day 44. C a, . 4Ws 4aMVFw 46. DWMwa'a a".- A.M.O.M. RSCOPI Of CIMM 4]. Oa4 ti X sz s 4e, IwMy wlM lw.L eM bM In uw dMnm ue lws uM mrtwYw pw bW M my tno'Msdp, WWMIW wM EMeL Thew OUnon male Mtjw M Ne pwWtlm of SaWan 4001 d M" CNree Cab (la Pe.CS. g 4004),aaS, M uNwJm IeMMMkn a AW'WaM. S ` o N>N BADGE NO. dB Nu.' OFF COOS SIDAATURE -{C^ 1 5 l PA PSP 1 vc,v 49. THIS CITATION HAS EEEN ISSUEOIPILED BY MEMBER OF THE PENNSYLVANIA STATE POMCE, HARRISBURG, PA. 17110. W. Spew THbp Cav opMmr Tlm W. Secs. TImM 54. Sp"e0 EqW, Seel No. _ .K EaID- T"A" 5]. AU1JM Na. ! L Ps.C.S. S 1513 Vahwtw,lu w . VOL W. Hw. Mat 1'? aL.? SS. ?. 1" anMa S ? YES ? VES 61. u ------------------ II SUPV. INR. BADD N.` E'll?. f L3. ow a4. Spa] p Tpa 02. Spedel A." ar w, p WL Nu uDe ,Ma amera remm. A ml Way a are Mons an nlpMny., aee orM mp.m.luare ...p CITATION NO. K0277267-4 SS <<yvtLt QAt? 41 I SP7 W17A DISTRICT JUSTICE KO277267- AOPL 4084,95 (Rev. WWI) m r r l ? o L Z ? { ?' U t { N ? U m ° C S o ?w m J } a J,- ? dv ^; a ?d m a ;m ? ec 5 c :? mA m )N S Gp? ..N et1 'J 7 Cc m m t 5 "ox' ;o 19 Q ? ?? N'm m Z ?? = r Q 01- ?a oa ? U' aQ ;oo U G K ro? rn m G ` p ? ? m ? r N 41 r a s U a 04 17 PI uHvur CONTINUATION NOTICE fm Emirs PI, ENa PA IeAW Y X167 J P WOLFE INSUR INC 1 11/01/01 TO 11/01/02 1911 0109896 H R. KENNETH L WHISLER & GWEN Y WHISLER 40 BRANDT LN NEWVILLE PA 17241-8655 ,mffV* - J P WOLFE INSUR INC 96 S. HIGH STREET AGENT PHONE - (717) 776-5213 NEWVILLE PA 17241 1414 *+r*,r*x*xx*:t*x*x**xxxxxx*x***xxxxx******x>txx *****?*xxx****** * CONGRATULATIONS! A PIQNEER EXPERIENCE RA ING CREDIT HAS * BEEN APPLIED TO YOUR POLICY PREM?UM, xxxxxx**xx *xxxxxx*******xxx**xx** *xxxx**??:xxxxxx**x****xxx ITEM 4 AUTOS COVERED C Spa ¢¢ 1 AUTO 97 EHA LEGACY GTR 4538 6751X7202586 PA 4F YM RA28LGM CLASS DDP MM30. ITEM S. INSURANCE IS PROVIDED WHERE A PREMIUM ORI?CL IS SHOWN FOR THE COVERAGE. COVERAGES, LIMITS AND ANNUAL P__15AS ARE AS FOLLOWS- ;? .+..+???.„+;;',..'7+!,."*3°MrSxnma Ak ate: ? t #1. j #2 '; ** DRIVER RATES APPLY***** NGER VEH -- THE FULL. _ ?• y ' . ka ICLES. LIABILITY PROTEC;:;, p';,•: :: +.,,.;•, ;:n I,;d.`;.r. BODILY INJURY ~.FISH'3?L?31 gi?aFJ?A ti-w wT2 7$r ° 4 PROPERTY DAMAG Cam? ' ¢ ! ` e i6 w FIRST PARTY BEN MEDICAL EXPENS INCOME LOSS g1M yWr?. `a w Ay ACCIDENTAL DEA + ,u+; b. FUNERAL SBOpSENEF I T J e %.!) UNDERIUNSUREDRM9PER ONO$100M ACC-SED 13 BgyD INJ ,550M/PERSONS$100M ACC-STACKED 48 48 PH COMPRREHENSIVE COV$E100 DED 82 81 OPTIIONALICOVERAGES D gg ??pp $$11 167 159 TRANSP EXPENSES - COLL S25jDAY; $1;125YLOSS 15 15 AUTO LEASE/LOAN SECURITYY g44 TOTAL ANNUAL PREMIUM FOR EACH AUTO $ 1,061 ! 512 TOTAL ANNUAL POLICY PREMIUM (SEE ReVERSS SIDE) RETURNED CHECK FEES WILL BE ADDED TO YO RACCOUNr XD WFS 09/29/01 _ aw T "'TAO" AGENT - Please return this portion with your olicy older s remittance INVOICE AOBNr POUOY NUMBER BATE E PAYMENT DUE PAYMENT PLAN AA7167 J P WOLFE INSUR INC Q11 0109896 H 102_001_02 26665:0p0p* D KENNETH L WHISLER & 05-0 -02 268.OQ* ENfERANy? GWEN Y WHISLER 08-01-02 269.0 * PAYP AN 40 BRANDT LN CHANeEHE NEWVILLE PA 17241-8655 * INCL ES $3.00 SERVICE CHARGE 'EFI E INSURANCE GROUP 100 Erie Insurance Place • ERIE, PA 18630 -010171611101098961621400000001-00265000010TO00- CERTIFICATE OF SERVICE I hereby certify that I have this day served the foregoing document upon all parties of record in this proceeding in accordance with the req ' ements of Section 33.32 (relating to service by a participant). 'rlx Dated this 10 day of August, 2006. By First Class, U.S. Mail: Jenni Henley Allen, Esquin Nealon, Gover & Perry, 2411 N. Front St. Harrisburg, PA 17110 13 C- -Ti (TIlT C A R jj r?? ? ro o D C=_ r rn a o U l r KENNETH L. WHISLER Plaintiff, V. SHAWN W. WEAVER Defendant. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY : PENNSYLVANIA : CIVIL DOCKET NO.: 04-2784 : JURY TRIAL DEMANDED NOTICE OF PRAECIPE TO ENTER JUDGMENT BY DEFAULT To: Shawn W. Weaver, Jenni H. Allen, Esquire Date of Notice: September 21, 2006 IMPORTANT NOTICE YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILE IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN TEN (10) DAYS FROM THE DATE OF THIS NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOU WITHOUT A HEARING AND YOU MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE THIS NOTICE TO A LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE FOLLOWING OFFICE TO FIND OUT WHERE YOU CAN GET LEGAL HELP: Cumberland County Lawyer Referral Service Bedford Street, Carlisle, Pennsylvania 17013 (717) 249-3166 AVISO IMPORTANTE To: Shawn W. Weaver, Jenni H. Allen, Esquire FECHA DEL AVISO: September 21, 2006 USTED ESTA EN REBELDIA PORQUE HA FALLADO DE TOMAR LA ACCION REQUERIDA EN ESTE CASO. A MENOS QUE USTED TOME ACCION DENTRO DE LOS PROXIMOS DIEZ (10) DIAS DE LA FECHA DE ESTE AVISO, SE PUEDE DICTAR UN FALLO EN CONTRA SUYA SIN LLEVARSE A CABO UNA VISTA Y USTED PUEDE PERDER SU PROPIEDAD Y OTROS DERECHOS IMPORTANTES. USTED DEBE LLEVAR ESTE DOCUMENTO INMEDIATAMENTA A SU ABOGADO. SI USTED NO TIENE UN ABOGADO O NO PUEDE PAGAR UNO, VAYA O LLAME LA OFICINA ABAJO INDICADA PARA QUE LE INFORMEN DONDE PUEDE CONSEQUIR AYUDA LEGAL. Cumberland County Lawyer Referral Service Bedford Street, Carlisle, Pennsylvania 17013 (717) 249-3166 & KUTULAKIS, L.L.P Jas P. Kutulakis, Esquire Su eme Court ID#80411 36 South Hanover Street Carlisle, PA 17013 (717) 249-0900 Attorney for Plaintiff CERTIFICATE OF SERVICE I hereby certify that I have this day served the foregoing document upon all parties of record in this proceeding in accordance with the requirements of Section 33.32 (relating to service by a participant). Dated this 21St day of September, 2006. By First Class, U.S. Mail: Jenni H. Allen, Esquire Nealon, Gover & Perry, 2411 N. Front St. Harrisburg, PA 17110 Shawn W. Weaver 61 S. High St. Newville, PA 17241 J Jaso P. Kutulakis, Esquire Attorney for Plaintiff t? C. Cm cz? Q ' e;" cn Yl f f ?- ti l KENNETH L. WHISLER, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA VS. NO. 04-2784 - CIVIL SHAWN WEAVER, CIVIL ACTION - LAW Defendant NOTICE TO PLEAD TO: Kenneth L. Whisler, Plaintiff and his attorney, Abom & Kutulakis 36 South Hanover Street Carlisle, PA 17013 YOU ARE HEREBY NOTIFIED to file a response to the enclosed Answer with New Matter within twenty (20) days of service hereof or a judgment may be entered against you. Respectfully submitted, NEALON & GOWR By: Date: Jenni He a Allen, Esquire Attorney I.D. 84311 2411 No h F nt Street Harrisbur P 171108 (717) 232- Attorney for Defendant 6- t KENNETH L. WHISLER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. NO. 04-2784 - CIVIL SHAWN WEAVER, CIVIL ACTION - LAW Defendant ANSWER TO COMPLAINT AND NEW MATTER 1-5. Admitted based upon information and belief. 6. Denied pursuant to Pennsylvania Rule of Civil Procedure 1029(e). 7-8. Admitted based upon information and belief. 9. Admitted based upon information and belief. 10. Admitted based upon information and belief. 11-51. Denied pursuant to Pennsylvania Rule of Civil Procedure 1029(e). WHEREFORE, the Defendant respectfully requests that the Complaint be dismissed with costs to be paid by the Plaintiff. NEW MATTER 52. Paragraphs 1-51 are incorporated herein as if set forth in full. 53. Plaintiffs claims may be barred in whole or in part by the application of the PA Motor Vehicle Financial Responsibility Act. WHEREFORE, the Defendant respectfully requests that the Complaint be dismissed with the costs to be paid by the Plaintiff. Respectfully submitted, NEALONr6OVFR & PERRY Date: By: Jen i enley AIIen?Esq I. #: 84311 2 11 orth Front Street Harris urg, PA 17110 717/232-9900 VERIFICATION I, SHAWN W. WEAVER, verify that the statements made in the foregoing ANSWER TO COMPLAINT are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsification to authorities. ? Date: 9:2257-0(,o SHAWN W. WEAVER CERTIFICATE OF SERVICE AND NOW, this day of September, 2006, 1 hereby certify that I have served the foregoing Answer to Complaint and New Matter on the following by depositing a true and correct copy of same in the United States mails, postage prepaid, addressed to: ABOM & KUTULAKIS 36 South Hanover Street Carlisle, PA 17013 t_ P C -Ti . : T ? a KENNETH L. WHISLER Plaintiff, V. SHAWN W. WEAVER Defendant. TO: Jenni Henley Allen, Esquire Nealon, Gover & Perry, 2411 N. Front St. Harrisburg, PA 17110 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY PENNSYLVANIA CIVIL DOCKET NO.: 04-2784 JURY TRIAL DEMANDED NOTICE TO PLEAD YOU ARE HEREBY NOTIFIED TO PLEAD TO THE WITHIN PRELIMINARY OBJECTIONS OF PLAINTIFF WITHIN TWENTY (20) DAYS OF THE DATE OF SERVICE OF THIS PLEADING. rr , KENNETH L. WHISLER Plaintiff, V. SHAWN W. WEAVER Defendant. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY PENNSYLVANIA CIVIL DOCKET NO.: 04-2784 : JURY TRIAL DEMANDED PLAINTIFF'S PRELIMINARY OBJECTIONS PURSUANT TO PA.R.C.P 1028 Plaintiff, Kenneth L. Whisler, files this responsive pleading by and through undersigned counsel and preliminarily objects to Defendant's New Matter pursuant to Pa.R.C.P. 1028 as follows: 1. Plaintiff filed his Complaint on August 10, 2006. A copy of the complaint is attached hereto as Exhibit "A." 2. Plaintiff filed a Notice of Default on September 21, 2006. 3. Defendant filed an Answer containing a New Matter on September 27, 2006. A copy of the Answer with New Matter is attached hereto as Exhibit "B." PRELIMINARY OBJECTION I-DEMURRER 3. Defendant has alleged in his New Matter that the claim "may be barred by the Pennsylvania Motor Vehicle Financial Responsibility Act." 4. Defendant fails to specify which section of the Pennsylvania Motor Financial Responsibility Vehicle Act. 5. Defendant fails to state what cause of action they are describing in the New Matter. 6. The New Matter fails to provide notice to Plaintiff as to the cause of action. 7. Defendant's New Matter fails to state a cause of action against Plaintiff and therefore should be dismissed. WHEREFORE. Plaintiff demurs to the Defendant's New Matter and requests that the New Matter be dismissed. PRELIMINARY OBTECTION II-Insufficient Specificity of a Pleading 4. Defendant has alleged in his New Matter that the claim "may be barred by the Pennsylvania Motor Vehicle Financial Responsibility Act." 5. Defendant fails to specify which section of the Pennsylvania Motor Vehicle Financial Responsibility Act. 6. Defendant fails to specify any facts that support the New Matter. 7. The New Matter fails to provide sufficient specificity to Plaintiff in violation of Pa.R.C.P. 1028(a) (3). WHEREFORE, Plaintiff respectfully requests this Court to require Defendant to plead more specifically the averments of his New Matter. Respectfully submitted, ABOM&KUTCrLA"S, LLP Kathleen A. le, Esquire Supreme Court ID No. 200616 36 S. Hanover Street Carlisle, PA 17013 (717) 249-0900 Attorney for Plaintiff CERTIFICATE OF SERVICE AND NOW, this -e day of October, 2006, I, Kathleen A. Engle, of ABOM& KUTULAKIS, LLP, hereby certify that I did serve or caused to be served a true and correct copy of the foregoing Preliminary Objections by First Class Mail on the following: Jenni Henley Allen, Esquire Nealon, Gover & Perry, 2411 N. Front St. Harrisburg, PA 17110 7 /kn A. En qutre EXHIBIT "A" KENNETH L. WHISLER : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY Plaintiff, : PENNSYLVANIA V. CIVIL DOCKET NO.: 04-2784 SHAWN W. WEAVER Defendant. : JURY TRIAL DEMANDED NOTICE TO DEFEND You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the court, your defenses or objections to the claims set forth against you. You are warned that if you fail to do so, the case may proceed without you and a judgment may be entered against you by the court without further notice, for any money claimed in the Complaint or for any other claim for relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Lawyer Referral Service ? Bedford Street, Carlisle, Pennsylvania 17013 x (717) 249-3166 - c7 f^ NOTICA Le han demandado a usted edn la corte. Si usted quiere defenderse de etas: demandas expurestas en las paginas signiuentes, usted tiene veinte (2) dias de p!4-0 al .r- partir de la fecha de la demands u la notificacian. Usted debe presentar una apnegia c, escrita o en persona o por abogado y archivar en la corte enforma escrita sus defenses sus objeciones a las demandas en contra de su persona. Sea avisdo que si usted no se defiende, la corte tomara medidas y piede enrrar una orden contra used sin previo aviso o notificacion y pox cualquier queja o alivio que es pedido en la peticion de demanda,. Usted puede perder dinero o sus propiedades o otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABOGADO INMEDIATEMENTE. Si no tiene abogadi o si no tiene el dinero suficiente de pagar tal servicio, vaya en persona o llame por telefono a la oficina cuya direccion se encuentra escrita abajo para averiguar donde se puede conseguir asistencia legal. Cumberland County Lawyer Referral Service Bedford Street, Carlisle, Pennsylvania 17013 (717) 249-3166 OM KENNETH L. WHISLER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY Plaintiff, PENNSYLVANIA V. CIVIL DOCKET NO.: 04-2784 SHAWN W. WEAVER Defendant. JURY TRIAL DEMANDED COMPLAINT AND NOW, this 1?) day of August 2006, comes the Plaintiff, Kenneth L. Whisler by and through his attorney, Jason P. Kutulakis, Esquire of ABOM & KUTULAKIS, L.L.P., and files this Complaint against the Defendant, Shawn W. Weaver as follows: 1. Plaintiff Kenneth L Whisler (hereinafter "Whisler"), is an adult individual residing at 40 Brandt Lane, Newville, Cumberland County, Pennsylvania 17241. 2. Defendant Shawn W. Weaver (hereinafter "Weaver"), is an adult individual residing at 61 S. High Street, Newville, Cumberland County, Pennsylvania 17241. 3. Defendant Weaver's operator's license number is 24852384. 4. On or about June 18, 2002, at approximately 10:30 a.m. Plaintiff Whisler was operating an automobile in Cumberland County, Pennsylvania 5. Plaintiff Whisler was operating his vehicle as it traveled westbound on SR 641. 6. Plaintiff's vehicle had fully operational taillights, brakelights, and turn signals. 7. Defendant Weaver was operating his vehicle as it traveled westbound on SR 641. 8. It is believed and therefore averred that Defendant Weaver was the owner of the vehicle he was operating at the time of this accident. 2 9. An unknown vehicle was traveling some distance in front of Plaintiff Whisler's vehicle as he traveled on SR 641. 10. The vehicle Defendant Weaver was operating was traveling some distance behind Plaintiff Whisler's vehicle as the two vehicles traveled westbound on SR 641. 11. An unknown vehicle, traveling in front of Plaintiff Whisler, prepared to make a left turn from SR 641 to Mountain Rock Road. 12. In preparation for that turn, the unknown vehicle reduced in speed and eventually stopped. 13. In observance of the unknown vehicle slowing down and eventually stopping on SR 641, Plaintiff Whisler safely reduced the speed of his vehicle and eventually stopped behind the unknown vehicle. 14. Plaintiff Whisler's vehicle remained stopped behind the unknown vehicle waiting to turn left onto Mountain Rock Road. 15. Plaintiff Whisler came to a frill, legal stop in observance of the unknown vehicle preparing to make a left turn that had also stopped. 16. At the same time and location, as Defendant Weaver's vehicle continued to drive westbound on SR 641, it began to approach the intersection at Mountain Rock Road. 17. At the same time and location, Defendant Weaver's vehicle approached the area in the road occupied by Plaintiff Whisler as it sat behind the unknown vehicle. 3 18. As Defendant Weaver operated his vehicle, he caused the front end of his vehicle to violently collide with the rear end of the vehicle being operated by Plaintiff Whisler. 19. Defendant Weaver was operating his vehicle in a negligent manner, so as to cause the front end of his vehicle to violently collide with the rear end of the vehicle being operated by Plaintiff Whisler. 20. Defendant Weaver was operating his vehicle in a careless manner, so as to cause the front end of his vehicle to violently collide with the rear end of the vehicle being operated by Plaintiff Whisler. 21. Defendant Weaver was operating his vehicle in a recklessly indifferent manner, so as to cause the front end of his vehicle to violently collide with the rear end of the vehicle being operated by Plaintiff Whisler. 22. Prior to impact, the Defendant failed to engage his vehicle's braking system. 23. The Defendant's car collided into Plaintiffs vehicle without braking whatsoever. 24. Following the collision, at 11:10 a.m., the Defendant told Pennsylvania State Police Trooper Chad F. Sydnor, that "I looked back at my daughter who was in the back seat. When I looked up, the car in front of me was stopped. I hit the car." (Attached Exhibit A at p. 8.) 25. The accident was directly and proximately caused by Defendant Weaver's negligent, careless, and recklessly indifferent behavior which breached the Defendant's duty to operate his vehicle in a careful manner, and such negligent, careless, and recklessly indifferent behavior consisted of the following: 4 (a) operating Defendant Weaver's automobile at a high and excessive rate of speed under the circumstances; (b) failing to maintain Defendant Weaver's automobile under proper and adequate control; (c) failing to keep a proper lookout for the automobile being operated by Plaintiff Whisler which was legally stopped in observance of a vehicle stopped ahead; (d) operating his motor vehicle with no warning of approach or intended direction; (e) failing to have his motor vehicle under the proper control so as to stop said vehicle within the assured clear distance ahead; (f) failing to use due care under the circumstances; (g) failing to notice the Plaintiffs motor vehicle; (h) failing to take evasive action in order to avoid impacting with Plaintiff's vehicle; (i) failing to apply his brakes in sufficient time to avoid striking Plaintiff Whisler's stationary vehicle; 0) operating his automobile in such a manner as to collide with the rear of the automobile being operated by Plaintiff Whisler, which was legally stopped; (k) operating his automobile without due regard for the rights, safety, well being, and position of Plaintiff Whisler under the aforesaid circumstances; (1) operating his automobile in violation of the ordinances of Cumberland County and the statutes of the Commonwealth of Pennsylvania pertaining to the operation of motor vehicles on the public highways; 5 (m) failing to maintain visual contact with the road in front of his vehicle, including a failure to maintain his attention and exercise of due care towards those automobiles directly in the path of his own. (n) such other acts of negligence, carelessness and recklessness as may be determined through the process of discovery and/or at trial. 26. At all times material hereto, Plaintiff Whisler acted with due care and was not contributorily negligent. 27. As a direct and proximate result of the collision and Defendant Weaver's careless conduct, Plaintiff Whisler was injured. 28. As a direct and proximate result of the collision and Defendant Weaver's negligent conduct, Plaintiff Whisler was injured. 29. As a direct and proximate result of the collision and Defendant Weaver's recklessly indifferent conduct, Plaintiff Whisler was injured. 30. Defendant's failure to operate a vehicle at such a speed which would permit the driver to bring his vehicle to a stop within the assured clear distance ahead is a violation of 75 Pa. C.S.A. § 3361. 31. Pennsylvania State Tropper Chad F. Sydnor charged Defendant Weaver with violating 75 Pa. C.S.A.§ 3361, because of Defendant Weaver's failure to operate his vehicle at such a speed which would permit Defendant Weaver to bring his vehicle to a stop within the assured clear distance ahead and thus avoid colliding with Plaintiff Whisler. 32. On 6/27/02, Defendant pled guilty to this violation of 75 Pa. C.S.A.§ 3361. (Attached Exhibit B.) 6 F 7111. 33. Defendant's conduct and plea of guilty to 75 Pa. C.S.A. § 3361, failure to maintain as assured clear distance, constitute Negligence Per Se. 34. As a direct and proximate result of the aforesaid collision, Plaintiff Whisler has suffered serious and permanent injuries, including but not limited to the following: a. Strain and sprain of the muscles, tendons, ligaments and other soft tissue at or about the cervical spine. b. Neck pain with left radicular-type symptoms in the left- upper extremities. C. Numbness and tingling that radiates in the spinal cervical area down his arm to mainly the middle two fingers of his left hand. d. Chronic denervation changes at the Abductor Pollicis Brevis e. Prolonged left Median Distal Motor Latency. f. Prolonged left Median Sensory Latency g. Aggravation of and post-traumatic progression beyond that which would have occurred absent the trauma from this collision. h. Post-traumatic left carpal tunnel syndrome. i. Decreased range of motion for left-upper extremities. j. Contusions. k. Severe headaches. 35. As a direct and proximate result of the aforesaid injuries, Plaintiff Whisler has undergone and in the future will undergo great pain and suffering for which damages are claimed. 7 36. As a direct and proximate result of the aforesaid injuries, Plaintiff Whisler has suffered and may continue to suffer a loss of earnings for which damages are claimed. 37. As a direct and proximate result of the aforesaid injuries, Plaintiff Whisler has and/or may in the future incur a loss of earning capacity for which damages are claimed. 38. As a further result of the aforesaid injuries, Plaintiff Whisler has sustained a permanent dimunition of his ability to enjoy life and life's pleasures for which damages are claimed. 39. As a direct and proximate result of the aforesaid collision, Plaintiff Whisler sustained damages due to his personal, physical injuries, pain and suffering, inconvenience, discomfort, and loss of life's pleasures, all of which are continuing into the future, and which Plaintiff Whisler believes will result in some permanent disability, for which damages are claimed. 40. As a direct and proximate result of the collision and Defendant Weaver's careless, negligent and recklessly indifferent conduct, Plaintiff Whisler has incurred, and in the future will perpetually incur, reasonable and necessary rehabilitative costs and expenses for medical treatment and physical therapy due to a likely permanent physical disability in an amount not yet ascertained. 41. As a further result of the aforesaid injuries, Plaintiff Whisler has incurred or may hereinafter incur financial expenses and losses which exceed sums recoverable under the limitations and exclusions of the Pennsylvania Motor Vehicle Financial Responsibility Law for which damages are claimed. 42. Plaintiff Whisler was the named insured on a policy of insurance issued to him by the Erie Insurance Group bearing policy number Q09 2940006 which was in effect on the date of the above-referenced collision. Plaintiff selected the full tort option regarding that policy. A copy of the declaration page of said policy is attached hereto and incorporated by reference herein as Exhibit C.) Therefore Plaintiff Whisler remains eligible to claim compensation for non-economic loss and economic loss sustained in this collision pursuant to applicable tort law. 43. Plaintiff Whisler sustained a serious bodily injury in this collision which has caused him a serious impairment of bodily function. Therefore, Plaintiff Whisler remains eligible to claim compensation for non-economic loss and economic loss sustained in this collision pursuant to applicable tort law. 44. As a direct and proximate result of the collision and Defendant Weaver's careless, negligent and recklessly indifferent conduct, Plaintiff Whisler's automobile was damaged to Plaintiff Whisler's detriment and financial loss 45. Plaintiff Whisler and his own insurance carrier have incurred costs of repairing the damage caused by Defendant in this collision. 46. As a direct and proximate result of this collision, Plaintiff Whisler has been unable to follow his usual occupation, and Plaintiff Whisler believes that he will likely be permanently unable to resume this occupation, whereby he has lost the income which would have come to him through this employment. 47. As a direct and proximate result of this collision, Plaintiff Whisler has sustained said injuries and disability, and by reason of these injuries and disability, Plaintiff Whisler was compelled to, and did employ a substitute drill- 9 operator to perform Plaintiff Whisler's duties. Employing this substitute drill- operator caused Plaintiff Whisler to incur additional financial liabilities that would have otherwise not been incurred had Plaintiff Whisler been physically able to operate the drill. 48. Additionally, since the substitute drill-operator has resigned, Plaintiff Whisler has been unable to find another suitable replacement, and as such Plaintiff Whisler and, his well-drilling business have been unable to operate this drill. This inability to operate the drill has prevented Plaintiff Whisler from pursuing and obtaining multiple drilling contracts, and as a result Plaintiff Whisler has incurred substantial losses. 49. As a direct and proximate cause of this collision, Plaintiff Whisler will likely never be able to operate a water drill again, causing him to incur permanent damage to his earning capacity. 50. Plaintiff Whisler also demands such other damages that the court finds just at trial. 51. Plaintiff Whisler has made a demand for compensation of the aforesaid injuries and losses, which Defendant Weaver has failed and refused and still refuses to pay. 10 WHEREFORE, Plaintiff Whisler demands judgment against Defendant Weaver in an amount in excess of the mandatory arbitration limit together with the cost of suit, interest, and delayed damages as allowed by law. ABOM & KUTULAKIS, L.L.P. JasP. Kutulakis; Esquire Su reme Court ID#80411 36 South Hanover Street Carlisle, PA 17013 (717) 249-0900 Attorney for Plaintiff 11 VERIFICATION Kenneth L. Whisler, being duly sworn according to law deposes and says that he is the Plaintiff, and that the facts set forth in the foregoing Complaint are true and correct to the best of his information and belief. Kenneth L. Whisler 12 1 A ,,W, Numb,,, POLICE REPORTING FORM NIA ???.s?? ?? 9CbNew P0425867 L!E Case Closed 1 Change/ i - -I-- AA 45 1 1 Page: Yes No : Continuation --- Police Agency Patrol Zone Incident Num,r)<, _- ---- -? ' ? 0 2 2 Noz-1 Z(dS 199 p' Agenr), Name - Precinct Invest; ation Date (MM.DD-YY" 0 2 co 0 D.,pa_tch Time t,i Arriva Time fmr)j Invesator- Badge Number a 1 _? 3 i9 T-15 2 Qs` G11 /w if 5` tbko+? o S J 4 Reviewer Bade Number Approval Date (MM- in f° 3 -?J- Count Coun Name Municipality Municipality Name Dav of Weems O Sun 0 2 ; LS Md IXL *ui t'Z . L c? ??1L4.B?J?v p Crash Di-tc IMM DD YYYY) T Crash Time (Mlhtar) No of U is No f People No In ured No Killed ?If > Od, Mon O Ff1 lets lift Tuff 0 1 i ) -- I ?'2 C7r 2 'J Form: ,z.? ! oT3 _ y rr,, I? o AA 45 r 1) O Wed C:) .I? v Reportabl Crash Notify NigMevay Maintenance School Bus Related School Zone Related PennDOT Property No Yes ACMPNo __,? 40 Yes No Ye, A30 No I' Yes 11120 No O Yes 4IMO 7 I -- --- F I Unit Number in Motor Vehicle in IJ Hit & Run Vehicle 0 Illegally Parked O Legally Parked O Non • Motorizedr Delete? Tya Transport Q ' Unit IL Pedestrian - Pedestrian on Skates, O Disabled From in Wheelchair, etc Previous Crash O Train O Phantom Vehicle Owner Last Name (rf Pedestrian, skip to form AA 45 3 1) ` ' ? ' _ Fl MI Telephone Number In ? ? ? Vehicle o Address (b ` 5 K rGll 5 r -_ City State - E 1»v rtiL F Qp zip 1124 CD Yes 4-9 No E Viet - -- ,t - -- - r F S iL- I M Model Year 4,C11 i 9! S 5 1 ?Q ? Vehicle Make" Z. F Yes, Complete (If Form. AA 45 C 1) Li en;e Plate Z.as?1.3? - _ Reg. State Travel Speed Q ?hys *Refer to List on Back of Overlay zy zy Insurance Company Insurance Un- ? Yes No known' A?1. Sn.cr; Policy NO L IS S3 y.'?l? Insurance Company Pfloney :t, 1?1 11 (j.? rJ??. Vehicle Towed Towed To `- Towed By Tow Agency Phone ? Yes s No Unit Number a Motor Vehicle in 0 Hit & Run Vehicle O Illegally Parked O Legally Parked O Non - Mc ----T Delete? R.De Transport C7 Z• Unit Pedestrian (._ j Pedestrian on Skates, Disabled From Train in Wheelchair, etc Previous Crash 0 O Phantom skip to Form AA 45 3 1) FI MI Telephone Number Owner Last Name (N Pedestrian _ , I - -- --r--t - -T - T tr ?' L" H l ?- ? commerrrlal 'S ` Vehk/e Address 'V 6 • Ci State d ® i c uG TL P N - S f li ? C Zip ll `?51 j Q Yes 4 No a e j, " 4v , t r %.*,cu o VIN Model Year /---+--r-----?- 1? U L1 ? G Lb r Vehicle Make* (M Yes. Compeeei Form: AA 45 C 1 - o License Plate Reg. State Travel Speed ] 3 p O "Refer to List on Back of Overlay - Insurance Insurance Company Policy No Insurance Company Phone; Yes No dIP to S? Un' ' q ?c?--??i -yam(, j/ . _. known;--°--------- -- _v_ehicle Towed Towed r--__._?--_ -- Towed By Tow Agency Phone Yes tp No EXHIBIT ; FO-M ` GA AS .71 711 PENNDOT COPY K `Q COMMONWEALTH OF PENNSYLVANIA POLICE CRASH REPORTING FORM AA 45 2 1 00-1644; Page: Z i. Unit NwnL"r f!0di0'J_U!lt1(?J TyVC of 1lm! 5-Camper Number 1.-Towmy Pass] nggr Veh 6=Trailer rO y of Trailmg 2=Towing Tr.-?k 7=Semi-Trailer Units: 3=Towing Utility Trailer 8=Other 4=Mobile or Modular Home 9=Unknown 4 hii!" _49_4r Vehi0e M2 0 A E 0 V L v 3, r.?. ?rr. 08=6old 01-Aulomobile -.Vhne 09=8(own ; 02=Motorcycle 04=Green 10=Orange 03=8us 05=Black 11=Purple ( 04=Small Truck 06=Yellow 12=0ther OS=large Truck 07=Silver 99=Unknown; 10=5nowmobile ____ --- - -----._.--- -'-L- ------T - t ?Ly? Crash Nu'm)er -06 New P0425867 Change! i I _. ' .. _. T. Continuation r - ' y Tag No ( I Tag Year J= Tag State ' ? Tag No -- --- Tag Year State Tag 11=farm Equip 22=14orse and Buggy 12=Construction Equip 23=Horse and Rider 18=Other Type Special Veh 24=Train 19=Unknown Type Special Veh 25=Trolley 20=Unicycle, Bicycle, Tricycle 98=0ther 21=0ther Pedalcycle 99=Unknown l J'X !mprtcc Pel-1 t ',Z Damage Indicator 5 1 wt dc Role J I 11 .11.. 01 - 0-None J 10;' ';02 04 / - 03 08 / ; as u7 )6 05 00=Non-Collision ' 1=Minor (Driveable) O=Non-Collision i 2=Functional 1=5triking (Moderate Damage, 13=Top 2=Struck May Not be Driveable) 3=Both Striking 14=Undercarriage 3=Disabling (Severe - and Struck 15-rowed Unit 99=Unknov,rn Not Driveable) 9=Unknown ---- --------- r!^ hv2.ol --; r?oeCIDt'nt 1 I 074ntering a Parked j_r71 Position " 01=150ng straight 08=Trying to Avoid Animal, r'=r'crr r 01=SlowingiStoppmg in Lane Ped, Object, Veh, etc S=urd, 03=Stopped in Traffic Lane 09=Turning Right on Red E=East w=/`J+at Oa __.Passing%Overtakmg Veh 10=Turning Right 11=1urning Left on Red U=Unkn„v,n 05=leaving a Parked Position 12=Turning Left 06 Parked 13=Making a U-Turn Usaae r? 12=Commercial 00=Not Applicable 01=Fire Veh Passenger Carrii 13=Taxi 02=Ambulance 21=1ractor Trailer x 03=Police 22=Twin Trailer 08=Other Emergency 23=Triple Trailer Vehicle 31=Modified Veh 11=Pupif Transport 99=Unknown Vehicle Position , 00=Not Applicable 01=Right Lane (Curb) 01=Right Turn Lane 03-Left Lane 04=Left Turn Lane OS=2-Direction Center Turn Lane 06=Other Forward Moving Lane 07=Oncoming Traffic Lane 15-Backing Up GrAdhw (; "i 1Changing lanes or Merging 1=Level Roadway 16=Negotiating 2=Uphill 08=Left of Trafficway 09=Right of Traffrcwa 10=HOV Lane 11=Shoulder Right ' 12=Shoulder Left 13-One Lane Road 98=Other 99-Unknown 3?Downhill .' 4--Sag/Bottom of Hill S=CrestlTop of Hill 9=Unknown Curve - Right 17=Negotiating 7=Straight Curare - Left 96=0ther 2=Curved 99=Unknown 9=Unknown Unit Number .O. 2. V "'>'chv f.,l;„ 41 1 - tth„• WmKed 03- White 04-Gr-?e•n 05_P,tack 06- . low (iT-)it: . C c (`o tc I a' ?7 (rFliljl g Unn 1 TyPt' of -!rail 1=Towing Passenger Veh 5=Cam et 6=Trailer 1 '? f f Tag No Tag (? L I Sta Number i T k T er T i l _ _ J Yea ---J ge ruc 2- ow ng of b Units: 3=Towing Utility Trailer 7=Sem - rai er 8=01her 1___, ? Tag No 1 _ ? Tag _ Tag 4=Mobile or Modular Home 9=Unknown - Year state D ' I l,t,lt' ryep o y ! 1 Saecraf ? ? _ 114,10 1 _-_.l _- 12=Com mercia l 08=Gold 0t=Automobile 11=farm Equip 22_ forse arid Buggy 0g=0rown 02=Motorcyde 12=Construction Equip 23=Horse and Rider 10-0rang•- 0-aus 18=Other Type Special Veh 24=Train 11-Purple 04=Small Truck 19=Unknown Type Special Veh 15=Trolley 12 :Other 05.1argt• Truck 20=Unicycle, Bicycle, Tricycle 98=Other 99z Unknown tOrSnowmahlle 21 =Other Pedalcycle 99=Unknown OOaNot AppNtable 01=Fire Veh 02=Ambulance 03=Police US-Other Emergency Vehicle 11 =Pupil Transport Passtnger Cprrler" 13=Taxi `, 21 =Tractor Trailer 22=Twin Trailer 23=Triple Trailer 31=Modified Veh 49=Unknown qu(:? _ imnotr.pS,rn1 ?,J'6 D?m?yS_Indr'"eaty1 y I V i le Role ? Vehicle Position FO---.Q 0=None I- i i (: 00=Nat Applicable 1 . . -. • . 1=Minor (Driveable) O=Non-Collision 01=Right Lane (Curb) tn, 02 OG .Non CoUrsion I 2=functional 1=Striking 02=R1 ht Turn Lane 03 13-Top (Moderate Damage, 2=Struck 03=Left Lane 04-Left Turn Lane . 0 May Not be Driveable) ld=Underrarrage 3=13oth Striking 0562-Direction 4 3=Disabling (Severe - and Struck Center Turn lane G7 05 G 15_T,)vjed Unit Not Driveable) 99 k U 06=Other Forward Moving Lane e n nown = 9=Unknown 07=Oncoming Traffic Lane C+r n r^! - - Movement 07=Entering a Parked 0 2 14=Backing Up s : r a Position 15=Changing Lane 08=Trying to Avoid Ani 01 Going Straight mal, or Merging 1=level Roadway N Nort'i Ped, Object, Veh, et 01=. SlowhtgtStnppiny in Lane c 16=Negotiating 2=Uphill =S" th 01:Srnntred in tralTir. Lane D9---Turning Right on Re d Curve -Right r l + 10=Turning Right 04 P ,ssm9/C' er aking ?eh 17=Negotiating Alignment r j 1 11=Turning Left on Red Curve -Left r.n q a Parked P,, tion 17=Turning Left 98cOther u 13=rv1aking a U-Turn 99=Unknown ` 08=Left of Trafficway 09=Right of Trafficwa 10=HOV Lane 11=Shoulder Right 12=Shoulder Left 13=one Lane Road 98=Other 99=Unknown 3=Downhill 4=Sag/Bottom of Hill S=Crestlfop of Hill 9--Unknown 1=Straight} ro? 2=Curved 9=Unknown Ax .;: t COMMONWEALTH OF PENNSYLVANIA J POLICE CRASH REPORTING FORM AA 45 3 1 00164 Page: 3_. Crash Number 00 New P0425867 Change! Continuation Unit Number Last Name ? 1 1:N E p `t -? -?R'-1- Address License Number _ 2 F4 !, t .3 ?g?_ - __ FI? MI Telephone Number _ S??1__ I i I U iA L I'll -_n4r-`13GZ City State Zip State p? if License Number Is unknow driver isnot licensed, sae ma 0 AkohobDrugs Suspected to No i_ Illegal Drugs (J Medication Alcohol O Alcohol and Drugs CD Unknown o C Acohol rest Type 51 0 lest Not C,iven i- i Breath ( i other _ Blood `.j Urine 1--a ow it Test Given a a Alcohol rest Results Unknown Test Refused j Results > , Test Given, u 0 ? - ! Contaminated Results - Pedestrian a Driver or Pedestrian Physical Condition r Q Apparently _ [Ilegat Drug Fatigue -.J Medication Normal Use - Had Been Drinking Sick Asleep ! Unknown -- Signal at Scene of Gash O No Pedestrian Signal O Not at Intersection O Pedestrian Signal Pedestrian Location O In Roadway < 10 feet } O Marked Crosswalks at Intersection O Not in Roadway Off Road > 10 Feet Ion • No O C l O Median - Off Road rosswa ks O Island O Outside Tra ffki O Cross ter section Crosswalks O Shoulder Shared Paths/ 4% O Trails = O Driveway Access O Sidewalk O Unknown Vehicle Corse List any Vehicle Code Section this driver has Chargged with - violated and mark if they were charged. ViolationT %; ?33G 1 40 Yes CD µ A, O Yes C lui OwnerrDriver 00=Not Applicable 03=Rented Vehicle 08=Other Municipal Driver Presence a " 01=Private Vehicle owned/ 04=State Police Vehicle Government Vehide 1=Driver Operated 3=Driver fled Scent C- Leased by Driver 05=PennDOT Vehicle 09=Federal Gov Vehide IT - r Vehicle 4=Hit and Run 02=Private Vehicle Not 06=Other State Gov Vehicle 98=0ther 2=No Driver 4=Unknown OwnedrLeased by Driver 07=Municipal Police Vehicle 99=Unknown Unit Number Last Name FI MI Telephone Number X14 15 1L -15 It Address City State zip r[" - f Pp ? ? y License Number State .Z 6 e; , N License Number is unknown of .°k? S' Z 3 i 4 f , . :. _ --- - ~-- -- driver is not licensed, see manual ?.i' -- - - - Alconoh'Drugs Suspected Pedestrian Signal at Scene of Crash o 40 No Illegal Drugs !__` Medication '' y psp _; No Pedestrian Signal O Not at Intersection 0 0 Alcohol Alcohol and Drugs Unknown C O Pedestrian Signal p C Alcohol Test Type C Pedestrian tocation < 10 feet rJ In Roadway 0 A ? Test Not Given Breath Other off Road < {.t' 21 O Marked Crosswalks e at Intersect on O Not in Roadway 1 '"`" - _ Blood r- Unknown if Urine ?- Test Given 0 feet > a r? At Intersection - No O Median O Off Road v a -. _. __ . __.. ------- -_ . __.----_-_----- Alcohol Test Results R Crosswalks ` O Island O Outside Traffkway a ? Unknown Test Refused Results Gi Q T w Non-Intersection Shared Pathsl ey:, O Crosswalks O Shoulder CD Trails - ven, est - - Contaminated Results Unknown a Q Driveway Access (7J Sidewalk d Dri. er or Pedestrian Physical Condition Vehicle Code List any Vehicle Code Section this driver has Charged wltb .. violated nd k if h h d i X ab Apparently r- Illegal Drug J: fatigue ( 3 Medication a mar t ey were c arge . V o boot ' . Q , Normal Use Had Been ' Sick Asleep r i Unknown O Yes d tYo, Drinking - -- ?? O Yes O No- Ov. rei D r iv^ r 00=Nut Applicable 03=Rented Vehicle 08=Other Municipal Driver Presence _ _ _ 01=Private Vehicle Owned' 04=State Police Vehicle Driver 05=PennDOT Vehicle Leased b Government Vehicle 1=Driver Operated 3=Driver Fled Scene 09=Federal Gov Vehicle y Z O Vehicle 4=Hit and Run 02=Privatc• Vehicle Not 06=Other State Gov Vehicle 98=Other i Owned.Leased by Driver 07=Municipal Police Vehicle 99=Unknown =No Driver 9=Unknown 4 J t??p COMMONWEALTH OF PENNSYLVANIA -J POLICE CRASH REPORTING FORM AA 45 4 1 001648 Page: r.r;,si, t;uII ix„ 4F New P8425867 -, Change; I - i -J Continuation ?"? ;.<.,., r t J Uti.. ,ot n Ps; ;enq r: Gtcupant E Safety EqufpmentOne:_ 00=None Used / Not Applicable - a:,ss- n _r 01=u:!-: er -Ali venires P iti i dl 01 =Shoulder Belt Used 02=Lap Belt Used 7-Pe csvia r . on os e 0?-i ront Seat M d 0"- runt Seat Right Side 03=Lap And Shoulder Belt Used 04=econd Row - Left Side Or 04=Child Safety Seat Used Motorcycle Passenger OS=Motorcycle Helmet Used . l d l U 05_'iecond Row - Middle Position met e He se 06=Bicyc 06- ',econd Row - Right Side 10=Safety Belt Used Improperly t =remale 077 hind Row Or Greater - 11 =Child Safety Seat Used Improperly 12= Helmet Used Improperly . M=frlale U -Unkna:vn Left Side 08=Third Row Or Greater- 90=RestralntUsed, Type Unknown Middle Position 99=Unknown 09=Third Row Or Greater Right Side 10=Sleeper Section Of Truckcab F Safety.EgIiJA nenf?N!a oO=None-Userl/NotApplieable 1nf:jry Severity. C O=Notln;urnd 11rinOther Enclosed 01=Front Air Bag De loyed (For This Seat) F Thi i S d 1=Ki11ed ?assenger Or Cargo Area oye or s eat) 02=side Air Bag Dep ( 2=htajor Injury d 12=1n Open Area Etc.) (Back Of Pickup ? g 03=OtherType Air Deployed 04=Multiple Air Bags Deployed ' erate 3=Mo injury , 13=Trailing Unit 05=Motorcycle Eye Protection G_r,!inor Injury 14=Riding On Vehicle Exterior 06=15icyclist Wearing Elbow/Knee/ d 9=Unknown 15=11usPassenger 98= OtF,er Other Pa s 10=Air Bag Not Deployed, Switch On 99=Unknown 11=Air Bag Not Deployed, Switch Off 11=Air Bag Not Deployed, Unit Switch Setting 13=Air Bag Removed (Prior To Crash) 19=Unknown if Air Bag Deployed 99=Unknown Ejection: G O=Not Applicable 1=Not Ejected 2=Totally Ejected 3=Partially Ejected 9=Unknown Ejection Path: H O=Not Ejected /Not Applicable.,, 1=Through Side Door Opening ? 2=Through Side Window , ^} r 3=Throug1 Windshield 4=Through Back Door S=Through Back Door Tailgate Opens 6=Through Roof Opening (Sunroaff Convertible T Down 7=Through Roof opening (ContfertlC? ' Top Up) 9=Unknown WoOpplicable 1=1ilot Extricated 2=Extricated By Mechanical Means -` 3=Freed By Non -Mechanical Means`. B:Other 9=Unknown ?t M {, ,t!40 Pnr,on No Date of Birth (MM•DD-YYYY) AA 0 LL U ( E FF ?E3 _ D?tete7 -S o?G i-j 1,`1 T] S-1 D? ? D_ L° 3 L! I ?Ii°J1?il 9 nn. Addr? v. r Pholle 'S 1I Iioow 1 to 1? fr.ti. O Yes a T NO Person No Date of Birth (MM-DD-YYYY) A B C D E F G H I "r Delete? -O it - 'l i0 j-rs it -?I? ?F IF6 F6T y o own _...... .1._.__. -.-_?.?.? n.= Address,'Phc,ne -_-_ -?_--`--?"--•?---V_-,- EMS Transport„ Qtr?<iGc.? V'?#VQIt. O YeS ®-No t Nu PerSOn No Date of Birth (MM•DD-YYYY) A B C D E F G H Delete? 1-061 se Address; Phone --- _ _ _. _ - -----_- - --- .-- --_- _-- EMS Transport. r s Lr O Yes a No L.rU ti? ti ___-- ?? F N L >: rN No Person No Date of Birth (MM-DD-YYYY) A B C D E3 F G H I Deletes - IL .? 7- P;1 ie r Addres / Phone EMSTranspo(t?i. 77A I.. kt0 55(o Rte} vnl 11b1 )+fwvril. LqeAPP 17z41 1I,-116 119 OYes No No Person No Delete? Date of Birth (MM OD-YYYY_) A B C D E F G H 1 ?_?DDDDDDCDDDDDCD e Address / Phone EMSTronsport.. O Yes O No No Person No Date of Birth (MM-DD-YYYY) A B C D E F G H I - --- {- ? s --?---? --? Deletes D - El El -11-1 F] e / Address 'Phone ------------------------ EM Transport - -- --- - -- _? O Yes O No -d "A ,. 1, i.! COMMONWEALTH OF PENNSYLVANIA POLICE CRASH REPORTING FORM AA 45 5 1 00IG49 Page:. r- I Crash (dumber "New P0425867 Change e o Inter-, crr r; r, n._ - intersection ction Of Ramp pecial LOCdrIOn o Mr'bf;xk Traffic Circle/ G' Not Applicable CD Bridge O Cross Over Related Round About Crossover 4 'P1a; (r.;e 5'.•. Jn . U Underpass CJ Tunnel (3 Driveway/Parking to a "T' i : , ;ecuon ;0 Multi-Leg Railroad Crossing C Intersection O Ramp CD Toll Booth CD Ramp & Bridge ?:D On Ramp ?- Other (If 'Ramp" is indicated, plea.e see manual) Unknown . Complete the Principal Road Section for all type of crashes. For crashes at intersections, enter Information in the Intersecting Road Section or the GPS= Section. If you have a midbloc c crash, you should enter information in the 'Distance from landmark" Section, the GPS Section, or the House 'Numberg Section in the Principal Road area. V o y Route Number Segment (Optional) Travel Lanes Speed Limit House Number (if appBcable)'-, _ Q North , -?-, ?--? - - -- -, ---?-- - J y S o South ., I ! ? L ! I ( L a _ _ _.- . - _ Street Name- _ Street Ending East? -1-- .? m iW West rt ?? 0 Unknown ?? W -- - --_ ----- - --_ ._ - - 1 - - ._. - _._-' R Si i - -- t gn ng --- ou e Interstate --; Turnpike _ Turnpike 0 State County C Local Road Private Other/ -- (Not Turnpike) _ (East/West) Spur Highway Road or Street Road Unknown '. p" County Route Number Segment (Optional) Travel Lanes Speed Limit " 'Q North ?° 0 0 South ° C) East a Street Name Street Endin •- g - _. i - - i OWest 0 U k ?-L , -LT1 k n nown _ __ Route Signing - -- --- - - - ----.._ e interstate Turnpike Turnpike State _J County CD Local Road CD Private C7 Other/ - 5 (Nut Turnpike) (East/West) Spur Highway Road or Street Road Unknown Intersecting Rt Num Or Mile Post Or Segment Marker r Feet , L ? 0 North A __' • . _ _ .. ?L- L?J Q South Or Intersecting Street Name St Ending East J ." Enter cD West 's. Or Miles E Information f 80 TH - -- - - - - - . - - -- -- -- N N ? o ,i d or -- - 4 rks ' Intersecting Rt Num Or Mile Post Or Segment Marker - Landma ,1 using N th -J 4 Distance From Crash 'i~- or This Option : ' Scene to Landmark 1 y.J .4 CD South r Or Intersecting Street Name St Ending Q East -- --- - (for Crash between Landmark f and r i 0 0 West 1 L F Landmark Z) Degrees Minutes Seconds Degrees Minutes Seconds v, o V Latitude: Longitude; -r??-? ?2 3 • / S Z 1 J^ I (O? __ Traffic Control Device Passive RR TCD Functioning ; --- " Stop Sign Crossing Controls ID Not Applicable Police Officer or i ld ; 4P No Controls C? Device Functioning 0 Emergency - S Fiashing Traffic -- Yie gn Flagman Improperly Preemptive Signs) ' Signal Active RR Crossing Other Type TCD Controls cD Device Not C_1 Device Functioning Unknown u Functioning Properly Traffic Signal - Unknown Type of Work Zone (if 'Not a Work Zone', skip rest of Work Zone section) Work Zone (Mark all that apply) ry ,, 40 Not a Work Zone --------------- - --- --- ? Lane Closure ? Work on Shoulder ? Flagger Control rov -- Work Zone Location r_J Transition Area _ • Construction - Before ist Work Road dosed with In Median V ': ? ? Intermittent or E3 D Oth Y Maintenance ' (J Activity Area - Zone Warning Sign etour er h., Work rr: Moving o Utility Company -, Advance Warning Termination Area -" Area _i - Oth Work Zone Workers Yes CD No CD Unknowns mtt m r er Other esent land fused (!f 'Not Applicable", skip rest of the Lane Closure section) w c c - , Q Not Applicable ui Partially Fully Unknown Traffic Detoured C_'j Yes 0 No ' o V » Closure Direction "forth East .: North and South Estimated Time Closed O 1.3 hours O 9.12 hours : ``' C < 30 Minutes O 3.6 hours 0 > 12 hours _ - P S ,uth _._- West East and West r ; 30-60 Minutes (D 6-9 hours (] Unknown PENNDOT COPY 1 i ' r 1 ?, Cr[i,h P1:,rnher COMMONWEALTH OF PENNSYLVANIA POLICE CRASH REPORTING FORM New P0425867 i 0016$0 Change/ , _ r - . , . __ Par 7 T-1 AA 45 6 1 ` Continuation -- --i -- - - r 0--tion-Collis on 2=Head On 4=Angle 6=Sideswipe 8=Nit Pedestrian I,P„ar End 3=Rear to Rear S=Sideswipe (Opposite Di(ection) o (Backing) (Same Dire(tion) 7=Hit fixed object 9=Other/Unknown m - - E r rr` i 1=0n Travel Lanes 3=Median 5=Outside TrafIicway 7=Gore (Ramp Intersection) `l i 2=Shoulder 4=Roadside 6=1n Parking Lane 9=Unknown 1=Daylight 3=Dark - Street S=Dawn B=Other ?/ I 2=Dark - No Lights 6=Dark - Unknown Street Lights 4=Dusk Roadway Lighting 1=No Adverse 3=Sleet (Hail) 5=Fog 7=Sleet & fog 9=Unknotmr Weather :onoit Conditions d L'J 2=Rain 4=Snow 6=Rain & Fog 8=01her c 01 -`"1 O-Dr 2=Sand, Mud, Dirt, 4=Slush 6=Ice Patches S=Other Ba,LrJ_ Ss ' s?c.s,r 1+114!11 i y Oil 7=Water - Standing Q 1=Wet 3=Snow Covered 5=Ice or Moving i Harm Event LtR Most? Utility Pole Number _ _ t[ Fpts (Harm Event) 30=Hit Fence Or Wall I 1 ( (? 01=HIt Untt 1 31=Hit Building i 4? ; 1 I 02=Hit Unit 2 32=Hit Culver O Unit No _ 03=Hit Unit 3 33=Hit Bridge Pier Or Abutment --T-T - - y - p4=Hit Unit 4 34-Hit Para t End 2 05=Hit Unit 5 35=Hit Bridge Rail 06=Hit Other Traffic Unit 36=Hit Boulder Or Obstacle Please Put - -- - ) - -T-r--T 07=Hit Deer On Roadway F Event; in 3 08=Hit Other Animal 37=Hit Impact Attenuator e 09=Collision With Other Non 38=HIt Fire Hydrant Ord .r Fixed object 39=Hit Roadway Equipment j S ) 1 11=Struck By Unit. t 40=Hit Mail Box a _. 1 12=Struck By Unit 2 41=1,11it Traffic island 13=Struck By Unit 3 42=Hit Snow Bank j 14=Struck By Unit 4 43=Hit Temporary Construction Harm Ev -nt L/R Most? Utility Pole Number _ __ 15=Struck By Unit S Barrier - _ ._ , .. 0 16=Struck By Other Traffic Unit 48=Hit other fixed Object t ' 21=Hit Tree Or Shrubbery 49=Hit Unknown Fixed Object No - - 22=Hit Embankment 50=Overtum/Rc11 Over 23=Hit Utility Pole 51=Struck By Thrown Or Falling D 2 2 i 24=Hit Traffic Sign Object - ' 25=Hit Guard Rail 52---Pot Holes Or Other Please Pur _ 26=Hit Guard Ralf End Pavement Irregularities Events in 3 27-Hit Curb 53=Jacknife .r 28=Nit Concrete Or S4=Fire In Vehicle Order Lai - - - .. ?; Order - -- -- Longitudinal Barrier 58=Other Non-Collision 1 29=11it Ditch 99=Unknown Harmful Event - L Vftht (L/R) L=Left R=Right O=Other U=Unknown F1lFS Unit No Harm Event Most Unit No Harm Event Driver Action (D) 16=Driving The Wrong Way Fla••rnru; _ !Lmlafv! _. On 1-Way Street Lrensr, J (vent rn O Z ) 00=No Contributing Action 17=Careless Or Illegal i 01=Driver Was Distracted i Le gash - the Crash - - - - `- Backing On Roadway 02=Driving Using Hand Held Phone 18=Driving On The Wrong 03=Driving Using Hands Free Phone Side of Road i 04=Making Illegal U-Turn 19=Making Improper E m irS67rn ni ' _ ?4?r1'C iy 1 P?Inn(i r! F i,+arL(EIP) 1 O 2 3 05=Improper/Careless Turning Entrance to Highway - - 06-Turning From Wrong Lane 20=Making Improper Exit t 1 Von iy Con m or, s 11 S1,t:pery Road Conditions (Ice,Snow) 07=Proceeding W/O From Highway ;;c ti , :"/eath,•r Condition., 12-5ubstance On Roadwav Clearance After Stop 21=Careless Park ng/Unparking i ?370tr:cr °; :.rher Conditiors 13=Potho c!S O9=Running Stop Siyn 22=Over/Under y E =po •r ,-, Po?.dway 14=8(UKEn Or Cracked Pavement 09=Running Red Light Compensation At Curve ( 0taiaclc On Roadway 15-TCD Obstructed 10=Failure To Respond To 23=Speeding oc,-et. /• r in ?-oanway 16i Soft Shoulder Or Shoulder Drup Off Other Traffic Control Device 24=Driving Too Fast For Conditions (177.Gi.-ire 28=0ther Roadway factor 11=Tailgating 25=Failure To Maintain Proper Speed J 99=ucknown 12=Sudden Slowing/Stopping 26=Driver Fleein Police r- -- -- -- 12=Wipers 13=I1legally Stopped On Road (Police Chase P F; i ?,, . . rg V h: le F.rfirref_(Jj 14=Careless Passing Or Lane 27=Driver Inexperienced to;=hor r 0u=Exhaust 13=Driver Seating/Control Change 28=failure To Use Specialized Equip 01 - furs 07-: Woo, fights 14=Budy, Doors, Hood, Etc. 15=Passing In No Passing Zone 98=Other improper Driving Actions tr._C<<ke system 09=S!gnal tights 15=Traier Hitch 0 r rg ,ystern OS=Other Ligh*s 1G=Wheels Unit r? 1 I 2 3 W 4 m jt ?,: it un 10=Horn. 17=Airbags No 05 Poy c!r Tr r,: 11=Mirrors 18=Trailer Overloaded 19=Unsecure/Shifted Unit Trailer Load No ,, O 1 {{- L 2 Ir--' 3 4 1 Q 2 m 20=Improper Town L?-J 21=Obstructed Win shield r P SS=Unknown estreaJametion --- O 03=Working u O 2 O O 2 00=None 04=Pushing Vehicle - 01=Entering Or Crossing At 05=Approaching Or Leaving Vehicle Specified Location 06=Playing Or Working On Vehicle indre,. ',;•d l'nm Factor Unit No factcr _Code 02=Walking, Running, Jogging, 01=Standing f O y Playing. Or Cycling 98=01her F R V D P Unit No Unit No rr l" i^ © if L-R i, the Prime Factor ?_, L_1 i,pe, leave Unit No blank COMMONWEALTH OF PENNSYLVANIA POLICE CRASH REPORTING FORM AA 45 7 1 001651 Page: FiT-1-1 Crash Number 0 New P0425867 C__J Change! Continuation ?? 0 Delete Page H 4 L.ti 4U. it (4--> IV-7 20 r,, c rend 2` .. _r p , 1 3 4r, n 4n1. j 7v _j, ?k r. err ' k S ? ... .. .. -. ..... .? ..,... .. ? ..J.. .....J i...... ... _ i .5. to, T •?? i.?ly ty 1 ....A... .I? ., sl.?. 3 ? ,I. h. M i • V g i.....,. .L a I { E j..,yr,? yn ........... ? J .... .. ........ y ' I ...,... 4 ......:.. .c... : :9rL ?4? n COMENIONWEALTH OF PENNSYLVANIA f40 CRASH REPORTING FORM °' New P0425867 Chanq?/ - - 1 AA 45 8 1 Continuation r 0016t-? .. o?q DPIC to Pag? i j plw- _•r,-,.:ryr: c y tr"Jwp, ort, witness, and olhF.,r information here. It is not required to restate information from the form. P.1' :yency. H7UjF Medical facility: Nl,tness t: Address: Won, ,: 1. Address: Narrat _ r 1Jor =1? 0' 3 --- - N ' '1_-?'N A q- ?' ?L? V N ?- ?u S R g 1 Ta. v?s_?__=??s-- ?cti???_?_??4 ??e.Qt??r?t) V?+?c Z'SYL AYE AND 1>Fc? st-•Q!?4? , .-ti7t'??-- ?Q-Fti.Pc?as Pv?t,Fp i \1 E ?ti. y EU rct?t?s ? ?t? i ?F? _... --aAc?s?_ .?,_w P?? t?.c-?,tiv X1.12 ??a o(o ?,??n Ac z . Av o _ S_?.A_. - 5-- - ?=? ok0! g Ltat-_A? ?•+y 17 A? GIa tE+?t. L s•? ??.-_ lqj4.ck_....5'FA"r?__????'_ L?,k??t? V? TM,E?R o o? ? ?. ? {±.?5. _5 ?C?QQ??p,----? -1-? L'?' ?V?? vT1+?r?? G.??_ z?<rEti?a c - M r 5-s -j-? ?T\% .7Qt?A A^T?ns Phone: Phone: LU-7 W P-5 r u vFtL-,., e , , ..- , . PENNOOT COPY t, COMMONWEALTH OF PENNSYLVANIA CITATION NO. K0277267-4 1. Magisterial Dist ic .` n .? TRAFFIC CITATION 3 Address cr fula isleriel District Oflica p? z1 w s ??aSVG P? Q?_'?. q?J. \? 1'1 E?Lav t LL {ice 4. Driver Num 4 5. C D.L? 8. Sl ale 7. DO .Sex y 1 ? A J S 9 ? F 9. Delendanl Name?r`t Middle La`s1 w ? ?w ? S T 10. Defendant Address (. treet-City-Stale-Zip Code) 11. Veh. Req. No? 1 2 c` 12. Reg. Yr. 13. Stale 14. Make, 4p 15- M 16. Color 1 2 A llMo ' sit 17. Veh. Reg. No. 18. Reg. Yr. 19. State 20. Make 21. Type - 22. Color ? PA 23. Owner/Lessee or Carrier Name 8 Address ? Same as Delendanl ? Not Required 24. Charge 26. VEHICLE CODE ? Maximum Speed Limits ? Drivers Required to be Licensed ? Careless Driving TITLE 75 ? Stop Signs a Yield Signs p ig? Registration 8 Certificate of Title Required 27. SEC. 3 28. SUB SEC. Driving Vehicle et Safe Speed ? Unlawful Activities ? TraM -Control Si al gn s ? Operation d Vehicle without Official CBNlkste of Inspection 29, FINE ft _` v-? ? Driving while Operating Privilege is Suspended or Revoked 30. E.M.S. ? Other r ), 31. GAT 25. Nature of Offense El 32. COSTS ?'y 1 Radar [I Clocked El A.O.V. ? Speeding MPH Allowed MPH ? ESP ? Vosoar ? Other 33 J C P . . . . ? Operated Veldde with Expired Inspection ? Operated Vehicle without Valid Ucense 1.50 ? Operated Vehicle with SuspendedlRevoked License ? Operated Unregistered Vehicle 34. TOTAL $ r ? Violated 67 Pa. Code Ref. 49 CFR DUE ? Filed on Info. Received h f w L C 0 K2 S T-;, .S s VI;' )i A s c.L_r PT ,l?p?? OS5?A4 N _-_7 T?1E V ?c1A 35. Location 5 V L4 W M c V-7a RD 36 Zona 23 37. Route 1 S 6vf 38. Twp: Boro ty T ?I 4S I3'' 39. Code 10., DI, of Travel +4 7 R7 1 .... ZI N S E 41. Dale I ?. ?? 42. Time 43. Day GJ 1'J? T"111 lc 44. Count' yg. fode Z 46. Delendan's Signature - Acknowledges Receipt of Citation 47. Dale 1 tredlFil X Lz at 48. I verity that the laces set forth in INS citation are true and correct to the best of my knowledge. Information and belief. This ve Iication Is made subject to the penalties of Section 4904 of the Crimes Code (18 Pa.C.S. § 4904) relating to unswom falsification to authorities. S ' OFFICER S SIGNATURE BADGE NO. ORI Number Y f 1 5 ^9 S PA PSP I co>-v \ C n 5xA i 49. THIS CITATION HAS BEEN ISSUED/FILED BY A MEMBER OF THE PENNSYLVANIA STATE POLICE, HARRISBURG, PA. 17110. 50. Speed Timing Device Operator o e Timed 53. Secs. Timed 54. Speed Equip. Serial No. t n aril to Equip. Tested r 57. Acciden Report No. ? ' ? 5 . omm. Veh. •_ Pa.C.S. § 1543 Violation-Juvenile 60. Haz. Mal. ' Z--- arents N - S ( ? YES ? YES 61. Remarks! Subpoena Ust Ir yq l L_ ------------- 62. Spatial Activity 63. top Obsw 1 64. Speed Deltic. Type 65. SUPV. INIT. BADGE?NI?. NOTICE II you plead guilt' or are lound guilty, points may be assessed against your driver's record. An accumulation of points may result in the suspension of your driving privilege. Also, your driving privilege WILL BE SUSPENDED if you plead guilty or are found guilty of certain offenses under the Vehicle Code, including but not limited to, driving while operating privilege is suspended or revoked, facing on highways, geeing or attempting to elude police, driving without lights to avoid iden- tification or arrest, accidents involving damage to attended vehicles or property, failure to slop for school bus with gashing lights, or subsequent convictions related to drivers required to be licensed. y? .P 7-0017A AOPC 40060 6C-95 (Rev. 6/2001) DISTRICT JUSTICE ..K0277267-4--- N m o 6 t a 0 E M NO m N m o r. ? H i Cd CD O. U E ca O CJ y ? Q 1 i h o t i U y y d C3? N d ? Q ? 3 `d' , d 6' io - { , cd ? i C 9 (n U i cb d ? :. oco o `1 a+ r CO 0 Bbd i L?O )?? S Gi o, 6l 151 1 ° U D 4 d N p.L 4 C3 r S-11 ul o to 04 N 0 N_ r? pw ;H A 08/10/2006 THU 13:23 FAX 717 776 4159 J P WOLFE INS-NEWYILLE ERIE - f INSURANCE GROUP ERIE, N0too E- Ins. PI. Erie, PA l fi&10 CONTINUATION NOTICE FOUCY NUMBER Q11 0109896 H AA7167 J P WOLFE INSUR INC 11/01/01 TO 11/01/02 Q11 0109896 H KENNETH L WHISLER & GWEN Y WHISLER 40 BRANDT LN NEWVILLE PA 17241-8655 AGENT - J P WOLFE INSUR INC 96 S. HIGH STREET AGENT PHONE -- (717) 776-5213 NEWVILLE PA 17241 1414 * CONGRATULA'T'IONS! A PIONEER EXPERIENCE RATING CREDIT HAS ? BEEN APPLIED TO YOUR POLICY PREMIUM. ITEM 4. AUTOS COVERED AUTO YR MAKE VIN ST TER SYM RATING CLASS ADP 1 99 JEEP GR CHR LAR 1J4GW58N9XC680378 PA 4F H A1BL-M MM30 2 97 SUBA LEGACY GT 4S3BD6751V7202586 PA 4F G A2BL-M PM30 ITEM 5. INSURANCE IS PROVIDED WHERE A PREMIUM OR INCL, IS SHOWN FOR THE COVERAGE. COVERAGES, LIMITS AND ANNUAL PREMIUMS ARE AS FOLLOWS- rv::•.rr.): +;,t:F•r•'Sk?r;:+lh+='Q',;. pvemxuvmmr?t y 41tJy, • # 2 .: rt',{?^!? Ni!{l;Y,lk.•.: a d?i:n?n T 1 jlA1e .... c,,T.,k:>Jn.. --- THE FUL LIABILITY PROTEC BODILY INJURY FI * UNINSURED MOTORISTS COVEKAG BOD INJ50M PERSON $100M ACC-STA?it'ED D MOTORISTS COVE GE- 13 °l UNDERINSURE BOD INJ $50M/PERSON $100M ACC-'STACKED COVERAGES- 48 48 PHYSICAL DAMAGE COMPREHENSIVE - $100 DED 82 81 COLLISION - 5500 DED 167 159 OPTIONAL COVER GES- TRANSP EXPENSES - COMP 25/,DAY, 1,125/LOSS 125/LOSS 11 5 5 15 , COLL 25/DAY, RANS T 44 LEASE/LOAN SE i UMCH AUTO REM 61 512 $ 1,0 I TOTAL ANNUAL POLICY P VER RATES APPLY***** SENGER VEHICLES. ---- (SEE REVERSE SIDE) RETURNED CHECK FEES WILL BE ADDED TO YOUR ACCOUNT XD WFS -- ------------- - - - - DETACH INVOICE AGENT - Please return AGENT AA7167 J P WOLFE INSUR INC KENNETH L WHISLER & GWEN Y WHISLER 40 BRANDT LN NEWVILLE PA 17241-8655 EXHIBIT 00 PIONEER. FAMILY AUTO POLICY * your Policyholder's DATE DUE PAYMENT DUE 11-01-01 265.00 02-01-02 268.00* 05-01-02 268.00* 08--01-02 269.00* 09/29/01 DETACH PAYMENT PLAN ENTER ANY PAY PLAN 5?1 CHAN(HE HEFT CHARGE INCLUDES $3.00 SERVICE ERIE INSURANCE GROUP 100 Erie Insurance Place • ERIE, PA 16530 -OI0I716T1101098461021400000001-002650000107000-- 02004482 CERTIFICATE OF SERVICE I hereby certify that I have this day served the foregoing document upon all parties of record in this proceeding in accordance with the requirements of Section 33.32 (relating to service by a participant). • -h Dated this 10 day of August, 2006. By First Class, U.S. Mail: Jenni Henley Allen, Esquire Nealon, Gover & Perry, 2411 N. Front St. Harrisburg, PA 17110 Kathleen A. , Esquire Attorney for Plaintiff 13 EXHIBIT "B" 1 KENNETH L. WHISLER, Plaintiff VS. SHAWN WEAVER, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA NO. 04-2784 - CIVIL CIVIL ACTION - LAW NOTICE TO PLEAD TO: Kenneth L. Whisler, Plaintiff and his attorney, Abom & Kutulakis 36 South Hanover Street Carlisle, PA 17013 YOU ARE HEREBY NOTIFIED to file a response to the enclosed Answer with New Matter within twenty (20) days of service hereof or a judgment may be entered against you. y Respectfully submitted, NEALON & G>OWR Date: By: Jenni He a Allen, Esquire Attorney I.D. 84311 2411 No h F nt Street Harrisbur P 171108 (717) 232- Attorney for Defendant KENNETH L. WHISLER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. NO. 04-2784 - CIVIL SHAWN WEAVER, CIVIL ACTION - LAW Defendant ANSWER TO COMPLAINT AND NEW MATTER 1-5. Admitted based upon information and belief. 6. Denied pursuant to Pennsylvania Rule of Civil Procedure 1029(e). 7-8. Admitted based upon information and belief. 9. Admitted based upon information and belief. 10. Admitted based upon information and belief. 11-51. Denied pursuant to Pennsylvania Rule of Civil Procedure 1029(e). WHEREFORE, the Defendant respectfully requests that the Complaint be dismissed with costs to be paid by the Plaintiff. NEW MATTER 52. Paragraphs 1-51 are incorporated herein as if set forth in full. 53. Plaintiffs claims may be barred in whole or in part by the application of the PA Motor Vehicle Financial Responsibility Act. WHEREFORE, the Defendant respectfully requests that the Complaint be dismissed with the costs to be paid by the Plaintiff. Respectfully submitted, NEALONrC,p'OVJ=7R & PERRY By: Date: Jen i enley AIIen",",Esquire 1.7. #.184311 2 11 North Front Street Harms urg, PA 17110 717/232-9900 % VERIFICATION I, SHAWN W. WEAVER, verify that the statements made in the foregoing ANSWER TO COMPLAINT are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsification to authorities. Date: 9:,--25 / SHAWN W. WEAVER r CERTIFICATE OF SERVICE AND NOW, this day of September, 2006, 1 hereby certify that I have served the foregoing Answer to Complaint and New Matter on the following by depositing a true and correct copy of same in the United States mails, postage prepaid, addressed to: ABOM & KUTULAKIS 36 South Hanover Street Carlisle, PA 17013 0 KENNETH L. WHISLER, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04-2784-CIVIL SHAWN WEAVER, : CIVIL ACTION-LAW Defendant REQUEST FOR PRODUCTION OF DOCUMENTS DIRECTED TO DEFENDANT-FIRST REQUEST To: Shawn Weaver c/o Jenni Henley Allen, Esquire 2411 N. Front Street Harrisburg, PA 17110 You are directed to produce the documents and things requested in the attached Request for Documents within thirty (30) days of service of this request to Jason P. Kutulakis, Esquire, ABOM & KUTULAKIS, L.L.P., 36 South Hanover Street, Carlisle, PA 17013. If you fail to produce the document or things required by this Request to Produce Documents, you may be subject to the sanctions authorized by Rules 234.5 and 4019(c) of the Pennsylvania Rules of Civil Procedure. ABOM & KUTULAKIS, L.L.P. , 1)'ra) , L Da e Jason P. Kutulakis, Esquire orney I.D. No. 80411 36 South Hanover Street Carlisle, PA 17013 (717) 249-0900 Attorney for Plaintiff INSTRUCTIONS 1. As referred to herein, "document' 'includes written, printed, typed, recorded, or graphic matter, however produced or reproduced, including correspondence, telegrams, other written communications, data processing storage units, tapes, contracts, agreements, notes, memoranda, analyses, projections, indices, work papers, studies, reports, surveys, diaries, calendars, films, photographs, diagram, drawings, minutes of meetings, or any other writing (including copies of any of the foregoing, regardless of whether you are now in possession, custody or control of the original) now in your possession, custody or control, your former or present counsel, agents, employees, officers, insurers, or any other person acting on your behalf. 2. If you object to the production of any documents on the grounds that the attorney/client, attorney work product or any other privilege is applicable thereto, with respect to that document. (a) State the documents date; (b) Identify the documents author; (c) Identify each person who prepared or participated in the preparation of the documents; (d) Identify each person from who received the document; (e) Identify each person from whom the documents were received; (f) State the present location of the document and all copies thereof, (g) Identify each person who has ever had possession, custody or control of it or a copy thereof, and (h) Provide sufficient information concerning the document and the circumstances thereof to explain the claim of privilege and to permit the adjudication of the propriety of that claim. 3. "You" means Defendant, Shawn Weaver. 4. "Plaintiff' means Kenneth L. Whisler. 5. When identifying any individual, please provide that individuals: (a) Name; (b) Current mailing address; (c) Current daytime telephone number; I DOCUMENTS AND THINGS REQUESTED 1. Please provide Shawn Weaver's complete driving record, including but not limited to the records from the state of Pennsylvania and any other state where he currently or in the past has resided. 2. Please provide any and all statements concerning the action, as defined by Rule 4003.4, from all witnesses including any statements from the parties herein, or their respective agents, servants or employees. 3. All photographs taken or diagrams prepared of the scene of the accident or any instrumentality involved therein. 4. Any and all documents containing the names and home and business addresses of all individuals contacted as potential witnesses. 5. Report any and all experts who will testify at trial. 6. Please provide any and all information related to Shawn Weaver's insurance policy at the time of the incident, including but not limited to the declaration page and any information regarding policy limits. 7. Please provide all federal, state, and local income tax returns for the past five years. 8. Please provide the names and addresses of all passengers in the car on the date of the accident. 9. Please list all assets. 10. Please provide a list of any and all legal actions brought against Defendant, Shawn Weaver. 11. List all motor vehicle driving history, including but not limited to, accidents and violations of the PA Motor Vehicle Code. 12. Please provide a list of any and all criminal actions involving the Defendant, Shawn Weaver. 13. Please provide any and all information regarding the Defendant and his involvement with racing motor vehicles, including but not limited to a copy of his racing license and all races that he has been entered during his lifetime. Respectfully submitted, ABOM & KUTULAKIS, L.L.P. Date Jas. Kutulakis, Esquire Attev I.D. No. 80411 36 gouth Hanover Street Carlisle, PA 17013 (717) 249-0900 Attorney for Plaintiff (CERTIFICATE OF SERVICE AND NOW, this S4day of November, 2006, I, Tracy L. Finkenbinder, of ABOM & KUTULAKIS, LLP, hereby certify that I did serve or caused to be served a true and correct copy of the foregoing Request for Production of Documents by First Class Mail on the following: Jenni Henley Allen, Esquire Nealon, Gover & Perry, 2411 N. Front St. Harrisburg, PA 17110 Tracy L. inkenbinder ?a - .. CV -71 !T, ,,I- KENNETH L. WHISLER, Plaintiff VS. SHAWN WEAVER, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA NO. 04-2784 - CIVIL CIVIL ACTION - LAW RESPONSE TO PLAINTIFF'S PRELIMINARY OBJECTIONS PURSUANT TO PA. R.C.P. 1028 1. Admitted. 3. Admitted. 4. Admitted. 5. Denied. 6. Denied. 7. Denied. WHEREFORE, the Defendant respectfully requests that the Plaintiff's Demurrer to the Defendant's New Matter be denied. PRELIMINARY OBJECTIONS TO INSUFFICIENT SPECIFICITY OF A PLEADING 4. Admitted.' 5. Admitted. 6. Admitted. 7. Denied. ' Undersigned counsel followed the number sequence in the Plaintiff's Preliminary Objections, which started with Number 'W'. WHEREFORE, the Defendant respectfully requests that this Honorable Court deny the Plaintiff's Request for Specificity of a Pleading. Respectfully submitted, NEALON GOVER & PERRY By Date: a Jen i H hley Allen, Esquire Atto ey I.D. No. 84311 2411 o h Front Street Harris rg, PA 17110 (717) 232-9900 CERTIFICATE OF SERVICE AND NOW, this 'b" day of December, 2006, 1 hereby certify that I have served the foregoing RESPONSE TO PLAINTIFF'S PRELIMINARYOBJECTIONS PURSUANT TO PA. R.C.P. 1028 on the following by depositing a true and correct copy of same in the United States mail, postage prepaid, addressed to: Michael T. Traxler, Esquire ABOM & KUTULAKIS 36 South Hanover Street Carlisle, PA 17013 Henley Allen, Esquire ?`'? ?? <.? C) "? ?,?:. ?a? .: G"'? i_" _. _.. { ? , .,,,_? jT -y)Li . l _ ; I s f_' _ty, - . ? ? CERTIFICATE ORIGIN PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: KENNETH WHISLER -VS- COURT OF COMMON PLEAS SHAWN WEAVER TERM, CUMBERLAND CASE NO: 04-2784 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS cri behalf of CASEY SHORE, E certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) The parties have waived the twenty-day notice provided in Rules 4009.21 and 4009.22 and, (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 04/17/2007 149S? on beef of ? CASEY S RE, ESQ. Attorney for DEFENDANT R1.33 133-H DE12 71556-LO1 i ., ft 1601 Market Street. Suite 800, Madelphia PmLoraaia (215) m . 090a Fax Number (2115) 246 - 0959 URGENTMH URGENTMH URGENTMH ARM 17, M07 CMW SM EM. - M-n Zrm? l?ae nest va*mmd IV t -m dwmi atia?ed anriga to dt9in udndvl = an e?edited 1398is f= ft)30W I.i-ld-l O?aLh3s. m a to =q2y with aria viamm %a nit bme y= sigr-tiae ki2iat!M tlvt yoavane eB t -*V rJ:U Psj4AI=4dW in RAW 40G3.21 M d 4aS.22. MOM Stc aria fg=n tO us *MCHWAY It MS) CORD Wth yaE si9gMM 90 em vie mV amity with, Ms Mz= . )tLx aqmotim WZLW be 9mEay agzmjwd. .Inmraly, azbxr3F A iQ amcm= mm -Mm=L Faxaz &xw_js ?3Z3E ?+Pi4+C? RSI?S CAE Fzamqj r Cam- X-M CRX MN Am - !wncElrx m NgFZLIE M91 M CIDER - ? &XFRS oz4m3L i &Pte. - MOM R372aB & xpas mm amma= ¢2k - NM S.Ms Pc lI N I?A[I . MM 249- A30 I agm to GeiNe vsdt m pKi3j . CL _ r CL#m: w M4 I arse to pv the in)dm p=ridad writ, tlv dxucErk-- FedeND03xpw=: yffi M At$t5W'cf CbEt AnB , %Ilir? fin: RRWI-DO05529 '73-55G-C:03. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: KENNETH WHISLER -VS- SHAWN WEAVER COURT OF COMMON PLEAS TERM, CASE NO: 04-2784 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 APPALACHIAN ORTHOPEDIC CENTER MEDICAL RECORDS & XRAYS CARLISLE REGIONAL MEDICAL CNTRMEDICAL RECORDS CARLISLE REGIONAL MEDICAL CTR.X-RAY ONLY PENN REHABILITATION ASSOC. MEDICAL RECORDS & XRAYS NEWVILLE MEDICAL CENTER MEDICAL RECORDS & XRAYS CAMILLE BAUGHMAN & ASSOC. MEDICAL RECORDS & XRAYS CASSES CHIROPRACTIC CLINIC MEDICAL RECORDS & XRAYS TO: JASON KUTULAKIS, ESQ., PLAINTIFF COUNSEL MCS on behalf of CASEY SHORE, ESQ. intends to serve a subpoena identical to the one that is.attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/17/2007 CC: CASEY SHORE, ESQ. - 06-291 PATRICIA HOFFMAN - MCS on behalf of CASEY SHORE, ESQ. Attorney for DEFENDANT Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 R1.33 133-H DE02-0360823 71556-CO2 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND KENNETH WHISLER VS. SHAWN WEAVER File No. 04-2784 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for APPALACHIAN ORTHOPEDIC CENTER (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following **** documents or things: **** SEE ATTACHED RIDER at The MCS Groin Inc 1601 Market Street Suite 800, Philadelphia, PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: CASEY SHORE. ESO. ADDRESS: 2411 NORTH FRONT STREET HARRISBURG, PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant WR 2 6 2001! Date: Seal of the Court BY THE COURT: Pro onotary/C tvi ivision Deputy 71556-01 COMMONWEALTH.QF_PELANSYLVANIA COUNTY OF CUMBERLAND KENNETH WHISLER VS. SHAWN WEAVER File No. 04-2784 SUBPOENA TO PRODM DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for CARLISLE REGIONAL MEDICAL CNTR (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things:_ **** SEE ATTACHED RIDER **** at The MCS Group. Inc.. 1601 Market Street. Suite 800. Philadelphia. PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: CASEY SHORE. ESO. ADDRESS: 2411 NORTH FRONT STREET HARRISBURG, PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ID 4: ATTORNEY FOR: Defendant APR 2 6 2007 Date: jpw ;Zw? Seal of the Court BY THE COURT: , 2z' Pr onot ivil ivision Deputy 71556-02 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: CARLISLE REGIONAL MEDICAL CNTR 361 ALEXANDER SPRING RD MEDICAL RECORDS CARLISLE, PA 17013 RE: 71556 KENNETH WHISLER Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire hospital medical file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physician, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, nurse's notes, doctor's comments, dietary restrictions, and all patient consent or refusal of treatment, procedures, test, and/or medication, lab and diagnostic test results, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care, treatment, admission, discharge, or emergency care pertaining to: Dates Requested: up to and including the present. Subject : KENNETH WHISLER 40 BRANDT LANE, NEWVILLE, PA 17241 Social Security #: XXX-XX-9007 Date of Birth: 05-10-1968 R1.33 105-N SU10-0681242 7 1 5 5 6- 1.0 2 CERTIFICATE ORGIN44 PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS KENNETH WHISLER TERM, CUMBERLAND -VS- CASE NO: 04-2784 SHAWN WEAVER As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of CASEY SHORE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) The parties have waived the twenty-day notice provided in Rules 4009.21 and 4009.22 and, (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 04/17/2007 MI SSon b e a l f off qsa,&% EY ORE, E Q. u Attorney for DEFENDANT R1.33 133-H DE12 71556-L03 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: KENNETH WHISLER -VS- SHAWN WEAVER COURT OF COMMON PLEAS TERM, CASE NO: 04-2784 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 APPALACHIAN ORTHOPEDIC CENTER MEDICAL RECORDS & XRAYYS CARLISLE REGIONAL MEDICAL CNTRMEDICAL RECORDS CARLISLE REGIONAL MEDICAL CTR.X-RAY ONLY PENN REHABILITATION ASSOC. MEDICAL RECORDS & XRAYS NEWVILLE MEDICAL CENTER MEDICAL RECORDS & XRAYS CAMILLE BAUGHMAN & ASSOC. MEDICAL RECORDS & XRAYS. CASSES CHIROPRACTIC CLINIC MEDICAL RECORDS & XRAYS TO: JASON KUTULAKIS, ESQ., PLAINTIFF COUNSEL MCS.on behalf of CASEY SHORE, ESQ. intends to serve a subpoena identical to the one that is.attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/17/2007 CC: CASEY SHORE, ESQ. - 06-291 PATRICIA HOFFMAN - MCS on behalf of CASEY SHORE, ESQ. Attorney for DEFENDANT Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 R1.33 133-H DB02-0360823 71556-C02. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND KENNETH WHISLER VS. File No. 04-2784 SHAWN WEAVER SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 400912 TO: Custodian of Records for CARLISLE REGIONAL MEDICAL TR. (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: * * * * SEE ATTACHED RIDER * * * * at The MC Group. Inc.. 1601 Market Street site 800, Philadelphia PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: CASEY SHORE. ESO. ADDRESS: 2411 NORTH FRONT STREET _HARRISBURG, PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant 'APR 2 6 20011 Date: T- 9 Seal of the Court BY THE URT: one Prot onotary/C I 1 Tision Deputy 71556-03 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: CARLISLE REGIONAL MEDICAL CTR. 361 ALEXANDER SPRING RD RADIOLOGY DEPT CARLISLE, PA 17013 RE: 71556 KENNETH WHISLER Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Any and all x-ray films and reports, including any and all such items as may be stored in a computer database or otherwise in electronic form, pertaining to: Dates Requested: up to and including the present. Subject : KENNETH VMISLER 40 BRANDT LANE, NEWVILLE, PA 17241 Social Security #: XXX-XX-9007 Date of Birth: 05-10-1968 81.33 105-N SU10-0681244 7 1 5 5 6 -L O 3 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: KENNETH WHISLER SHAWN WEAVER -VS- 10,91,914 COURT OF COMMON PLEAS TERM, CUMBERLAND CASE NO: 04-2784 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of CASEY SHORE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be. served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) The parties have waived the twenty-day notice provided in Rules 4009.21 and 4009.22 and, (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 04/17/2007 S on behalf of U014 EO Attorney for DEFENDANT R1.33 133-H DE12 71556-L04 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF : KENNETH WHISLER -VS- SHAWN WEAVER COURT OF COMMON PLEAS TERM, CASE NO: 04-2784 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 APPALACHIAN ORTHOPEDIC CENTER MEDICAL RECORDS & XRAYS CARLISLE REGIONAL MEDICAL CNTRMEDICAL RECORDS CARLISLE REGIONAL MEDICAL CTR.X-RAY ONLY PENN REHABILITATION ASSOC. MEDICAL RECORDS & XRAYS NEWVILLE MEDICAL CENTER MEDICAL RECORDS & XRAYS CAMILLE BAUGHMAN & ASSOC. MEDICAL RECORDS & XRAYS. CASSES CHIROPRACTIC CLINIC MEDICAL RECORDS & XRAYS TO: JASON KUTULAKIS, ESQ., PLAINTIFF COUNSEL MCS on behalf of CASEY SHORE, ESQ. intends to serve a subpoena identical to the one that is.attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/17/2007 CC: CASEY SHORE, ESQ. - 06-291 PATRICIA HOFFMAN - Any questions regarding this matter, contact R1.33 133-H MCS on behalf of CASEY SHORE, ESQ. Attorney for DEFENDANT THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 D1902-0360823 71556-C02 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND KENNETH WHISLER vs. SHAWN WEAVER : File No. 04-2784 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for PENN REHABILITATION ASSOC (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: * * * * SEE ATTACHED RIDER * * * * at The MCS Gr=. Inc 1601 Market Street Suite 800 Philadelphia PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: CASEY SHORE. ESQ. ADDRESS: 2411 NORTH FRONT STREET HARRISBURG- PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant BY T OURT: Prot onotary/CI t I D' ision APR 2 6 2007 Deputy Date: Seal of the Court 71556-04 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: PENN REHABILITATION ASSOC. 1 DUNWOODY DRIVE CARLISLE, PA 17013 RE: 71556 KENNETH WHISLER Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical, billing, and diagnostic file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, medical billing and payment records, x-ray films and tests with subsequent reports, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care or treatment pertaining to: Dates Requested: up to and including the present. Subject : KENNETH WHISLER 40 BRANDT LANE, NEWVILLE, PA 17241 Social Security #: XXX-XX-9007 Date of Birth: 05-10-1968 21.33 105-N SU10-0681246 7:L-5-56-T,04 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA 0191GIN41 PURSUANT TO RULE 4009.22 IN THE MATTER OF: KENNETH WHISLER SHAWN WEAVER COURT OF COMMON PLEAS TERM, CUMBERLAND CASE NO: 04-2784 -VS- As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of CASEY SHORE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena ..attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) The parties have waived the twenty-day notice provided in Rules 4009.21 and 4009.22 and, (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 04/17/2007 &M(?s on behh lff of EORE E Q• Attorney for DEFENDANT R1.33 133-H DE12 71556-L05 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: KENNETH WHISLER -VS- SHAWN WEAVER COURT OF COMMON PLEAS TERM, CASE NO: 04-2784 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 APPALACHIAN ORTHOPEDIC CENTER MEDICAL RECORDS & XRAYS CARLISLE REGIONAL MEDICAL CNTRMEDICAL RECORDS CARLISLE REGIONAL MEDICAL CTR.X-RAY ONLY PENN REHABILITATION ASSOC. MEDICAL RECORDS & XRAYS NEWVILLE MEDICAL CENTER MEDICAL RECORDS & XRAYS CAMILLE BAUGHMAN & ASSOC. MEDICAL RECORDS & XRAYS. CASSES CHIROPRACTIC CLINIC MEDICAL RECORDS & XRAYS TO: JASON KUTULAKIS, ESQ., PLAINTIFF COUNSEL MCS on behalf of CASEY SHORE, ESQ. intends to serve a subpoena identical to the one that is.attached to this.notice. You"have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/17/2007 CC: CASEY SHORE, ESQ. - 06-291 PATRICIA HOFFMAN - MCS on behalf of CASEY SHORE, ESQ. Attorney for DEFENDANT Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 R1.33 133-H DE02-0360823 71556-C02. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND KENNETH WHISLER vs. SHAWN WEAVER File No. 04-2784 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for NEWVILLE MEDICAL CENTER (Name of Person or Entity) Within.twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: **** SEE ATTACHED RIDER **** at The MCS Group, Inc 1601 Market Street Suite 800 Philadelphia PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: CASEY SHORE. ESO. ADDRESS: 2411 NORTH FRONT STREET HARRISBURG. PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant BY THE C RT: 'APR 2 6 20071 Protho tary/CI , t ivi ion Deputy Date: Seal of the Court 71556-05 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: NEWVILLE MEDICAL CENTER 100 S. HIGH STREET NEWVILLE, PA 17241 RE: 71556 KENNETH WHISLER Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical, billing, and diagnostic file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, medical billing and payment records; x-ray films and tests with subsequent reports, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care or treatment pertaining to: Dates Requested: up to and including the present. Subject : KENNETH WHISLER 40 BRANDT LANE, NEWVILLE, PA 17241 Social Security #: XXX-XX-9007 Date of Birth: 05-10-1968 R1.33 105-N SU10-0681248 7 1 5 5 6- L 0 5 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA ORKIN& PURSUANT TO RULE 4009.22 IN THE MATTER OF: KENNETH WHISLER SHAWN WEAVER COURT OF COMMON PLEAS TERM, CUMBERLAND CASE NO: 04-2784 _VS_ As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of CASEY SHORE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) The parties have waived the twenty-day notice provided in Rules 4009.21 and 4009.22 and, (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 04/17/2007 ?MqS on be if of? - CASEY HO SQ.f Attorney for DEFENDANT R1.33 133-H DE12 71556-L06 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF : KENNETH WHISLER -VS- SHAWN WEAVER COURT OF COMMON PLEAS TERM, CASE NO: 04-2784 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 APPALACHIAN ORTHOPEDIC CENTER MEDICAL RECORDS & XRAYS CARLISLE REGIONAL MEDICAL CNTRMEDICAL RECORDS CARLISLE REGIONAL MEDICAL CTR.X-RAY ONLY PENN REHABILITATION ASSOC. MEDICAL RECORDS & XRAYS NEWVILLE MEDICAL CENTER MEDICAL RECORDS & XRAYS CAMILLE BAUGHMAN & ASSOC. MEDICAL RECORDS & XRAYS CASSES CHIROPRACTIC CLINIC MEDICAL RECORDS & XRAYS TO: JASON KUTULAKIS, ESQ., PLAINTIFF COUNSEL MCS on behalf of CASEY SHORE, ESQ. intends to serve a subpoena identical to the one that is.attached to this notice. You have twenty (20.). days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/17/2007 CC: CASEY SHORE, ESQ. - 06-291 PATRICIA HOFFMAN - MCS on behalf of CASEY SHORE, ESQ. Attorney for DEFENDANT Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 R1.33 133-H D1902-0360823 71556-CO2 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND KENNETH WHISLER vs. SHAWN WEAVER File No. 04-2784 SUBPOENA TO PR,_ PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for CAMILLE BAUGHMAN & ASSOC (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: **** SEE ATTACHED RIDER **** at The MCS Groun Inc 1601 Market Street Suite 800 Philadelphia PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: CASEY SHORE. ESO. ADDRESS: 2411 NORTH FRONT STREET HARRISBURG- PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant BY THE OURT: APR ? ? ZOQ? I ProL?on o it vision Deputy Ila Xy 2=7 Date: Seal of the Court 71556-06 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: CAMILLE BAUGHMAN & ASSOC. 218 YORK ROAD CARLISLE, PA 17013 RE: 71556 KENNETH WHISLER Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical, billing, and diagnostic file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, medical billing and payment records, x-ray films and tests with subsequent reports, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care or treatment pertaining to: Dates Requested: up to and including the present. Subject : KENNETH WHISLER 40 BRANDT LANE, NEWVILLE, PA 17241 Social Security #: XXX-XX-9007 Date of Birth: 05-10-1968 R1.33 105-N SU10-0681250 7 1 5 5 6- L O G IN THE MATTER OF: KENNETH WHISLER SHAWN WEAVER CERTIFICATE ORGIN4 PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 COURT OF COMMON PLEAS -VS- TERM, CUMBERLAND CASE NO: 04-2784 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of CASEY SHORE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the'date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) The parties have waived the twenty-day notice provided in Rules 4009.21 and 4009.22 and, (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 04/17/2007 MCS on behalf of CASEY O*, AS Attorney for DEFENDANT R1.33 133-H DE12 71556-L07 r COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF : KENNETH WHISLER -vs- SHAWN WEAVER COURT OF COMMON PLEAS TERM, CASE NO: 04-2784 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 APPALACHIAN ORTHOPEDIC CENTER MEDICAL RECORDS & XRAYS CARLISLE REGIONAL MEDICAL CNTRMEDICAL RECORDS CARLISLE REGIONAL MEDICAL CTR.X-RAY ONLY PENN REHABILITATION ASSOC. MEDICAL RECORDS & XRAYS NEWVILLE MEDICAL CENTER MEDICAL RECORDS & XRAYS CAMILLE BAUGHMAN & ASSOC. MEDICAL RECORDS & XRAYS. CASSES CHIROPRACTIC CLINIC MEDICAL RECORDS & XRAYS TO: JASON KUTULAKIS, ESQ., PLAINTIFF COUNSEL MCS on behalf of CASEY SHORE, ESQ. intends to serve a subpoena identical to the one that is.attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/17/2007 CC: CASEY SHORE, ESQ. - 06-291 PATRICIA HOFFMAN - MCS on behalf of CASEY SHORE, ESQ. Attorney for DEFENDANT Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 R1.33 133-H D802-0360823 71556-C02 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND KENNETH WHISLER vs. SHAWN WEAVER File No. 04-2784 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY_PURSUANT TO RULE 4009.22 TO: Custodian of Records for CASSES CHIROPRACTIC CLINIC (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: **** SEE ATTACHED RIDER **** at The MCS Group. Inc.. 1601 Market Street. Suite 800. Philadelphia. PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the-documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: CASEY SHORE. ESQ. ADDRESS: 2411 NORTH FRONT STREET HARRISBURG, PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant APR 2 6 2007! Date: .21J 2zsq 7 7 Seal of the Court BY THE ouRT: Prot notary /Cl i I D' ision Deputy 71556-07 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: CASSES CHIROPRACTIC CLINIC 313 S. HANOVER STREET CARLISLE, PA 17013 RE: 71556 KENNETH WHISLER Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical, billing, and diagnostic file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, medical billing and payment records, x-ray films and tests with subsequent reports, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care or treatment pertaining to: Dates Requested: up to and including the present. Subject : KENNETH WHISLER 40 BRANDT LANE, NEWVILLE, PA 17241 Social Security #: XXX-XX-9007 Date of Birth: 05-10-1968 21.33 105-N SU10-0681252 7 1 5 5 6 -L 0 7 ?? ? __, _ .? ;" ?3 ,_ _$ ' ,.. may. CERTIFICATE ORIGINAL PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS KENNETH WHISLER TERM, CUMBERLAND -VS- CASE NO: 04-2784 SHAWN WEAVER As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of CASEY SHORE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) The parties have waived the twenty-day notice provided in Rules 4009.21 and 4009.22 and, (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 06/08/2007 MCS on behal f ASEY SH , ESQ. Attorney for DEFENDANT R1.35 133-H DE12-0247755 71556-LOB 08/09/2007 11:59 FAX 0 16M 142* 0 Street, Suite 800, PM&4 a yMA'pesmaylvoia 19= P15)246-09M Fsx N1aber C45) 246 - 0959 la 001/001 I]RGENT? ! i !, URGENT! ! ! ! ! URGENT! ! 111 AM 8, 20x7 - KENNEM VnML R KENNETI3 WHISLBR Vs SHAWN WEAVER NEAIAN, CLOVER, Er AL CASEY SHORE, ESQ. - (717) 236-9119 We have been requested by the above-mentioned taunts to obtain Mat"ial on an expedited basis fxom the below listed custodians. in order to comply with this regnest we muu have your Apmre medicating that yQu waive the twenty-da?yy nvttc:e Pad od pxw.4 in Rules 4009.21 and 4009.22. Please fax this form to us imtacdiately at ) 245-0959 with your signature so that we may comply with this "zgtest. Your cooperation would be y aPPrxiated. sincerely, f' N CAROL HAMILTON ! P Custodians: MASLAND ASSOCIATES, INC. -14IEDICAL RECORDS dt XRAYS Counsel: kt? JASON KUTULA]KLS, ESQ- (717) 249-3344 J I agree tv waive wai ft period y Date: (? 1 Copies: Yes Na I agree to pay tie invoice provided with the documents Review Documents: Yea No Advise of Cost I do not agree to waive rule: Daze: Billing Info: MVI-000 93 13 71556-Ct11 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: KENNETH WHISLER -VS- SHAWN WEAVER COURT OF COMMON PLEAS TERM, CASE NO: 04-2784 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 MASLAND ASSOCIATES, INC. MEDICAL RECORDS & XRAYS TO: JASON KUTULAKIS, ESQ., PLAINTIFF COUNSEL MCS on behalf of CASEY SHORE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 06/08/2007 CC: CASEY SHORE, ESQ. - 06-291 PATRICIA HOFFMAN - Any questions regarding this matter, contact MCS on behalf of CASEY SHORE, ESQ. Attorney for DEFENDANT THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 R1.35 133-H DE02-0365742 71556-C02 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND KENNETH WHISLER vs SHAWN WEAVER File No. 04-2784 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for MASLAND ASSOCIATES INC (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: _ * * * * SEE ATTACHED RIDER * * * * at The MCS Groun.Inc,, 1601 Market Street, Suite 800, Philadelphia, PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: CASEY SHORE. ESO. ADDRESS: 2411 NORTH FRONT STREET HARRISBURG-PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant JUN 2 0 M? Date: 1.5.) L ?Dd 7 Seal of the Court BY THE OURT: 2-2.. Pro honotary/Clerk, Civil Divi Deputy 71556-08 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: MASLAND ASSOCIATES. INC. 220 WILSON STREET SUITE 109 CARLISLE. PA 17013 RE: 71556 KENNETH WHISLER Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical, billing, and diagnostic file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, medical billing and payment records, x-ray films and tests with subsequent reports, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care or treatment pertaining to: Dates Requested: up to and including the present. Subject : KENNETH WHISLER 40 BRANDT LANE, NEWVILLE, PA 17241 Social Security #: XXX-XX-9007 Date of Birth: 05-10-1968 R1.35 133-H Su10-0690068 71556-LO8 c::P WTI ? fi L c7) OWENS, BARCAVAGE AND MCINROY, LLC BY: Stephen J. Barcavage, Esquire Attorney I.D. No. 78867 2000 Linglestown Road, Suite 303 Harrisburg, PA 17110 (717) 909-2500 KENNETH L. WHISLER, Plaintiff vs. SHAWN WEAVER Defendant TO THE PROTHONOTARY: IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 04-2784-CIVIL CIVIL ACTION - LAW ENTRY OF APPEARANCE Please enter the appearance of Stephen J. Barcavage, Esqurie, Matthew L. Owens, Esquire and the law firm of Owens Barcavage and McInroy, LLC. as counsel of record for Shawn Weaver in the above-captioned matter. OWEN AGE AND MCINROY, LLC. DATE: ?? j Z 2 9 BY: S J. Barcavage, Esqurie ZIV D478867 2000 Linglestown Road Harrisburg, PA 17 (717) 909-2500 DATE: li BY: atthe wens, Esquire ID# 76080 2000 Linglestown Road, Suite 303 Harrisburg, PA 17110 (717) 909-2500 a CERTIFICATE OF SERVICE We, Stephen J. Barcavage, Esquire and Matthew L. Owens, Esquire, do hereby certify that on this 17' "? day of November, 2009, we served a copy of the foregoing document via First Class United States mail, postage prepaid as follows: Wayne Melnick, Esquire ABOM & KUTULAKIS 36 South Hanover Street Carlisle, PA 17013 4t. arcavage, Esquire Matthew L. Owens, Esquire OF THE FFOT' .: OTARY 2009 NOV 19 PM 2: 41 CUP?C s4 4_2 , UI V I l PENN:)YLVA V; KENNETH L. WHISLER, Plaintiff VS. SHAWN WEAVER, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 04-2784 - CIVIL CIVIL ACTION - LAW PRAECIPE FOR WITHDRAWAL OF APPEARANCE TO THE PROTHONOTARY: Please withdraw the undersigned's appearance on behalf of the Defendant, Shawn Weaver, with regard to the above-captioned matter. Respectfully submitted, Date: , Of GOVER PERRY & SHORE By: Cas -IM Shore, Esquire 1. D. 321 RRY & SHORE 2411 North Front Street Harrisburg, PA 17110 717/232-9900 CERTIFICATE OF SERVICE AND NOW, this day of November, 2009, 1 hereby certify that I have served the foregoing Praecipe for Withdrawal of Appearance on the following by depositing a true and correct copy of same in the United States mail, postage prepaid, addressed to: Wayne Melnick, Esquire ABOM & KUTULAKIS 36 South Hanover Street Carlisle, PA 17013 LED-Cffl OF Tkt' PPOTIHO ` OTARY 2009 NOV 19 PH 2: 4 2 GUME. pt-:INt,'t!`i E ri i