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HomeMy WebLinkAbout10-4279KRAFT & KRAFT, P.C. BY: Robert E. Cherwony, Esquire Identification No. 17623 1311 Spruce Street Philadelphia, PA 19107 (215) 546-5100 reckraf@bigplanet. com THE HORACE MANN COMPANIES, AS SUBROGEE OF ANN McGINN P. O. Box 10539 Bradenton, FL 34282 vs. SUSAN PETERS and JOHN J. PETERS 506 Louisa Lane Mechanicsburg, PA 17050 Attorne?, arlt? CU"- COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA CIVIL ACTION AT LAW NO. Ir%/6 1/a71 PI'V'/ CIVIL ACTION COMPLAINT "NOTICE" "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 or 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, GO TO OR "TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Court Administrator Courthouse, 4th Floor 1 Courthouse Square Carlisle, PA 17013 "AVISO" "Le ban demandado a usted en la corte. Si usted quiere defenderse de este demandas expuestas en las paginas siguientes, usted tiene veinte (20) dias de plazo al partir de la fecha de la demands y la notification. Hace falta asentar una comparencia escrita o en persona o con un abogado y entregar a la corte en forma escrita sus defensas o sus objeciones a las demandas en contra de su persona. Sea avisado que si usted no se defiende, la corte tomara medidas y puede continuar la demanda en contra suya sin previo aviso o notification. Ademas, la corte puede decidir a favor dei demandante y requiere que usted cumpla con todas las provisioner de esta demanda. Usted puede perder dinero o sus propiedades u ostros derechos importantes para usted. "LLEVE ESTA DEMANDA A UN ABOGADO IMMEDIATAMENTE. SI NO TIENE ABOGADO O SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA O LLAME POR TELEFONO A LA OFIICINA CUYA DIRECCION SE ENCUENTRA ESRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL." 'W? mil-wn-el 1/,/* el/ 7 KRAFT & KRAFT, P.C. BY: Robert E. Cherwony, Esquire Attorney No. 17623 1311 Spruce Street Philadelphia PA 19107 (215) 546-5100 reckraft@bigplanet.com Attorney for Plaintiff(s) THE HORACE MANN COMPANIES, AS SUBROGEE OF ANN McGINN P. O. Box 10539 Bradenton, FL 34282 V. SUSAN PETERS and JOHN J. PETERS 506 Louisa Lane Mechanicsburg, PA 17050 CIVIL ACTION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA CIVIL ACTION AT LAW No. 1. Plaintiff is a corporation with an address as set forth above. 2. Defendants are individuals who reside at the address set forth above. 3. On or about July 8, 2008 due to defendant's' negligence and carelessness, plaintiffs insured sustained damages in the sum of $6,540.27. Attached hereto, made a part hereof and marked Exhibit "A" is a true and correct copy of plaintiffs proof of liability. 4. Although demand has been made, defendants have failed and refused to compensate plaintiff. WHEREFORE, plaintiff claims of the defendants the sum of $6,540.27 plus interest in the amount of $784.83, for a total of $7,325.10 plus court costs, all of which are justly due and owing from the defendants to the plaintiff. KRAFT & KRAFT, P.C. BY: Robert E. Cherwony, Esquire Attorney for Plaintiff Print CRS W0085305 -AA Page 1 of 7 J COMMONWEALTH OF PENNSYLVANIA POLICE CRASH REPORTING FORM Case Closed Reportable Crash *5001 O Yes O No O Yes ONO Incident Number raft A en estrot tone -` HAM20080700268 21103 200 Name F4vcinct I sti tion D t 0AM DD yyyV nve a e - - ) Elampden Township 07 - 08 - 2008 ' DI Time fm0 Arrhrai time In ator ba Num 0921 0922 CPI. JEFFREY A SNYDER 19-11 , RWiewer bed Number val Date M-DD•YYYYf H T SGT S AUN A FEI. Y 1902 07 - 24 - 2008 Coup Cou Name Munkipelft Municipality Name ? (> grove k 21 Cumberland , 103 afnpden Township O sun O Thu M t Crash Date (MM,-DVYYYY) Crash Time No of Units People injured KDled• Oil > 00 on 0 Fd Q 07 - 08 200$ 110921 2 2 2 0 complete O Tug Q sat Form F 0 Wed 0 Unk WoAksone W?t? 29) Q Yes Q No RSA te bus Q Yes O No School 1, Zone Q Yes Q No M g-WO TO Yes O No t O a Way intenedion O 'Y- intenettion 0 nierNsecoon O Off Ramp Q Railroad Crossing 'Saadll y J (] Midbkxk Q •T• htersettion Q Ro? Ab Q On Rsmp Q Crossover Q Other !ee Routs Number F -51 o segment ( Travel Lanes Speed umk Q North House Number Of a licaitte) 1010 03 40 O South t strew Name Street Ending O East rat Mld-Olod: crashes Use MARKET SQ O west postil ?" ? We O unknown MW in y urk O intersta T t u o O leu Sce 0Turnpike 0 state O 8wd O aS oact 0 R dle C:) o ur!e c kn wn Route Number meat ( b Travel sLkNt Q North South South 0 Sheet Name ? Ing C7 East C3 Unknown O (Not T tumptke) Q (Eas U Q SPn n?pike Q lii m Q Road Q w S rett Q Roads 0 Unknown intersecting Rt Num or Mile post or Segment Market ?? Q Norh Feet . Or Intatsecgn Street Name h a 0 Pl ase St Endin E st e Or miles hiamation O West la LOIN untimarks wts"ecft Rt Num or mile Post Or Segment Marker N This Option .E O North ©S h C Saw* to from crash kerse to 4ntfmatk 1 ouh Or Intersecting Street Nana St Ending I East O west (for crash between Landmark I and Landmark 2) Latitude: Tees Minutes Seconds Degrees Minutes Seconds t4 -1 17 40 : 13 • 000 WngRnsde: - 76 58 . 13 000 p z Q Yield Sign Police Oliker or - Flaqwn C Not Applicable O traffic Signal 0 ACtiveRR Crossing 0 TCD 0 No tontrois 0 Q Eq? C ntr l o o I 0 mil g Traffic Co std s Q Cr p Controls O linkatwun 0 wenvxae Not Q emWnctioning o Unknown oning &ELa smd Of 'Noe Appumm ; skin Aw of the Lane Oorure wal rd ypg-QW= C:) North Q East Q North and South Q AN 0 Not Applicable Q Panialiy Q Fully Q Unknown QbdhM 0 South Q Wert Q East and West (N.S.E.W) 1>ld mgd unknown 0 O < 30 Min. 0 3460 Min. Q t-3 hrs Q 3.6 hrs 0 6.9 hn 0:., 9 hour Q Unknown rateraA"amarl PENNDOT COPY htto://www.dot6.state.va.us/crsapp/Printlmages/XmlFiles/20080781572008072909441444... 7/29/2008 Print CRS W0085305 COMMO AUN of MA1NSYLVMIA I FOUC'E CRAEM REPONYING FORM AA 500 2 up" 1111111111111111 Pages W0085305 Page 2 of 7 Crash Number 7 p Motor Vehicle in p Wt & Run Vehicle O Ileolij Parked O tegaly Parked O Non - Motorized Transport Comaaevdai Vehicle r tt Pedestrian on Skates. Disabled From O Pedestrian O in Wheelchair. etc O Previous Crash ? Train O Phantom Vehicle O Yes ONO !Il Ye; Complete Form C1 'PedeMan' or 'Pedestrian on Skat in Wheekhalr etc' Co a form M SecNas ?8 unit No Pint Name Ml Date Of Wrth(MM•00-mm, 01 SUSAN E? O1 22 1954 0ekle7 Cast Name hone Number p PETERS 7175259855 dtan / Ckv 1 State zi 306 LOUISA LN MECHANICSBURG PA 17050 DAwr Uoense Number Class 18239376 PA Alcoholl&M Odver a Hadeserkn Phwkal Condldon O No O kvI Drugs O Medication p WW "y p Nagai Drug O Fatigue p Medication O Alcohol O Alcohol and Drugs O unknown O gkdk%n O Sick O Asleep 0 Unknown Ak" Test T "v O Test Not Given p Breath O other mom V %N# Coda yiobNon Charged! om if p Blood O urine p ?an DRIVING ON RIGHT SIDE OF O Yes O No G y Akohol Test AMP O Test Refused o ResuRs Test Gwen Ddw ftm" i-viher operated 3-Dntver Fled scene Vehicle 4aHil and Run a• O Contarnhuted Results 2-No Diner 9aUnknwm f doer W-Not Applicable 02-FOnte Vehicle Not 04aState Police Vehicle 07-Wnidpal Poke Veh 09nFederal Gov Veh OI.Pdnle Vehicle Owned! Ownedlleued by Driver 05-PENNOOT Vehicle O8sOther Munl*al 98-Other leased by Orirver 03aRented Vehicle 06-Other State Gw Veh Government Vehicle ".Unknown H Some owner Nrst Name Owner last None or Business Name Of Pe*ndar< sic MIsSecdoiQ arl1ff p LYCOMING AUTO TRUST &Make code Anddrness / / State / Zip Vehicle Make 1500 SYCAMORE RD ST 200 WILLIAMSPORT PA 17703 _ Chevrolet 20 YIN Model Year Vehicle Model bee ondayl -? I IGIAL52FO57553990 2005 I COBALT Ue"se Plate Reg. State Est. Speed Yahkk Towed Toured By I GWP1860 PA 033 O Yes O No I ROADSIDE AUTO R ?i rw armor hquranae Company Poky No O yes O No O ki own G EICO 4055-84.39.26 1-Towing Pass. Veh 4aMobkdldodtalar Ilarrae 7-S diet aikr lap Al Tag Year T St ?p o ? 2•TOwaagTnack S=camper 8=Olher 00 e l. J g uni 340wing UliEty Trailer 6-W9 Trailer 9-Unknown J t_ on o?/ a •Vehclle Aos0on -Momment 01 -5" d $,,&1 Upt?e w O" ay VW" 1Vsh der 11me OSAArge Track le. Bicycle. ? ? 12•Cort r(wdal er 07a5ilvlo =T de O 1 O1,A Aomobife 06aSUV 02*Worgde 07avan Pedatcytk OOaNot Applabk Carrier Of A V h 1 08wGoid Olublue 0mrown 03a8us IO.Snowrnobde 228Horse d Buggy 04aSroal Truck i laFarm EW 23¦Hoae S Rider re e Ot+ra 210tsctor Traller fance 02=Red IOaoranape 03a1Mhite 1 I•Purple Of •02-, Ch"*te form 12aCanslnrtt on Equip 24aTrain Aq section 26) 13-ATV 25aTroley dice 03:Police 22aTWn Trailer ler 08v0dw Emergency 23=Triple Trailer 0"Green 12aOMer 99aUnkrnowrt OfheiT Veh 98a0Uner f17f C?mpkte 19 18aaUnk T peeSp Veh 99-Unknown Vehicle 31.Maditied Veh 11?Pupil Transport 99•Unksavvrs y . olat F Damage IndR? livelftnt 3•Downhill Road AHonmen 00-Hon{oBniorn 14aUnderorriage -2•bd Pbints 15aTowed Unlt PO 1 1 f 2 O.None 2-functional I-:! Ohabling r 3% I leleM "Bottom of Hill 2aUpt Salop of ".unknown 1 3- ap U . 9arnkrawrn 9=Unknown 9-Unknown Pona a A 4AXo (it" PENNDOT COPY http://www.dot6.state.pa.uslcrsappIPrintlmageslXm1Fi les/20080781572008072909441444... 7/29/2008 Print CRS W0085305 A MXX COMMONWMALTH RASH WMWI N G$ ?? 81111111Ni1FORM ? Page: AA 500 2 R_-U-0* --:::] = W0085305 Page 3 of 7 Crash Number r Vehicle in Trans 111voy Parked O Legally O Transport C) K1 b Run Vehicle Q I Parked Q Non • Motorized Lr Canmen/a! VsAkie S ' O Pedestrian O Pedestrian on Skates, O Disabled From O Train O Phantom Vehide O Yes Q No In Wheekhak, etc Previous Crash W Yer Complete Form Q (N 'Pedestrian' or 'Pedestrian on Ska in WAeekhafr etc' Com Iete Fort" M Section ?$ Unit ft F1nt Nana MI Date of Binh 11MM•DD•YYYYI 02 ANNE F K1 21 1946 Delete? Last None Tek Phone Number _ r ? Q MCGINN 7177370387 Address I I State ZI 218 INDIAN CREEK DR MECHANICSBURG PA 17050 Dnwr Lkense Number State class 19607812 PA AkohoWng; Suspected Driver or Mdestdon Phy*#1 Condition O NO Q illegal Drugs Q Medkatan O Anendy Q 02al 0109 0 Fatigue O Medication O AkotvDl O Akohd and Orugs O Unknown O p 4een O Sidle Q Asleep 0 Unknown Ak" Test Trroe Q Test Not Given Q Breath O ahrr Yrlrrta?Y Vahlde Code Vidafbn «qed? O Blood Q Urine O el Gf l N/A O Yes Q NO Akohof Test Results 0 Test Refused Q cults Test GMen ? Rdmmn I=Driver Operated 3=Driver Fled Scene Vehicle 4=lit and Run , • O ConWnlnated Results 1 ] 2-NO Driver 9=Unknown OwnertDrltrer 00aNol Ap*ahle 02°Private Vehkfe Not OloState Poike Vehicle 074dsesidpol Pollee Veh 09-Federal Gov Veh O1.Prsvate Vehicle Owned/ Ownedlleased by Driver 05-PENNDOT Vehice OBmother Municipal 98=01her 01 leased by Driver 03-Rented Vehicle 06=Other Stale Gov Veh Government Vehicle 99=Unknown Some as owner FIM None Owner Lest Name or Business Name (ill Pedestrian, skl th(s S"Won) Driver ANNE KANE MCGINN Address I I State I Zip Vehkle Make 'Make Code 218 INDIAN CREEK DR MECHANICSBURG PA 17050 I Toyota F49 VIN Model Year Vehicle Model (see Irby) 4T1BK36B46U112164 200b AVALON ucersso Plata Reg. State Est Speed Vehkk Tom Towed EKL4452 PA 025 O Yes ONO ROADSIDE AUTO R? Inswa Insurance Company Policy No O YL4 O O known HORACE MANN ^] 37.60386340 L F No of InTowing Pass, Veh 4°MobilNModular home 7=Sami•Trar7er Tagag N TaT ? OD a 2¦T?ng Truck 5=Camper Trailin unk g Units; 3•Tovvtng Utility Trailer 6-N11 Trailer 9•Unknown J I..._ I of Q •Vehlde /bsltbn 01 Afovement O) 'See O l Spolel Usaae ver ay X1' or VON& Type 05-large Truck 20-Unirycit Bicycle. 12•torrlmMCial KI passersget 06-Yellow O$ 07=Slwer Ol=Automobile 06¦SUV Trkyde O1 02.Motorcyck 07=Van Zinother Pedalcydle W-Not Applicable Cartier 01?B Veh 13 d T 08=60141 01:Biue 09•Brown 03.8us f0=Snowmoble 22.NOrse & 04=Small Truck 11=firm Equip 23811orse & Rider e = a 02=Ambu4na 21=Traps Trailer 02=Red 10=Orange 03¦White I 1 e (if 102', Compkte Form 12=Conslnxtion Equip 24-Train µ Section. 76) 6) 11= 03.Aotke 22=Twin Trade 08-Other Emergency 23•Tripk Trailer 04-Green 12 trh OSa81ac1 99aUnknown Type S Veh 98-Ot?r {ice 14 or Wr '21', 27) pkN 1921.111k. TyppK Veh 29-Unknown Vehicle 31-ModifieciVeh 11=Pupil Transport 99-Unknown MM mom #Wn Damage In"tw fiwLeat 3-Downhill Road Atkmment 10 O2-cloc unts 15-Towerarriage O1•IldlOCk Points 1Towed Unit a 1M ins 3=Disabling Nnnional lnlevN S?TBop«i HW Hill 0 2•Gurv dt 13.top 99=Ur*nowm 9-Unknown 2-UphU 9=Unknowm 9=Unknown FOFW r "ON 1122 PENNOOT COPY http://www.dot6.state.pa. us/crsapp/Printlmages/XmlFiles/2008078157200807290944 1444... 7/29/2008 Print CRS W0085305 I COMMONWEALTH OF PENNSYLVANIA POLICE CRASH REPORTING FORM Page AA 500 3 lsa«urearl - -'-?1 Page 4 of 7 111111I'1I1111 Crash Number 7 W0085305 A 1-6m D W1% ager/Ottupant D i l ll V 0 Ego- one / Not Applicable G omw ' plicswe 1 h d I kl " r ri ver -A e 2-Passengern 01- 7-Pedesbra 02-Front Seat Middle Position er Use 0 -S ou "" I" 024ap Brit Used 2¦Tota Elected 8.Odler 03.Ffont Seat Right Side 9--UMnown 04-Second Row - Left Side Or 03wW And Shoulder Bell Used 3-Parti*r Ejected 04-Child Safety Seat Used 9-t/nknown MOlorcycle Passenger OS=Motorcycle Helmet Used D6s8itycle HltnKt Used ?pp?? OS-Second Row - Mkkb Position H 06=Second Row - Right Side Bak 07-Third Row Or Greater - , 10.Sa Bdt /Nerd Impopdiy =NOO t Ejected / Not Applicable 11=gsd Safety Seat Used improperly 11-Through Side Door Opening MuMaIR Leh Side U =Unkno+m OB'Third Row Or Greater . 12-Helmet Used Mprapery 2-Through Side MRndow 90-Restraint Used, Type Unknown 3-Through 1Nmtkhleld Middle Position 09-Thid Row Or Greater - 99-Unknown 4-Through Back Door S=Ibmwb Back Door Tailgate Operdng 1We" r5ttitron of Truckcab p- -a I r ErMosed C t:Killed Passenger Or Cargo Area F O?Jone Osed / Nol Applicable 6-Through Roof Opening (Sunrod/ 01-from Atr Bag (for fits Seat) Convftwe Top t)own) 02-Side Air Bag Q?(For This SeaU 7- trot Ain Roof Opening (Convertible 2:Major r,Jtrcy 12-In Open Area 3¦Moderate lead Of Pickup. Etc.) i 03.Odta Type AI1Oeplow 04=Multiple Ai BagsDecoyed 9=Unknovm i 05 M E t l b y 13- raving Un t 4.Minor Injury 14-Riding On Vehicle Eztedor B.lnjuix UT 15mous passenger - otorcyc ye ect on e o 06=8kydW Waring Etbow/KnedPads 10-Ak Sag Not 0epioyed. Switch On (O Applicable Seventy 9b-Otter 9-Urdrnown If 99dlnknown 11.0 Bag Not 0eptoyed. Switch OR 1-NOt Extricated 12-M Bag Not Dip". 2-Extricated By Mechanical Means ' injury Unk Switch Se 3=Freed By Non - Mechanical Means 13-Air Bag Renlova tier To Crash) 8-Other 19-Unknown N Air Sag Deployed 9=Unknown 99-Unknown EMS Agenc r I AMB 171, MEDIC 81 Medial FadRty: HOLY SPIRIT HOSPITAL Unk No Person No Data of birth (MM-OD-YYYY) A B C D E F G H I 7_1 D F] 01 01 p 7 O 1 - 22 - F I 1954 ? D 01 03 10 a a Now / Address I Phone EMS Tnnspon ? s ? « PETERS, SUSAN E506 LOUISA LN MECHANICSBURG PA 17050 717 O yK O Unit No hrson No Delote7 Date of birth (M"D•YYYY) A 8 C D E F G H 1 - ? 02 O I Q 10 - 21 - 1946 la E] 4a 01 03 10 a a Hulse I Address I Phone EM3 Transport Smw paatur MCGINN, ANNE K 218 INDIAN CREEK DR MECHANICSBURG PA 1705 O Yes O No ? O Unit No Parson No b B M-5D•YYY10 E D D 0' -D-ORnE1===F1C1? Name I Address I Phone EMS Transport 0 I Same as operator O Yes ONO Unit No Pens" No Delete? Date of Birth (MM-DD-YYYY) A B C 0 E F G N I == c?-c?-oQOOOC?ooa? / tMrorw Name /Address EMS Transport I] Some as Operator O Yes O No Unit No Person No Delete? Date of Birth (MM-OD•YYYY) A B C 0 E F G H I == 0 =-=- a0n== =aa? Noma / Address /P EMS Transport Q as same Operator O Yes O No Unit No Parson No Delete? Date o il (MM•DD•YYYY) A B nC 0 E F G H 1 == =-=- ? OnEl ==F]C]C' Name / Address / Phone a Same as EMS Transport Operator Q Yn ONO sows a A"m (I-M PENNDOT COPY http:/lwww. dotb.state.pa. uslcrsapp/PrintImageslX mlFi lesl20080781572008072909441444 ... 7/29/2008 Print CRS W0085305 COMMONWEALTH OF PENNSYLVANIA POLICE CRASH REPORTING FORM Page AA 500 4 rake UN 1 MMOO ante e'-wo,e) 5.Outatd9 ToKrcway 6-in Pa4dV Erne poscoboon 0•NorrOoTabn 2dtead On 1-Am End 3*Mj 11 Mayon I.On Travel Eaves 3•Medlen D 2=Shwwr 4=Road" M I.Day0pitl 2.11s,,k. No 3-t4kts SO father d+ndHlont n '-M= &-Sleet Mug Roi?Surfm CorAwas 04xy 2•W Mad. ch, lowel S.9vowCovrrae unit No t 02 U p 01 2 ? O -?? vlea:e f?l 3 O Events in Se+9aa+ntlal Mann E"M E/R Vona UUIk Pole Number Unit No t 1 ! Q c.?2o?0c- flNre Put O Eren4 in 3 4=?° Ekil Unit No Haan EYMt tlnk ta0 Irian Evanl n xi 01 02 01 KI 9049 /I?NI 9U{ ifM.1WaI1 Mh?` rt. Nan IEot+bTfnma?aa?JR9adwar t I-"1 2 rOO 3F PateOHalhclon (FA I J 0?ebtt! t l23 Road CortdiBoro Oce5now) 01aWtdy Conditions 12aSubstann On Roadrwy 02.5urdden Weather Conditiom 13-potholes 03•olher wea0rer Condlidu 14.8rdwa Or Cracked Pavemerd 0020eer In Road" 1540 Obstructed 05yDbslade On aoadw+y 16.5011 Shakier Or Shoulder Drop Oil 06.O0ser Anr let Roadway 28=0lhen POW" Facto 07-wre 29.0ther Environmental Factor DB•'Wodc Zone Relaled 99•Unknown oP?Rrle V_9hldq faPM M 1 Z=Wipers 00•tl0tte 06.tirduust 13• ' enpKonVd 01-Des 07.Head hts 14. DSe0rati9, Hood. Elc 02.6rake S)Vem pg.?p?q 15=Trailer 114th 030Sleerrng lent 09=oiherlUglkts 1,6-Wheels 17.41 OI.Susyenswn tOsllorn OS.POVkrer Train 11.Aairtors 18.Trater Ovtrbaded t9•UnWAWShihed Noh 01 i 00 2 00 20* rn piwoper?ToN;ng???? 21.Obstructed writdl Wd pole 02 1 Q 2 00 99•Unknown ktd/a,(od Prkne Factor Uftlt No FaRor Code ?1 w+nranntion °" O l 92 EM V A 1 0 0 0 0 If Elk Is the Prime factor type, leave unit No blank 04id Pedestrian 7-M F"d ObjW ohcft) 0.011 MMlonorm 7-Ow (Flame Intersection) 1N-Unknown 6-Dawn 6.rlarlk . HA MM 64W A Fog 4.SIlralt b•k4 (Harm E nt O?•i4l rill 02.IFA Unit 2 03¦M Unit 3 MUM UM 4 OS¦H4 UnM S 06.911 Other l k Unit WHO Deer 08-M Other Animal sFsed ObJW Other Non 11.Strt a By Unit 1 12=Struck 8y Unit 2 13=Struck By unit 3 14.51tUtk By Utlh 4 1525&uc k By Wt. S 16.SVudk By Other Traffic UAH it Enid of Alf Page 5 of 7 7=8199 d FW "raw" B.Odter 111111111111111 Crosh Number -1 W0085305 3"a d fence of wall 31.1F4 8rdldirq 32.144 Cuke1 33=144 Bridge Piet Or Abutment 34.16t Parapet End 35.Ii4 8 Bait 36=1Gt poadwayOr Owed, 37.114.. act dttenwta 38•Hil Fire Hydrant 39-M Roadway Equipment 40-NN Mai Be>< 41.IGt Tralk bond 42=Hi1 Snow Bank 43:?cmpwary Comuuction 48-Ko Other FmW Object 49-M Unknown Fined Object SO.OrMuuVBotl Over S1 :Shuck By Thrown Or FaBng 52•PbtU Or Other Pavement irregularities 53.la*Me 54.tire M Vetrde SB•Oft NwKallnion 99.Unknoem 4vmhd Event phMe "lorle w•1unry nuns mwy aae nvm rcy.ng7 07=Piooeedag MAO 21•Carekw ParkmgNnpark4 q tiearance Aker Stop 22=OvedUnder pg,R StOp?Sign $Cpom?penssation At Curve 23 10.faiwe Toned m To 24 .Drhr, Too rag For Conditions Outer TreIl of DrAt 25-Falure To Mai Speed it ntain ProperChao) .Tail Iirw 26-0" FW4Po6ee iPd 12•y bwknQStoppirq 27.Driver netncM ,Cr 14.Careksa S?POao g Or LaaRoo?aaHd 24?adwe lo SperiaFaed fgoiP g 92=ANeded By Physical C4rW*n 15•P in No Passing Zone 9we Mtprow DIMV Actions 160001" The Mhong Way On 99=UnknoA4n My Street pole 01 t 92 2 00 3 4 00 it 02 1 Foo ---- I 2 00 3 00 45-6---] Ptde"n Acoon A 03.w"" _ Y Ol=#ntering Or Crowing At SPerSlred tocalion O'Appr 01M-n9 Yetkicle 06.YV cirlkirngVehidc 02 0 4 Running. logging, 0705 wing 99.Unknown Unn No OF, ? Unit He 02 sores IF AA41001INX PENNDOT COPY http://www.dot6.state.pa.uslcrsappIPrintlmageslXmiFiles/20080781572008072909441444... 7/29/2008 Print CRS W0085305 J COMMONWEALTH OF PENNSYLVANIA POUCE CRASH REPORTING FORM AA 500 5 w-we0* 1 Page -- -------- --- W0085305 Page 6 of 7 Crash Number I .. -. .. ._....... t t , i i t t i ' 4 : i i ' : t j J wttess Name Address Phone i JULIE MORRISON SI0 PARTRIDGE CT MECHANICSBURG PA 17 7179790148 r 2 TED MOHN 6112 CHARING CROSS MECHANICSBURG PA 7177736083 Narrative and additional whriso s. Accident Investigation Nodrkatiorr issued? O Property Damage O V1 was westbound In the 4900 bik of the Carlisle Pike. V2 was eastbound. Witness Mohn was behind V1 and witness Morrison was behind V2. Oper V1 stated that she either passed outor fell asleep at the wheel and drifted across the roadwayinto V2. Oper V2 stated that she tried to swerve right butcould not avoid Vt. Both V1 & V2 were towed byAo Roadside Auto Rescue. Oper V1 was transported by Ambulance 171 to Holy Spirit Hospital. i 10M • A&0X (1M PENNDOT COPY http://www.dot6.state.pa.uslersappIPrintl mages/XmIFilesl2008O78157200807290944l444... 7/29/2008 Print CRS W0085305 Crash Number: W0086305 Incident Number: HAM20080700268 dM61kCa11sk Ills CDR 1010 Page 7 of 7 /TIN NOT TO ,: B 8odio http://www.dot6.state. pa.uslcrsappIPrintlmagcslXm]Files120080781572008072909441444... 7129/2008 YNI1 VERIFICATION Robert E. Cherwony, Esquire hereby states that he is the Attorney for Plaintiff in this action and verifies that the statements made in the foregoing pleading are true and correct to the best of his knowledge, information and belief. The undersigned understands that the statements therein are made subject to the penalties 18 Pa. C.S. 4904 relating to unsworn falsification to authorities. Date: 6 0 A obert E. Cherwony SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson ~' ~-r-4 - - " Sheriff ~ (' ` ~~~:' ~$~,tsr of ~ua~6rt~~~D Jody S Smith ~ n ~ ~ , Chief Deputy ~ . ' o ~ L is i ~ ~ ~ . c~ ~ ~~ `i ~ • .; , ~"~ ;~ ~ ~ PM 3.33 Richard W Stewart , •`"~ '`~ ~U;ti~ ~ ~ ~~ SoilCltor +',~FICE ~'F T~+E c•~RIfF L ,. J~ ( i i t i `~ . .- 1 . -? j:-1 The Horace Mann Companies vs. John J. Peters (et al.) Case Number 2010-4279 SHIERIFF'S RETURN OF SERVICE 06/30/2010 Ronny R. Anderson, Sheriff,. who being duly sworn according to law, states that on July 1, 2010 at 1345 hours this Complaint and Notice upon defendant John J. Peters is retuned not served per request from Attorney Robert E. Cherworiy. 06/30/2010 Ronny R. Anderson, Sheriff, who being duly sworn according to law, states that on July 1, 2010 at 1345 hours this Complaint and Notice upon defendant Susan Peters is returned not served per request from Attorney Robert E. Cherwony. 07/01/2010 Ronny R. Anderson, Sheriff who being duly sworn according to law states that he made a diligent search and inquiry for the within named defendant, to wit: John J. Peters, but was unable to locate him in his bailiwick. He therefore deputized the Sheriff of Luzerne County, PA to serve the within Complaint and Notice according to law. 07/01/2010 Ronny R. Anderson, Sheriff who being duly sworn according to law states that he made a diligent search and inquiry for the within nadned defendant, to wit: Susan Peters, but was unable to locate her in his bailiwick. He therefore deputized the Sheriff of Luzerne County, PA to serve the within Complaint and Notice according to law. 07/07/2010 04:27 PM -Luzerne County Return: And now July 7, 2010 at 1627 hours I, Charles Guarnieri, Sheriff of Luzerne County, Pennsylvania, do herby certify and return that I served a true copy of the within Complain and Notice, upon the within named defendant, to wit: John J. Peters by making known unto himself personally, at 3-4 Brookhill Square East, Sugarloaf, PA 18249 its contents and at the same time handing to him personally the said true and correct copy of the same. 07/07/2010 04:27 PM -Luzerne County'Return: And now July 7, 2010 at 1627 hours I, Charles Guarnieri, Sheriff of Luzeme County, Pennsylvania, do herby certify and return that I served a true copy of the within Complain and Notice, upon the within named defendant, to wit: Susan Peters by making known unto John J. Peters Husband of defendant at 3-4 Brookhill Square East, Sugarloaf, PA 18249 its contents and at the same time handing to him personallly the said true and correct copy of the same. SHERIFF COST: $53.00 July 22, 2010 SO ANSWERS, RON R ANDERSON, SHERIFF (c) CountySuite Sheriff. Teleosoff Inc. In The Court of Common Pleas of Cumberland County, Pennsylvania The Horace Mann Companies vs. Susan Peters 3-4 Brookhill Square East Sugarloaf, PA 18249 Civil No. 2010-4279 Now, July 1, 2010, I, SHERIFF OF CUMBERLAND COUNTY, PA, do hereby deputize the Sheriff of Luzerne County to execute this Writ, this deputation being made at the request and risk of the Plaintiff. O~. of Cumberland County, PA Affidavit of Service Now, (,V _ _ _ ~~ 7 , 20 / ~, at y,' a.7 o'clock P. M, served the within ~ upon. by handing to a 1..P, .~o„NL,. ~r•~.r copy of the original, and made known to ~,,.,r,,., the contents thereof. So ~y~, Sheriff' '~ a ~ County, PA Sword i ~. NSYLV 17~ SIC $ MILEA NN11:E ,MA ~ Y PUBLIC AFFIDAVIT L 1 M R~ In The Court of Common Pleas of Cumberland County, Pennsylvania The Horace Mann Companies vs. John J. Peters 3-4 Brookhill Square East Sugarloaf, PA _18249 Civil No. 2010-4279 Now, July 1, 2010, I, SHERIFF OF CUMBERLAND COUNTY, PA, do hereby deputize the Sheriff of Luzerne County to execute this Writ, this deputation being made at the request and risk of the Plaintiff. /X""'L~ '^'`~ oY Cumberland County, PA Affidavit of Service Now, _ ~_ ~ , 20 , at ~" d 7 o'clock ~ M, served the within ~~ ~, t upon . Pa at 3 - '~ F~i.~~ S^ by handing to ~~ ~ a and made known to ~.~ copy of the original. So answers, A.~.~.. Sheriff of COSTS Sw ~1R~l4MNBYLWWIA ', SER~ O 10 MIL M IE R~ . ~ E ~~~ ~ AFFIDA nn IS N 3 the contents thereof. County, PA $~jy.oo+lo•oo KRAFT & KRAFT, P.C. BY: Robert E. Cherwony, Esquire Attorney No. 17623 1311 Spruce Street Philadelphia PA 19107 (215) 546-5100 reckraft@bigplanet.com s? ?atv 141.oG- 13 P/?1 'Sl:al(o 2ri '!J ? 3 Attorney for Plaintiff THE HORACE MANN COMPANIES, AS SUBROGEE OF ANN McGINN VS. SUSAN PETERS and JOHN J. PETERS COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA CIVIL ACTION AT LAW NO. 2010-04279 ORDER TO SETTLE. DISCONTINUE AND END TO THE PROTHONOTARY: Kindly mark the above matter settled, discontinued, and ended, upon payment of your costs only. Date Robert E. C erwony, Esquire Attorney for Plaintiff