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HomeMy WebLinkAbout10-7554 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA a AI J ? a -t a/k/a Aekerijah Ljuca r_,0, IV 0. rQ ?7ss7 M r-n n- Deceased °? .C p =' PETITION FOR SETTLEMENT AND APPORTIONMENTS .Z rn . 5_4 OF WRONGFUL DEATH AND SURVIVAL ACTION 7V Petitioner, Jasmina Ljuca, Administratrix of the Estate of Zekerijah Ljuca, Deceased, by and through her undersigned attorney, respectfully requests permission to enter into the below described settlement, and in support thereof avers: 1. Petitioner, Jasmina Ljuca, was appointed Administratrix of the Estate of Zekerijah Ljuca, Deceased, on July 12, 2010, by the Register of Wills of Cumberland County. A copy of the decree of the register is attached as Exhibit A. 2. This wrongful death action arises from a motor vehicle collision on April 12, 2010, near Hazen, Arkansas. 3. Zekerijah Ljuca was killed when the tractor-trailer he was driving was struck head-on by a second tractor-trailer owned by Wayne Smith Trucking. Liability lies solely with Wayne Smith Trucking and its driver, Stephen Stell. 4. All causes of action arose in Arkansas. 5. In Arkansas, the conflicts of law state the action arises where the tort occurred. The Eighth Circuit, interpreting Arkansas laws, stated in Glick v. Ballentine Produce, Inc., 343 F.2d 839 (1965), that "under the Arkansas conflict of laws rule, the courts of that state look to the laws of the state where the tort occurred in determining who is entitled to recover and the amount recoverable." 6. There is no Pennsylvania cause of action. 7. Arkansas law applies to all causes of action arising out of the accident. 8. Under Arkansas' Wrongful Death Statute, A.C.A. §16-62-102, the beneficiaries of the wrongful death action are the surviving spouse, children, mother, father, brothers and sisters. A.C.A. §16-62-102(d)(1). 5_q.106 /°( cyls-3 y 3 ? - :1135 . , 9. Petitioner has served a copy of this petition on the intestate heirs of decedent as provided in 20 Pa. C.S.A. 2101 et seq. who are as follows: Jasmina Ljuca(wife) 6302 Valleybrook Drive, Mechanicsburg, PA 17050 Eldin Ljuca(son) 6302 Valleybrook Drive, Mechanicsburg, PA 17050 Eldina Tandir(daughter) 1 Mandy Court, Camp Hill, PA 17011 10. Petitioner has served a copy of this petition and a copy of the Notice of Filing, attached hereto as Exhibit B, on the following parties listed below who may have a possible interest: Jasmina Ljuca(wife) 6302 Valleybrook Drive, Mechanicsburg, PA 17050 Eldin Ljuca(son) 6302 Valleybrook Drive, Mechanicsburg, PA 17050 Eldina Tandir(daughter) 1 Mandy Court, Camp Hill, PA 17011 11. Decedent died intestate. 12. There remain outstanding claims against the estate as follows: Bank of America in the amount of $2,334.97 Chase in the amount of $1,225.03 Southern Paramedic Service - Hazen in the amount of $750.00 13. Funeral Expenses for Zekerijah Ljuca totaled $13,221.16. Said expenses were paid by the family who seeks reimbursement from the estate. 14. The Department of Public Welfare has verbally confirmed for the undersigned that there are no claims or liens against the estate or the beneficiaries. The undersigned has been awaiting written confirmation of this for at least 3 weeks and is informed that it is forth coming. 15. Petitioner engaged The Duncan Firm of Little Rock, Arkansas to pursue an action against Wayne Smith Trucking, Inc. and its driver Stephen Stell. 16. Prior to the filing of any action, the following settlement has been proposed: Due to Wayne Smith Trucking's responsibility for the death of Zekerijah Ljuca, Wayne Smith Trucking's insurance carrier, Northland Insurance, has agreed on behalf of its insured to pay the sum of $781,671.93, which is the sum remaining of its liability limits of all applicable insurance policies, and is offered in exchange for a full and final release of any and all claims against Wayne Smith Trucking and its driver. 17. Wayne Smith Trucking's limits of liability are $1,000,000.00. Various sums were paid to third parties from the aggregate amount, as follows: a. $13,647.50 for total loss of the leased trailer; b. $19,680.57 for towing, storage and clean-up of the collision scene; C. $35,000.00 for total loss of the tractor; and, d. $150,000.00 for total loss of the cargo. 18. A balance of $781,671.93 is offered to the family of Zekerijah Ljuca for wrongful death. 19. From the balance of $781,671.93, attorneys' fees are owed at the contractual rate of thirty-five (35) percent. The total amount of attorneys' fees to be deducted from the balance at the contractual rate of 35 percent is $273,585.18. See fee agreements attached collectively as Exhibit C. All clams litigation expenses have been waived at this time. The undersigned counsel's fees for all work performed including the administration of the estate will be paid through the referral fee received from The Duncan Firm. That referral fee is 25% of The Duncan Firm's fee. 20. The net amount to the family from this settlement is $508,088.75. 21. Petitioner's counsel are of the professional opinion that the proposed settlement is fair and reasonable given that Wayne Smith Trucking's insurer has tendered its liability limits and a thorough investigation has been made to determine that there are no other applicable policies of insurance for Wayne Smith Trucking. Counsels have made a full and complete investigation of the facts and circumstances surrounding the underlying incident and have made other such investigation and inquiry to convince them that acceptance of such settlement is in the best interest of the Estate and heirs. 22. There are additional causes of action which may remain, and the attorneys are continuing to. investigate and pursue those causes of action in an effort to obtain recovery for the Estate and hens. Included in those causes of action are potential product liability claims against the tractor manufacturers. 23. Petitioner and her attorneys are investigating and pursuing potential Under Insured Motorist claims against the following: Great American Assurance Company/Great American Insurance Group Ohio Casualty Nationwide Canal Insurance Company Each of these companies has been notified of the proposed settlement and has consented to the settlement. See attached letters of consent attached as Exhibit D. 24. Petitioner is of the opinion that the proposed settlement is reasonable for the reasons listed above. 25. From the balance of $781,671.93, attorneys' fees are owed at the contractual rate of thirty-five (35) percent. The total amount of attorneys' fees to be deducted from the balance at the contractual rate of 35 percent is $273,585.18. The claim/litigation expenses have been waived at this time. The undersigned counsel and The Duncan Law Firm of Little Rock, Arkansas, who has been engaged on behalf of the estate to pursue all actions in Arkansas, will be compensated from the contractual 35 percent. The undersigned counsel and The Duncan Law Firm request these fees in the amount of $273,585.18 which represents full and fair compensation for their representation of petitioner. 26. Petitioner requests allocation of the net proceeds of the settlement after deduction of costs and attorney's fees as follows: (a) Wrongful Death Claim: $457,279.87 (b) Survival Claim: $50,808.88 26. All those parties named in Paragraphs 9 and 10 believe that the proposed allocation is fair and reasonable and their consents are attached as Exhibit E. 27. The reasons for the requested allocation are as follows: Arkansas Wrongful Death Statute states that "no part of any recovery ... shall be subject to the debts of the deceased or become, in any way, part of the assets of the estate of the deceased person." ACA 16-62-102(e) Additionally, Under Arkansas' Wrongful Death Statute, the following damages are recoverable by the beneficiaries: a. Pecuniary injuries ("present value of benefits, including money, goods and services which the deceased would have contributed to the claimed beneficiaries had [he/she] lived." Lowe v. U.S., 662 F. Supp. 1089 (W.D. Ark. 1987)). In determining this recovery the court should look at the following factors: • What was customarily contributed in the past and what he might reasonably have been expected to contribute had he lived; • The period during which any beneficiary might reasonably expect to have received contributions from the deceased; • What the deceased earned and what he might reasonably have expected to earn in the future; • What he spent for customary personal expenses and other deductions; • What instruction, moral training, and supervision of education he might reasonably have given the children had he lived; • His health; • His habits of industry, sobriety and thrift; • His occupation; • The life expectancy of the deceased and of the spouse; and Lowe v. U.S., 662 F. Supp. 1089, 1095 (W.D. Ark. 1987)) b. Mental anguish which includes the following factors: • The duration and intimacy of their relationship and the ties of affection between the decedent and the survivor, • Frequency of association and communication between an adult survivor and an adult decedent; • The attitude of the decedent toward the survivor and of the survivor toward the decedent; • The duration and intensity of the sorrow; • The violence or suddenness of the death; • Sleeplessness or troubled sleep over an extended period of time • Obvious extreme or unusual nervous reaction to the death; • Crying spells over an extended period of time; • Adverse effect on survivor's work or school; • Change of personality of the survivor; • Loss of weight by survivor or other physical symptoms; and • Age and life expectancy of the decedent. Zekerijah Ljuca was killed suddenly, violently and miles from home. His family had no opportunity to see him before his untimely death. Zekerijah and Jasmina Ljuca were married on February 12, 1971 in Brcko, Bosnia. They immigrated to the United States of America, with their two children Eldin Ljuca and Eldina Tandir, on October 23, 1997. Jasmina Ljuca has never worked, is physically disabled, and relied solely upon the financial support of Zekerijah Ljuca. Jasmina has now lost that financial support. Additionally, Jasmina, whose native language is Bosnian, has lost the emotional, physical and mental support of her husband of 39 years. Zekerijah and Jasmina Ljuca had plans of retiring to their native Bosnia, which will not occur now due to the sudden and tragic death of Zekerijah. Jasmina Ljuca has lost the comfort and society of her husband. Under Arkansas' wrongful death statute, Zekerijah Ljuca's children, Eldin Ljuca and Eldina Tandir, have their own right to recovery. Zekerijah Ljuca lived with each of his children, alternating weeks living between Eldin's and Eldina's residences. They have each lost a member of their respective households. They have lost the guidance and support of the man who brought them to this foreign country. They have lost their father. There was no economic evaluation of the potential lost wages for Zekerijah Ljuca. Petitioner attaches tax returns for 2008 and 2009 as an illustration of the total income for Zekerijah Ljuca for those years. 28. The Department of Revenue and the Office of Chief Counsel have approved the proposed allocation of settlement funds. See Exhibits F and G. 29. Pursuant to the Arkansas Wrongful Death Statute, A.C.A. §16-62-102(d)(1), the beneficiaries of the Wrongful Death Claim, and the proportion of their interest are as follows: Jasmina Ljuca, wife of the decedent: $228,639.93 Eldin Ljuca, son of the decedent: $114,319.96 Eldina Tandir, daughter of the decedent: $114,319.96 30. The beneficiary of the survival claim is the Estate of Zekerijah Ljuca. After payment of outstanding claims, the balance of the survival damages will be divided pursuant to the intestacy statute as indicated to the following beneficiaries: Jasmina Ljuca, wife of decedent: $31,638.86 Eldin Ljuca, son of decedent: $819.46 Eldina Tandir, daughter of decedent: $819.43 WHEREFORE, Petitioner requests that an order be entered approving the proposed settlement and the proposed allocation and authorizing Petitioner as Administratrix of the Estate of Zekerijah Ljuca to execute all necessary releases and checks, pay the appropriate creditors and make the appropriate distribution. Respectfully submitted, Date: Son visto, Esquire PA ID 92919 MARCELLO & KMSTO, LLC 1200 Walnut Bottom Road Third Floor, Suite 331 Carlisle, PA 17015 T: (717)240-4686 Attorney for Petitioner IN THE ORPHANS' COURT CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA No. 2010-00681 a/k/a Aekerijah Ljuca Deceased VERIFICATION I, Jasmina Ljuca, hereby states that I am the Administratrix of the Estate of Zekerijah Ljuca and verify that the statements made in the foregoing Petition for Settlement and Apportionment of Wrongful Death and Survival Claims are true and correct to the best of my knowledge, information and belief. I understand that the statements therein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to the unsworn falsification to authorities. Ja?mina Ljuca, A ?'inistratrix REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA No. 2010- 00681 PA No. 21-10-0681 Estate Of : ZEKERIJAH LJUCA (First, Middle, Last) a/k/a : AEKERIJAH LJUCA Late Of: MECHANICSBURG BOROUGH CUMBERLAND COUNTY Deceased Social Security No: 157-02-6904 WHEREAS, ZEKERIJAH LJUCA (First, Middle, Last) a/k/a AEKERIJAH LJUCA late of MECHANICSBURG BOROUGH CUMBERLAND COUNTY died on the 12th day of April 2010 and, WHEREAS, the grant of Letters of Administration is required for the administration of the estate. THEREFORE, I, GLENDA FARNER STRASBAUGH Register of wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, have this day granted Letters of Administration to: JASMINA LJUCA who has duly qualified as ADMINISTRATOR(RIX) of the estate of the above named decedent and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURTHOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my office on the 7th day of duly 201C. **NOTE** ALL NAMES ABOVE APPEAR {FIRST, MIDDLE, LAST) IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA 2010-00681 a/k/a Aekerijah Ljuca Deceased NOTICE OF FILING To: Jasmina Ljuca 6302 Valleybrook Drive Mechanicsburg, PA 17050 YOU ARE HEREBY NOTIFIED THAT Jasmina Ljuca, administratrix of the estate of Zekerijah Ljuca, deceased, has filed on December 7, 2010, a Petition to Approve a Settlement of a Wrongful Death and Survival Action. A copy of that petition is enclosed. I hereby certify that the within notice has been mailed to the above named individual(s) on the date set forth above. Respectfully submitted, Date: 2 . C- L? &?? "7 Sonya Kivisto, Esquire PA ID 92919 MARCELLO & KIVISTO, LLC 1200 Walnut Bottom Road Third Floor, Suite 331 Carlisle, PA 17015 T: (717)240-4686 Attorney for Petitioner z,-v,q r/3 it B (J) IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA 2010-00681 a/k/a Aekerijah Ljuca : Deceased NOTICE OF FILING To: Eldin Ljuca 6302 Valleybrook Drive Mechanicsburg, PA 17050 YOU ARE HEREBY NOTIFIED THAT Jasmina Ljuca, administratrix of the estate of Zekerijah Ljuca, deceased, has filed on December 7, 2010, a Petition to Approve a Settlement of a Wrongful Death and Survival Action. A copy of that petition is enclosed. I hereby certify that the within notice has been mailed to the above named individual(s) on the date set forth above. Respectfully submitted, Date: 4 ". , o Syya Kivisto, Esquire PA ID 92919 MARCELLO & KIVISTO, LLC 1200 Walnut Bottom Road Third Floor, Suite 331 Carlisle, PA 17015 T: (717)240-4686 Attorney for Petitioner ?' Y iT . YJ iT fl IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA alkla Aekerijah Ljuca 2010-00681 Deceased NOTICE OF FILING To: Eldina Tandir 1 Mandy Court Camp Hill, PA 17011 YOU ARE HEREBY NOTIFIED THAT Jasmina Ljuca, administratrix of the estate of Zekerijah Ljuca, deceased, has filed on December 7, 2010, a Petition to Approve a Settlement of a Wrongful Death and Survival Action. A copy of that petition is enclosed. I hereby certify that the within notice has been mailed to the above named individual(s) on the date set forth above. Respectfully submitted, Date: onya Kivisto, Esquire PA ID 92919 MARCELLO & KIVISTO, LLC 1200 Walnut Bottom Road Third Floor, Suite 331 Carlisle, PA 17015 T: (717)240-4686 Attorney for Petitioner IE>(H 113 / T 6 ( 3) 06124/2010 10:22 17177610750 EDOS TRUCKING PAGE 02/08 06/2312010 WED 17123 FAX 7172584686 DUNCAN FIRM, P.A. goo South Shackleford Road, Suite 725 Little Rock, AR 72211 CONTRACT FOREMPLOYMENT OF ATTORNEYS The undersigned, referred to as "CLIENT", whether one or more persons, hereby employs the law firth of Duncan Firm, P.A. (referred to as "LAWFIRM") as my attorneys to pursue and/or settle all of CLIENT'S claims against any or all others who may be liable to CLIENT for the damages resulting from an incident or accident &nORNEY FEES & LITIGATION EXPENSE It is understood that if there is no recovery, I am to owe nothing. In the event of recovery by settlement or litigation, the attorneys' fee will be 35% or the gross recovery. I understand that a lawsuit will only be filed if there is a mutual agreement to do so between CLIENT and LAWFIRM. CLIENT understands and agrees that the prosecution of any claim such as CLIENT'S involves the expenditure of money for litigation expenses. CLIENT understands that litigation expenses are those expenses advanced by LAWFIRM in pursuit of the claim. Litigation expenses do not include CLIENT'S medical bills or other expenses incurred directly by CLIENT. Expenses consist of items such as court costs, deposition costs, investigation costs, long distance phone calls, postage, copying, scanning and data expense, sheriff s fees, travel expenses, fees for medical reports, records, experts, etc. I understand that if I collect any money from my group carrier or any other insurance company that I will in all probability have to pay theta back under subrogation, and my attorney will negotiate for me any lien filed or served. In the event that LAWFIRM recovers money for CLIENT, the contingent attorney fee will be calculated on the total amount. ThereaRer, CLIENT will reimburse LAWFIRM all litigation expenses from CLIENTS portion of the settlement. CLIENT agrees that LAWFIRM is authorized to withhold and pay directly said expenses and attorney fees from any settlement proceeds in the claim and to withhold future litigation expenses for the presentation of the remainder of the case. CLIENT further authorizes LAWFIRM to pay all medical bills, subrogation expenses, or liens to which CLIENThas authorized LAWFIRM to pay, and to which LAWFIRM has agreed to negotiate and pay, from CLIENTS share of the proceeds of suit or settlement. CLIENT understands and LAWFIRM agrees that in the event there is no recovery of money, that there will be no attorney fee charged to CLIENT and CLIENT will not be obligated to pay any of the litigation expenses. SETTLEMEL1T LAWFIRM shall have no right to settle or compromise CLIFNT"S claims without CLIENTS consent. If CLIENT fails to cooperate fully in the preparation and prosecution of CLIENTS claims, LAW FIRM shall have the right to withdraw from representation of CLIENT, in which event CLIENT agrees to pay a reasonable fee to LAWFIRM for the work performed to the date of withdrawal. CASE ITILIS With the exception of any personal itoms such as photographs, tax returns or other such items provided by CLIENT to LAWFIRM. CLIENT agrees that the file generated by.LAWFIRM, including any exhibits, documents, records or other materials will remain the property of LA1 WFIRM at the conclusion of the case and can be used for any purpose. CLIENT can have a copy of any file upon request. IE? /I ej-r (2 6) 06724/2010 10:22 17177610750 EDOS TRUCKING PAGE 03/08 06/23/2010 WED 17:23 Fax 7172584666 W,,,,,, V.,., CONTRACT FOR EMPLOYMENT OF ATTORNEYS Page 2 of 2 NO GUARANTEE OF OUTCOME CLIENT understands and agrees that because of the uncertainties of any litigation, LAWFIRM cannot warrant Or guarantee the outcome of the case and that LA WFiRM has not represented to the CLIENT that the CLIENT will recover all or any of the funds they desire. . ASSOCIATED COUNSEL CLIENT agrees that if LAWFIRM believes it to be beneficial to employ or associate with any other attorney to assist in the preparation or prosecution of the case, that I.A WFIRM may do so in their discretion. In the event that LAWFIRM chooses to associate other counsel, such association will not result in any increase in the attorney fee charged to client. PRE-LtM1NARY INVESTIGATION CLIENT understands that LAWFIRM will conduct a preliminary investigation of CLIENT'S claim. If after a 60 day preliminary investigation of CLIENTS claims, LAWFIRM declines further representation of CLIENT, LAWFIRM may withdraw with, no further obligation to CLIENT. This agreement supersedes and replaces any prior contracts or agreements for attorney's fees and expenses. DATED oC . g 3 • "l 0 PRINT NAME o/b/o Zekerijah Ljuca, Deceased SIGNATURE o/blo Zekerijah Ljuca, Deceased 4 / V11 a- 4 GLC? - W /Y -I?oM lNS1X ACCEPTED BY: s o/\/ r -C1 DUNCAN FIRM P.A. ' r 1 (> S 2 IEx?/Ii3 i; (1 (.).? Attorneys: Phillip J Duncon Jaynes H. Borlolornei William R. Pointer Mrs. Jasmina Ljuca 6302 Valley Brook Drive Mechanicsburg, PA 17050 Case lLiai?aaeis ? T t?rJn C,ri)f r, ?i 4inyre D ;n: an DUNCAj `I F 1 R M September 7, 2010 Re: The Estate of Zekerijah Ljuca v. Wayne Smith Trucking et al, Dear Jasmina: Confirming our conversation of September 2, you have given us authority to settle the wrongful death claim of the Estate of Zekerijah Ljuca against Wayne Smith Trucking and Northland Insurance. The aggregate policy limits is $1,000,000.00. All claims must be satisfied from this amount, including both the wrongful death claims and property damage claims. Following is a breakdown of how the money will be distributed pursuant to our conversation: Trailer total loss (paid): $13,647.50 Tow/storage/clean-up for Edo's Trucking (paid): $19,680.57 Cargo (paid): $150,000.00 Tractor for Edo's Trucking (pending): $35,000.00 Wrongful death claim (pending): $781,671.93 TOTAL: $1,000,000.00 We are continuing to investigate the possibility of a products liability claim, as well as claims against other insurance policies. We hope to be able to report the results of our investigations shortly. We have agreed to not take a fee percentage on any of the property damage. Our 35% fee is based on the wrongful death claim amount of $781,671.93. The total attorney's fee is $273,585.18, and we have agreed to defer our expenses until such time as we are able to collect on an additional claim or insurance policy. The net amount to the Estate is $508,088.75. 900 S. Shockleford • Three Financial Centre Suite 725 • Little Rock, AR 72211 (501) 228.7600 office • Toll Free 877-6-DUNCAN • 501-228-0415 fox • DuncanFirm.corn rx'" r,P IT' l The settlement will need to be approved by the Pennsylvania probate court. Thereafter, the $508,088.75 net proceeds will be distributed to the Estate's heirs pursuant to Pennsylvania law. We hope to have the funds from Northland Insurance within the next 21 days. The check will be made payable to Jasmina Ljuca, as Administrator of the Estate of Zekerijah Ljuca, and to your attorneys. In order to negotiate the check and disburse the funds as noted above, I have enclosed a limited power of attorney that will allow us to facilitate the settlement, Please sign below to indicate your acceptance of the terms of this correspondence. Should you have any questions, please do not hesitate to contact myself or Ms. Kivisto. Thank you for allowing us to represent you in this matter. Sincerely, Rob Pointer Encl. Jasmina Ljuca, as Administratrix of the Estate of Zekerijah Ljuca. 2 ExN,2 IT C (4) Canal Ilibul'alm;U GMT 9/7/Z010 3:34:Z47-Pm -PAZr1~: - 170W -rax 5Vrvtdr Canal INSURANCE To: Rob Pointer Fax: 501-228-0415 Company: Duncan Firm, PA City State. Little Rock, AR From: Jeanie Schamell Email: Jeanie.Schamell@canal-ins com Fax Number. 864-679-2518 Phone Number: 800-452-6911 No. of Pages: 2 Date and Time of Transmission: 917/2010 5:33:36 PM Your File No: L459430 Our File No: Edo's Trucking Notes: Attorney Pointer, This fax is serves as Canal Insurance's approval to proceed with the liability settlement as outlined with Northland Insurance in the above matter. Please call me with any questions. Jeanie Schamell Canal Insurance 864-250-9457 Coarkdandatity Notice: These pages are intended only for the person(s) named above and may conlain information that is confidential, privileged, and exempt from disclosure under applicable law. Pr vi" is claimed as to the entire content thereof. r the reader received this Communication in error, please contact the sender for dtrectlons On returning the communkatlon to us by mall. P.O. Box 7 • Greenville, South Carolina 29602 • 400 East Stone Avenue (29601) 1 600.452.6911 I F: 864.679.2518' canal insurance.com )(H /37T 4 Canal insurance GMT 917/2010 9:34:Z4--]?M -PAGE ' 27i7i7? -1 ax=5ervUr 9/7/2010 ::15 PH rFOH: 7uncan Dncan rirro P.A. TO: +1 (064) 679-2510„ S0000240f PAG3: OC1 Or 004 At'or..eys. •,!'y ;?, Cr?r M??ope(s PI'IIiP Cunc:an Uan Ori°1i: y:, ves H o DUNCAIi Doncar N1+i licm K. P., r lee, i F I R M „ September 7, 2010 V afataimHe at 864-6791518 and U.S. Mail Ms. Jeanie Schamell Canal Insurance Company PO Box 7 Greenville, SC 29602 Re: Our client: Jasmina Ljuea, as Administrator of the Estate of Zekerijah Ljuca., deceased Claim #: L459430 Your insd: Fdn's Trucking D/L 04/12/2010 Dear Ms. Schamell: Pursuant to your conversation with Wayne Duncan on September 1, this letter confirms that die liability carver in the above-rcfm-need matter has offered to pay the We are asking that you give us approval to settle the liability claim prior to pursuing the UIM claim. Under Arkansas law, you may elect to post the $781,671.93 and pursue the underlying tortfeasor, Wayne Smith Trucking, directly. Please let us know how you wish to proceed. Time is of the essence, so please let us know as soon as possible, or within the next ten (10) days if you approve of the liability settlement. We are not making a UIM claim at this time, we are merely asking for your approval, per the policy, to settle the liability claim. Please let me know if I can do anything to facilitate the request. Sincet'ply, Rob Pointer 000 S. Shackleford • ritno =oanrlal Cc 1••o • 5jite /25 l.`r. 4ock AR 7'2'2'1 tSGli 22t1-: 6UU of Dieu TolY Frea 877.o•M:NUAN . 50?-228-0.1i5 iox • Ounconh •r, rom Pagel of 4 received on VN712010 4:11IM PM (Eaetm, DWIghtTlmel on server CAM21 IN THE ORPHANS' COURT CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA No. 2010-00681 a/k/a Aekerijah Ljuca ; Deceased CERTIFICATE OF ADMINISTRATRIX I, Jasminia Ljuca, hereby certify that I am the Administratrix of the Estate of Zekerijah Ljuca and I join in this petition and pray that this Court approves the proposed settlement and apportionment. Jasmina Ljuca, Administratrix IV, CXH Ira rr E ?I? IN THE ORPHANS' COURT CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA No. 2010-00681 a/k/a Aekerijah Ljuca Deceased CERTIFICATE OF BENEFICIARY I, Jasminia Ljuca, hereby certify that I am a beneficiary of the wrongful death and survival actions and I join in this petition and pray that this Court approves the proposed settlement and apportionment. ?asmina Ljuca / IN THE ORPHANS' COURT CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA No. 2010-00681 a/k/a Aekerijah Ljuca Deceased CERTIFICATE OF BENEFICIARY I, Eldina Tandir, hereby certify that I am a beneficiary of the survival action and I join in this petition and pray that this Court approves the proposed settlement and apportionment. Eldina Tandir lx?, eJT L-0) IN THE ORPHANS' COURT CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA No. 2010-00681 a/k/a Aekerijah Ljuca Deceased CERTIFICATE OF BENEFICIARY I, Eldin Ljuca, hereby certify that I am a beneficiary of the survival action and I join in this petition and pray that this Court approves the proposed settlement and apportionment. r Eldin Ljuca /3 ir- E N ) WIA c , COMMONWEALTH OF PENNSYLVANIA GOVERNOR'S OFFICE OF GENERAL COUNSEL November 10, 2010 Sonya Kivisto, Esq. Marcello & Kivisto, LLC 1200 Walnut Bottom Road Suite 700 Third Floor, Suite 331 Carlisle, PA 17015 Re: Estate of Zekerijah Ljuca, Deceased Wrongful Death Action Inquiry Dear Ms. Kivisto: I am in receipt of your correspondence dated October 13, 2010, concerning the above-referenced decedent. Specifically, you asked for this Office's opinion on (1) whether proceeds recovered from the settlement of potential wrongful death and survival actions in Arkansas are subject to Pennsylvania inheritance tax and; (2) if so, whether the allocation as proposed in your letter is acceptable to the Department. As I understand the facts, the decedent died in a tractor trailer accident in Arkansas on April 12, 2010. Decedent, a Pennsylvania resident, was survived by a disabled spouse as well as two adult children. Decedent earned modest income during his life. An estate was opened for the decedent in July, 2010. A claim was instituted on behalf of the decedent against Wayne Smith Trucking. This matter was settled before an actual wrongful death or survival action was filed in Arkansas. At issue is whether the net proceeds of the action (approximately $500,000.00) are subject to Pennsylvania inheritance tax, as taxable survival proceeds. This Office concurs with your conclusion that Arkansas law applies to the matter at hand, and that the Arkansas Wrongful Death Statute prohibits the taxation of any recovery under such Statute. However, based upon the facts presented, it appears a portion of the recovery should be allocated to the survival action under Arkansas law, and as such would be considered a taxable intangible asset of the decedent's estate. OFFICE OF CHIEF COUNSEL I PO BOX 281061 1 HARRISBURG, PA 17128-1061 Ph: (717) 783-7539 1 Fax: (717) 772-1459 1 tgohsler@state.pa.us E01,13 IT- pennsylvania DEPARTMENT OF REVENUE K Sonya Kivisto, Esq. November 10, 2010 Page 2 Consequently, this Office would accept the proposed allocation of the net proceeds of the action ninety-percent to wrongful death action and ten percent to the survival action. If you concur with this offer, kindly contact Holly Moore or Shannon Baker at the address listed below so that you may formally request an allocation approval from the Department: PA Department of Revenue Inheritance Tax Division Bureau of Individual Taxes 5th Floor, Strawberry Square Harrisburg PA 17128 (717) 787-8327 I trust this response is satisfactory. If you have any additional questions or concerns, please contact me at your earliest convenience. Thomas J. Go r Counsel cc: Holly Moore TJG:dmm #36169 J EAR 10 IT I , r pennsylvania DEPARTMENT OF REVENUE November 29, 2010 Sonya Kivisto, Esquire Marcello & Kivisto, LLC 1200 Walnut Bottom Road Third Floor, Suite 331 Carlisle, PA 17015 Re: Estate of Zekerijah Ljuca File Number 2110-0681 Court of Common Pleas Cumberland County Dear Ms. Kivisto: The Department of Revenue has received the Petition for Approval of Settlement Claim to be filed on behalf of the above-referenced Estate in regard to a wrongful death and survival action. It has been forwarded to this Bureau for the Commonwealth's approval of the allocation of the proceeds paid to settle the actions. Pursuant to the Petition, the 61 year old decedent died as a result of a motor vehicle accident in Arkansas. Decedent is survived by his 'wife and two adult children. Please be advised that, based upon these facts and for inheritance tax purposes only, this Department has no objection to the proposed allocation of the net proceeds of this action, $457,279.87 to the wrongful death claim and $ 50,808.88 to the survival claim. Proceeds of a survival action are an asset included in the decedent's estate and are subject to the imposition of Pennsylvania inheritance tax. 42 Pa.C.S.A. §8302; 72 P.S. §9106, 9107. Costs and fees must be deducted in the same percentages as the proceeds are allocated. In re Estate of Men yman, 669 A.2d 1059 (Pa. Cmwlth. 1995). I trust that this letter is a sufficient representation of the Department's position on this matter. As the Department has no objections to the Petition, an attorney from the Department of Revenue will not be attending any hearing regarding it. Please contact me if you or the Court has any questions or requires anything additional from this Bureau. Sin erely, h n E. Baker Trust Valuation Specialist Inheritance- Tax Division Bureau of Individual Taxes ( PO Box 280601 1 Harrisburg, PA 17128 1 717.783.5824 1 shabaker@state:pa.us LX 8/Bl 7- IN THE COURT OF COMMON PLEAS DEC 0 8 2010 CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA aWa Aekerijah Ljuca " Deceased Noll ORDER AND NOW, this day of e_G , 2010, on consideration of the Petition for Settlement and Apportionment of Wrongful Death and Survival Action, it is hereby ORDERED that Petitioner is authorized to enter into a settlement with Wayne Smith Trucking and Stephen Sell in the gross sum of SEVEN HUNDRED EIGHTY- ONE THOUSAND SIX HUNDRED SEVENTY-ONE DOLLARS AND NINETY-THREE CENTS ($781,671.93). It is further ORDERED that the settlement proceeds be distributed as follows: 1. To the Duncan Law Firm: $273,585.18 for counsel fees. 2. The remaining balance of $508,088.75 is apportioned as follows: (a) Wrongful Death Claim: $457,279.87 (b) Survival Claim: $50,808.88 3. The Wrongful Death Claim of $457,279.87 shall be paid as follows: (a) Jasmina Ljuca, wife of the decedent: $228,639.93 (b) Eldin Ljuca, son of the decedent: $114,319.96 (c) Eldina Tandir, daughter of the decedent: $114,319.96 4. The Survival Claim of $50,808.88 shall be paid to the Estate of Zekerijah Ljuca and shall be apportioned pursuant to the intestate laws of The Commonwealth of Pennsylvania. Y ?a nY4 ,? , u; SAD, ?? SPY a ?? ecf I a J13?/1? ON IV I ':i ,d 'Ni 3 ?\ J W,j i`~ !`f :yam. !^} ? 17 `. t ? IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA NO. 10-7554 - f a/k/a Aekerijah Ljuca Deceased CIVIL TERM PETITION FOR APPROVAL OF SETTLEMENT w Petitioner, Jasmina Ljuca, Administratrix of the Estate of Zekerijah Ljuca, Deceased, by and through her undersigned attorney, respectfully requests permission to enter into the below described settlement, and in support thereof avers: 1. Petitioner, Jasmina Ljuca, was appointed Administratrix of the Estate of Zekerijah Ljuca, Deceased, on July 7, 2010, by the Register of Wills of Cumberland County. A copy of the decree of the register is attached as Exhibit A. 2. Zekerijah Ljuca was killed when the tractor-trailer he was driving was struck head-on by a second tractor-trailer owned by Wayne Smith Trucking. Liability lies solely with Wayne Smith Trucking and its driver, Stephen Stell. 3. Petitioner has served a copy of this petition on the intestate heirs of decedent as provided in 20 Pa. C.S.A. 2101 et seq. who are as follows: Jasmina Ljuca(wife) 6302 Valleybrook Drive, Mechanicsburg, PA 17050 Eldin Ljuca(son) 6302 Valleybrook Drive, Mechanicsburg, PA 17050 Eldina Tandir(daughter) 1 Mandy Court, Camp Hill, PA 17011 4. Petitioner has served a copy of this petition and a copy of the Notice of Filing, attached hereto as Exhibit B, on the following parties listed below who may have a possible interest: Jasmina Ljuca(wife) Eldin Ljuca(son) Eldina Tandir(daughter) 6302 Valleybrook Drive, Mechanicsburg, PA 17050 6302 Valleybrook Drive, Mechanicsburg, PA 17050 1 Mandy Court, Camp Hill, PA 17011 5. Decedent died intestate. 6. The estate and beneficiaries have previously settled the wrongful death and survival action against Wayne Smith Trucking and Stephen Sell arising out of the above accident. Said settlement was approved by this Court. 7. The Department of Public Welfare has confirmed for the undersigned that there are no claims or liens against the estate or the beneficiaries. See letters attached collectively as Exhibit C. 8. Canal Insurance has offered its Underinsured Motorist limits of $35,000.00. 9. Petitioner's counsel are of the professional opinion that the proposed settlement is fair and reasonable given that Canal Insurance has tendered its Underinsured Motorist limits and a thorough investigation has been made to deterniine that there are no other applicable policies of insurance. Counsels have made a full and complete investigation of the facts and circumstances surrounding the underlying incident and have made other such investigation and inquiry to convince them that acceptance of such settlement is in the best interest of the Estate and heirs. 10. There are additional causes of action which may remain, and the attorneys are continuing to investigate and pursue those causes of action in an effort to obtain recovery for the Estate and heirs. Included in those causes of action are potential product liability claims against the tractor manufacturers. 1.1. Petitioner is of the opinion that the proposed settlement is reasonable for the reasons listed above. 12. From the balance of $35,000.00, attorneys' fees are owed at the contractual rate of thirty-five (35) percent. The total amount of attorneys' fees to be deducted from the balance at the contractual rate of 35 percent is $12,250.00. The claim/litigation expenses have been waived at this time. The undersigned counsel and The Duncan Law Firm of Little Rock, Arkansas, who has been engaged on behalf of the estate to pursue all actions in Arkansas, will be compensated from the contractual 35 percent. The undersigned counsel and The Duncan Law Firm request these fees in the amount of $12,250.00 which represents full and fair compensation for their representation of petitioner. 13. All those parties named in Paragraphs 3 and 4 believe that the proposed allocation is fair and reasonable and their consents are attached as Exhibit D. 14. After payment of attorney's fees, $22,750.00 will be paid to the Estate of Zekerijah Ljuca. After payment of outstanding claims, the balance of the survival damages will be divided pursuant to the intestacy statute to the following beneficiaries: Jasmina Ljuca, wife of decedent Eldin Ljuca, son of decedent Eldina Tandir, daughter of decedent WHEREFORE, Petitioner requests that an order be entered approving the proposed settlement and the proposed allocation and authorizing Petitioner as Administratrix of the Estate of Zekerijah Ljuca to execute all necessary releases and checks, pay the appropriate creditors and make the appropriate distribution. Date: 3 S }? / Respectfully submitted, k- 'Y' ony ' visto, Esquire PA ID 92919 MARCELLO & KMSTO, LLC 1200 Walnut Bottom Road Third Floor, Suite 331 Carlisle, PA 17015 T: (717)240-4686 Attorney for Petitioner EXHIBIT A REGISTER OF WILLS CUMBERLAND COUNTY PENNSYLVANIA CERTIFICATE OF GRANT OF LETTERS ADMINISTRATION No. 2010-00681 PA No. Estate Of : ZEKERIJAH LJUCA (First, Middle, Last) a/k/a : AEKERIJAH LJUCA Late Of: MECHANICSBURG BOROUGH CUMBERLAND COUNTY Deceased Social Security No: 157-02-6904 WHEREAS, ZEKERIJAH LJUCA 21-10--0681 (First, Middle, Last) a/k/a AEKERIJAH LJUCA late of MECHANICSBURG BOROUGH CUMBERLAND COUNTY died on the 12th day of April 2010 and, WHEREAS, the grant of Letters of Administration is required for the administration of the estate. THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and for CUMBERLAND County, in the Commonwealth of Pennsylvania, have this day granted Letters of Administration to: JASMINA LJUCA who has duly qualified as ADMINISTRATOR (RIX) of the estate of the above named decedent and has agreed to administer the estate according to law, all of which fully appears of record in my office at CUMBERLAND COUNTY COURTHOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of m- office on the 7th day of July 2010. **NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST) EXHIBIT B IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA 2010-00681 a/k/a Aekerijah Ljuca : Deceased NOTICE OF FILING To: Eldin Ljuca 6302 Valleybrook Drive Mechanicsburg, PA 17050 YOU ARE HEREBY NOTIFIED THAT Jasmina Ljuca, administratrix of the estate of Zekerijah Ljuca, deceased, has filed on February 25, 2011, a Petition For Approval of Settlement. A copy of that petition is enclosed. I hereby certify that the within notice has been mailed to the above named individual(s) on the date set forth above. Respectfully submitted, Date: J Y-P "?; Sony?K visto, Esquire PA ID 919 MARCELLO & KIVISTO, LLC 1200 Walnut Bottom Road Third Floor, Suite 331 Carlisle, PA 17015 T: (717)240-4686 Attorney for Petitioner IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA 2010-00681 a/k/a Aekerijah Ljuca Deceased NOTICE OF FILING To: Jasmina Ljuca 6302 Valleybrook Drive Mechanicsburg, PA 17050 YOU ARE HEREBY NOTIFIED THAT Jasmina Ljuca, administratrix of the estate of Zekerijah Ljuca, deceased, has filed on February 25, 2011, a Petition for Approval of Settlement. A copy of that petition is enclosed. I hereby certify that the within notice has been mailed to the above named individual(s) on the date set forth above. Respectfully submitted, Dated i Sonya Kivisto, Esquire PA ID 92919 MARCELLO & KIVISTO, LLC 1200 Walnut Bottom Road Third Floor, Suite 331 Carlisle, PA 17015 T: (717)240-4686 Attorney for Petitioner IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA : a/k/a Aekerijah Ljuca 2010-00681 Deceased NOTICE OF FILING To: Eldina Tandir 1 Mandy Court Camp Hill, PA 17011 YOU ARE HEREBY NOTIFIED THAT Jasmina Ljuca, administratrix of the estate of Zekerijah Ljuca, deceased, has filed on February 25, 2011, a Petition for Approval of Settlement. A copy of that petition is enclosed. I hereby certify that the within notice has been mailed to the above named individual(s) on the date set forth above. Respectfully submitted, Date:' o -So Kivisto, Esquire PA 92919 MARCELLO & KIVISTO, LLC 1200 Walnut Bottom Road Third Floor, Suite 331 Carlisle, PA 17015 T: (717)240-4686 Attorney for Petitioner EXHIBIT C Dec. 7. 2010 6:21PM COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBI.JC WELFARE BUREAU of PROGRAM ME43RIiY DIVISION OF THIRD PARTY LWILITY CASUALTY UNIT P.OQBOX 8468 HARRISBURG. PA 77105-8486 December 7, 2010 MARCELLO & KIVISTO LLC SONYA KIVISTO ESQUIRE 3RD FL STE 331 1200 WALNUT BOTTOM RD CARLISLE PA 17015 Re: Ze%erijah Ljuca SSN: ###-##-6904 Dear Attorney Kivisto: No. 1938 P. 2/5 Pursuant to your letter dated September 23, 2010, the Department of Public Welfare (DPW), Third Party Liability (TPL) - Casualty Unit, has reviewed the information you provided regarding the above-referenced individual. Based on this information, we have no record of this individual receiving medical and/or cash benefits at this time. Therefore, the Department's TPL - Casualty Unit has no claim on this individual. If your client applies for medical assistance at a later date or currently has an application pending, please advise us and provide any additional information that may affect a recovery by our department. If you have any questions, please feel free to contact me. Sincerely, Vince A. Porter Recovery Section Manager (717)772-6604 Dec. 7. 2010 6:21PM COMMIONWMTH OF PGNNMVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF PROGRAM INTEGRITY DIVISION OF THIRD PARTY LMUTY CASUALTY UNrr P.O.eOx 8486 HARRISBURG, PA 17105.8486 December 7, 2010 M&RCELLO & KIVISTO LLC SONYA KIVISTO ESQUIRE 3RD FL STE 331 1200 WALNUT BOTTOM RD CARLISLE PA 17015 Re: Jasmina Ljuca SSA]: ###-##-5713 Dear Attorney Kivisto: No. 1938 P. 3/5 Pursuant to your letter dated September 23, 2010, the Department of Public Welfare (DPW), Third Party Liability (TPL) - Casualty Unit, has reviewed the information you provided regarding the above-referenced individual. It has been determined that DPW has no claim against this individual. If you have any questions, please feel, free to contact me. Sincerely, Vince A. Porter Recovery Section Manager (717)772-6604 Dec. 7. 2010 6:21PM COMMONWEALTH OF PENNSYLVANIA OEPAMMENT OF PUBUC WELFARE BUREAU OF PROGRAM INMRCw RITY DMSION OF TWO O PARTY LIABILITY CASUALTY UNIT P.O.BOX um NARRI38UR0. PA 17105&186 December 7, 2010 MARCELLO & KIVISTO LLC SONYA KIVISTO ESQUIRE 3RD FL STE 331 1200 WALNUT BOTTOM RD CARLISLE PA 17015 Re: Eldin Ljuca SSN: ###-##-6905 Dear Attorney Kivisto: No.1938 P. 4/5 Pursuant to your letter dated September 23, 2010, the Department of Public Welfare (DPW), Third Party Liability (TPL) - Casualty Unit, has previewed the information you provided regarding the above-referenced individual. Based on this information, we have no record of this individual receiving medical and/or cash benefits at this time. Therefore, the Department's TPL - Casualty Unit has no claim on this individual. If your client applies for medical assistance at a later date or currently has an application pending, please advise us and provide any additional information that may affect a recovery by our department. If you have any questions, please feel free to contact me. Sincerely, Y Vince A. Porter Recovery Section Manager (717)772-6609 Dec. 7. 2010 6:21PM COMMONVJEALT14 OF PENNSYLVANIA KPARTMENT OF PUBLIC WELFARE BUREAU OF PROGRAM INTEGRrrY DIVISION OF THIRD PARTY LIABILITY CASUALTY UNIT P.O.BOX 99a6 HARRISBURG. PA 17105-UN December 1, 2010 MARCELLO & KIVISTO LLC SONYA KIVISTO ESQUIRE 3RD FL STE 331 1200 WALNUT BOTTOM RD CARLISLE PA 17015 Re: Eldina Tandir SSN: ###-##-6360 Dear Attorney Kivisto: No. 1938 P. 5/5 Pursuant to your letter dated September 23, 2010, the Department of Public Welfare (DPW), Third Party Liability (TPL) - Casualty Unit, has reviewed the information you provided regarding the above-referenced individual. Based on this information, we have no record of this individual receiving medical and/or cash benefits at this time. Therefore, the Department's TPL - Casualty Unit has no claim on this individual. If your client applies for medical assistance at a later date or currently has an application pending, please advise us and provide any additional information that may affect a recovery by our department. If you have any questions, please feel free to contact me. Sincerely, Vince A. Porter Recovery Section manager (717)772-6604 EXHIBIT D IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL'V'ANIA ESTATE OF ZEKERIJAH LJUCA a/k/a Aekerijah Ljuca Deceased CERTIFICATE OF AD NISTRATRIX Y, Jasminia Ljuca, hereby certify that i am the Administratrix of the Estate of Zekerijah Ljuca and I join in this petition and pray that this Court approves the proposed settlement of the Underinsured Motorist claim and apportionment thereof. L44 k Pmint I' atrix 90/b0 39Vd JNU1onai SOQ3 09LMLLTLT 0b:ZT TTOZ/8T/Z0 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA a/k/a Aekerijah Ljuca Deceased CERTIFICATE OF BENEFICIARY 1, Eldin Ljuca, hereby certify that I am a beneficiary of the survival action and I join in this petition and pray that. this Court approves the proposed settlement of the Underinsured Motor Claim and apportionment. Eldin Liu( 90/ZO 39dd JNI>1omi SOQ3 09L0T9LLTLT 017:ZT ITOZ/81/Z0 IN T14E COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERiJAH LJUCA aWa Aekerijah Ljuca Deceased CERTIFICATE OF BENEFICIARY I, Jasminia Ljuca, hereby certify that I am a beneficiary of the survival action and I join in this petition and pray that this Court approves the proposed settlement of the Underinsured Motorist Claim and apportionment. ?asmina Ljuca 90/60 39Vd DNIAonN1 SOQ3 09LO19LLTLI Ob:ZT TIOZ/8T/Z0 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA a/k/a Aekerijah Ljuca Deceased CERT'IF'ICATE OF BIENEFIC"RY I, Eldina Tandir, hereby certify that I am a beneficiary of the survival action and I join in this petition and pray that this Court approves the proposed settlement of the Underinsured Motorist Claim and apportionment. . e 4 : ?7" ?, 3 ? - Eldina Tandi3r 90/90 39Vd 9NI71onNi SOQ3 09L0T9LLTLT 0b:ZT TTOZ/ST/Z0 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ZEKERIJAH LJUCA NO. 10-7554 a/k/a Aekerijah Ljuca Deceased CIVIL TERM ORDER AND NOW, this 2"? ? day of Uuf e e- l , 2011, upon consideration of the Petition for Settlement, it is hereby ORDERED that Petitioner is authorized to enter into a settlement with Canal Insurance in the gross sum of THIRTY FIVE THOUSAND DOLLARS AND ZERO CENTS ($35,000.00). It is further ORDERED that the settlement proceeds be distributed as follows: 1. To the Duncan Law Firm: $12,250.00 for counsel fees. 2. The remaining balance of $22,750.00 shall be paid to the Estate of Zekerijah Ljuca and shall be apportioned pursuant to the intestate laws of The Commonwealth of Pennsylvania. 3. Petitioner, as Administratrix of the Estate of Zekerijah Ljuca, is authorized to execute all necessary releases and checks, pay the appropriate creditors and make the appropriate distribution. 00Py Mct ? l M 31a/r? 1. CZ1 7 n BY THF, COURT: