HomeMy WebLinkAbout01-05-10 ~. I 4^w.1
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IN THE COURT OF COMMON PLEAS -
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CUMBERLAND COUNTY, PENNSYLVANIA ~ -, ~,
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IN RE: ESTATE OF STEVEN G. DOLLINS c°, ~ -~, `--
No.: 2008-003 50 ~ `~' ~'~' ' r'
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1. Your Petitioner, Carolyn Dollins, is the personal representative for ~ Estate of
Steven G. Dollins, who is the deceased father of the minors, Gage D 11 ns, Owen
Dollins, and Taryn Dollins. ~'~~
2. The minor children, Gage Dollins, was born on March 17, 2003, O e Dollins,
was born on December 12, 2006, and Taryn Dollins was horn on F~bruary 8,
2008.
3. On Mazch 3, 2008, Steven G. Dollins was killed in a motor vehicle dident. At
the time of his death he was single and had three minor children, Dollins,
Owen Dollins, and Taryn Dollins. ~ '~
4. Carolyn Dollins was appointed administratrix of the estate of Steve ~. Dollins
on April 2, 2008, by .Glenda Fanner Strasbaugh, the Register f Wills of
Cumberland County. ~~
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5. All sums set forth above constitute damages on account f personal
injury/wrongful death, arising from the occurrence, within the me g of § 104
(a) (2) of the Internal Revenue Code of 1986, as amended. 'i II
6. A $15,000.00 insurance payment from decedent's UIM carrier Progressive
Insurance is to be divided pursuant to the fee agreement as follows: ~~
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a. 25% to Rominger & Associates as an attorney fee, in the ~rnount of
$3,750.00 (see attached fee agreement) '' '~
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b. 50% of the remaining $11,250.00 to the Estate, as the pro~e~ds of the
survival action in the amount of $5,625.00. I II
c. 50% of the remaining $11,250.00 to the Estate, as the pro~e~ds of the
wrongful death action in the amount of $5,625.00, which will b~ placed in
a federally insured bank or saving institution as permitted by th~ Rules of
Civil Procedure for benefit of each of the minor children, in equal shares.
7. The Department of Revenue has agreed to an allocation of 50% of ~ awazd to
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the wrongful death action. (See attached letter)
8. Progressive has reviewed this matter and agrees to the content of this ~e~ition.
WHEREFORE, your petitioner prays that the settlement afore referenced be
approved. ~I 'III
Respectfully submitted, ~I
RONIINGER dic ASSOCIATE
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Date: January 5, 2011
Kaz~P~ominger, Esquire ~ ~I~
155 South Hanover Street
Cazlisle, PA 17013 I '
(717) 241-6070
Supreme Court ID # 81924
Attorney for Petitioner ',
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
IN RE: ESTATE OF STEVEN G. DOLLINS
No.: 2008-00350
AFFIDAVIT
I hereby swear or affirm that the Foregoing is true and correct to
knowledge and/or information and belief. This is made subject to the
Pa.C.S §4904 relating to unsworn falsification to authorities.
hest of my
Mies of 18
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
IN RE: ESTATE OF STEVEN G. DOLLINS
No.: 2008-00350
CERTIFICATE OF SERVICE !,
The same has been provided sent, addressed to responding counsel,
mail, as follows.
Erica Conway, Claim Representative
State Farm Insurance Companies
Complex Claims unit
P.O. Box 142
Concordville, Pennsylvania 19331
Respectfully submitted,
ROMINGER & ASSOCIA'
Date: January 5, 2011
v ~~ first class
Karl E ominger, Esquire
155 outh Hanover Street
Carlisle, PA 17013 '
(717) 241-6070
Supreme Court ID # 81924 ',
Attorney for Petitioner ',
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