HomeMy WebLinkAbout04-3518
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
NO. tN. J SIt? ~
CYNTHIA M. DYER AND ROBERT W. DYER
and CYNTHIA M. DYER AND ROBERT W.
DYER, as Parents and Natural Guardians of
KATHERINE M. DYER, a Minor,
2663 Marcia Drive
Lawrenceville, GA 30044
PLAINTIFFS
v.
I GLENN C. KOONTZ,
1919 Plank Road
Everett, PA 15537
and
NEW ENTERPRISE STONE AND LIME
COMPANY,INC.
3912 Brumbaugh Road
New Enterprise, PA 16664
DEFENDANTS
JURY TRIAL DEMANDED
I PRARCTPF, FOR SlfMMONS
TO THE PROTHONOT ARYfCLERK OF SAID COURT:
Issue summons in Trespass against the Defendants in the above case.
..xx. Writ of Summons shall be issued and forwarded to the Sheriff.
DATE: 7/;9/02/
I ,
-~-4Je
Leah B. Gratl~ Esquire
Attorney ID No. 29176
Two West Market Street
P.O. Box 952
York, PA 17405
(717) 846 . 0606
Attorney for the Plaintiff
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SUMMONS IN CIVIL ACTION
TO: Glenn C. Koontz, 1919 Plank Road, Everett, PA 15537
New Enterprise Stone and Lime Company, Inc., 3912 Brumbaugh Road, New Enterprise,
PA 16664
YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFF(S) HAS/HAVE
I COMMENCED AN ACTION AGAINST YOU.
'751 ~ /3. ~&'
Prothonotary/Clerk, Ci;il D~
DATE:~ d/. ;;zmr
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SHERIFF'S RETURN - OUT OF COUNTY
CASE NO: 2004-03518 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
DYER CYNTHIA M ET AL
VS
KOONTZ GLENN C ET AL
R. Thomas Kline
, Sheriff or Deputy Sheriff who being
duly sworn according to law, says, that he made a diligent search and
and inquiry for the within named DEFENDANT
, to wit:
NEW ENTERPRISE STONE AND LIME COMPANY INC
but was unable to locate Them
in his bailiwick. He therefore
deputized the sheriff of BEDFOED
County, Pennsylvania, to
serve the within WRIT OF SUMMONS
On August
4th , 2004 , this office was in receipt of the
attached return from BEDFOED
Sheriff's Costs:
Docketing
Out of County
Surcharge
So
--:7 _ ---
~....---
6.00
.00
10.00
.00
.00
16.00
08/04/2004
DALE ANSTINE
/'. ." -
; ~omas Kline
Sheriff of Cumberland
County
Sworn and subscribed to before me
this q~ day Of~~
J..W'-I A.D.
~ Q 'rvtAih~, "O~,
Prothonotary' T-J
SHERIFF'S RETURN - OUT OF COUNTY
CASE NO: 2004-03518 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
DYER CYNTHIA M ET AL
VS
KOONTZ GLENN C ET AL
R. Thomas Kline
, Sheriff or Deputy Sheriff who being
duly sworn according to law, says, that he made a diligent search and
and inquiry for the within named DEFENDANT
, to wit:
KOONTZ GLENN C
but was unable to locate Him
in his bailiwick. He therefore
deputized the sheriff of BEDFORD
County, Pennsylvania, to
serve the within WRIT OF SUMMONS
On August
4th , 2004 , this office was in receipt of the
attached return from BEDFORD
Sheriff's Costs:
Docketing
Out of County
Surcharge
Dep Bedford County
18.00
9.00
10.00
76.50
.00
113.50
08/04/2004
DALE ANSTINE
SO~~~
R. tThomas Kl ine
Sheriff of Cumberland County
~.--- --
Sworn and subscribed to before me
this qf!: day of ~
J. WI( A.D.
~ \ () ~ ^O..r;;.
fY'F,rothonotary.T7
In The Court of Common Pleas of Cumberland County, Pennsylvania
Cynthia M. Dyer et al
VS.
Glenn C. Koontz et al
SERVE: New Enterprise Stone and Lime Ccmpany Inc
No.
04-3518 civil
~ovv, July 26, 2004
, I, SHERIFF OF CUMBERLAND COUNTY, P A, do
hereby deputize the Sheriff of Bedford
County to execute this Writ, this
deputation being made at the request and risk of the Plaintiff.
~ ~//,
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Sheriff of Cumberland County, PA
Affidavit of Service
~ovv,
IJI11 Y ?q
,2004 ,at 14: 20 o'clock P M. served the
within
Writ of Summons
upon _,__,_.l\le.lo/...,En.tBIp.i s pSt 0 QEL_.amL~Lj me__<: O!!!Q9J:lYL_J.EL"-_____. ___~~_~_~_______
. ~q17 Rrumbaugh Road, New Enterprise, PA 16664
by handing to ,Ti'lmps Van Bur on
Vice President )
a
.trtle
copy of the original Wr it of Summons
and made known to
Him
the contents thereof.
So answers,
. -4? JtL-
~eriffof Bedford
County, PA
Sworn and subscribed before
me this 3CE!'day of 1--' 'O"J ' 20.Q:l
.Ii J /)1 La tX.~ 6rl Mn~.c~
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""'.' .Y\,V.~ EMUS NUIAHY". f'uBLlC
""""'DFOllD ,8EDFOW"(}UN1Y
MY~ISSION EXPIRES~, "H 5, 2OOl.
COSTS
SERVICE
MILEAGE
AFFIDA VIT
$
$
In The Court of Common Pleas of Cumberland County, Pennsylvania
Cynthia M. Dyer et al
VS.
Glenn C. Koontz et al
SERVE: Glenn C. Koontz
No.
04-3518 civil
Now,
July 26, 2004
, I, SHERIFF OF CUMBERLAND COUNTY, P A, do
hereby deputize the Sheriff of Bedford
County to execute this Writ, this
deputation being made at the request and risk of the Plaintiff.
.r:,~~~..t"
Sheriff of Curnherland County, PA
Affidavit of Service
Now,
July 2C)th
, 20-lliL.., at 1 Po.()C) o'clock P
M. served the
within Wri t of Sllmmons
UpOD_. r;lpnn ('.-.Koontz
at 1<)1<) P]rink Ro"n, Rvprptt, PA lSS.17
by handing to Him pprsona1Jy
a
'rrlJP
copy of the original Wri t nf ,C:nmmmnnc:
and made known to
Him
the contents thereof.
So answers,
~~
Sheriff of Bedford County, PA
Sworn and subscribed before
me this3:P'1day of ra...ll' 6 ,20m
.X,-Ihd ~,1{;rrdtJYYU-VJ
flY ~ t',i,;(.,.r,!OI1~I~l1~".~fA, RY.,PUBUC I
EDFOf1!' '<,}R.~ COUNTY
MY MMC,' " -I 5, 2OOe.
COSTS
SERVICE
MILEAGE
AFFIDA VIT
$
$
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
CIVIL DIVISION
CYNTHIA M. DYER AND ROBERT W. CASE NUMBER: 04-3518 Civil
DYER and CYNTHIA M. DYER AND
ROBERT W. DYER, as Parents and ISSUE NUMBER:
Natural Guardians of KATHERINE M.
DYER, a Minor,
PLEADING:
Plaintiffs
PRAECIPE FOR APPEARANCE
v.
GLENN C. KOONTZ and NEW
ENTERPRISE STONE AND LIME
COMPANY, INC.,
CODE AND CLASSIFICATION:
Defendants
FILED ON BEHALF OF:
Glenn C. Koontz and New Enterprise Stone
and Lime Co., Inc., Defendants.
COUNSEL OF RECORD:
DENNIS J. BONETTI, ESQUIRE
Pa.lD# 34329
CIPRIANI & WERNER, P.C.
1017 Mumma Road
Lemoyne, P A 17043
(717) 975-9600
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
CIVIL DIVISION
CYNTHIA M. DYER AND ROBERT W.
DYER and CYNTHIA M. DYER AND
ROBERT W. DYER, as Parents and Natural
Guardians of KATHERINE M. DYER, a
Minor,
Plaintiffs
v.
GLENN C. KOONTZ and NEW
ENTERPRISE STONE AND LIME
COMPANY, INC.,
Defendants
) CASE NO: 04-3518 Civil
)
)
)
)
)
)
)
)
)
)
)
)
)
) JURY TRIAL DEMANDED
PRAECIPE FOR APPEARANCE
TO: PROTHONOTARY OF CUMBERLAND COUNTY
Kindly enter my appearance on behalf of the Defendants, GLENN C. KOONTZ
and NEW ENTERPRISE STONE AND LIME COMPANY, INC. ,in the above-
captioned matter.
BY:
A JURY TRIAL IS DEMANDED
Respectfully submitted,
CIP
D ONETTI, ESQUIRE
A rney for the Defendants
GLENN C. KOONTZ and NEW
ENTERPRISE STONE AND LIME
COMPANY, INC
CERTIFICATE OF SERVICE
That counsel for the Defendants, hereby certifies that a true and correct copy of its
PRAECIPE FOR APPEARANCE has been served on all counsel of record, by first class
mj, po~e pre-paid, according to the Pennsylvania Rules of Civil Procedure, on the
LJ day of , 004.
Leah B. Graff, Esquire
Dale E. Anstine, P.C.-York, PA
Two West Market Street
P.O. Box 952
York,PA 17405
Respectfully submitted,
BY:
IS ONETTI, ESQUIRE
Att ey for the Defendants
GLENN C. KOONTZ and NEW
ENTERPRISE STONE AND LIME
COMPANY, INC
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYL VANIA
CYNTHIA M. DYER AND ROBERT W.
DYER and CYNTHIA M. DYER AND
ROBERT W. DYER, as Parents and Natural
Guardians of KATHERINE M. DYER,
a Minor,
: NO. 04-3518 CIVIL
v.
GLENN C. KOONTZ and NEW ENTERPRISE
STONE AND LIME COMPANY, INC.
: JURY TRIAL DEMANDED
PETITION FOR FINAL SETTLEMENT AND DISTRIBUTION
OF PROCEEDS OF A MINOR'S CLAIM
1. Cynthia M. Dyer and Robert W. Dyer are adult individuals, wife and husband,
residing at 2663 Marcia Drive, Lawrenceville, Georgia 30044 and are the parents and natural
guardians of Katherine M. Dyer, a minor, date of birth June 3, 1992.
2. On July 31, 2002, the minor was a passenger in a vehicle owned and operated by her
mother, Cynthia Dyer, involved in a collision with a vehicle that was operated by Glenn Koontz
and insured by AIG Construction Risk Management Group.
3. The accident occurred on SROOll, Harrisburg Pike, at its intersection with Sunday
Drive in Middlesex Township, Cumberland County, Pennsylvania.
4. The minor Katherine M. Dyer sustained neck and shoulder pain in the accident. She
HA:L.iIoJ }i~" J.\.S~~TiJN:~I. 11,(',
also experienced nightmares.
TWO WEST "'A"~ET ST"En
"OST OFFICE !lO~ g!l2
YOHK, "IlNNSYISANIA 17 H"'"'
5. The minor Katherine M. Dyer has made an excellent recovery from her injuries.
Attached hereto as Exhibit "A" are the notes from the office visit with Alan Czarkowski, D.O.,
1-
as well as Charlene H. Beard, M.D. The Minor, Katherine M. Dyer, has not required any
additional treatment for her injuries.
6. AIG has offered $2,000.00 in settlement of Katherine M. Dyer's claim.
7. The parents are aware that acceptance of this offer will waive the minor's right to a
jury trial.
8. The parents believe this settlement to be fair and reasonable under the circumstances
and in the minor's best interest, and have fully discussed this settlement with their counsel, Leah
B. Graff, Esquire.
9. All medical expenses for the minor's injuries have been paid by the parents' health
. .
Insurance carner.
10. The undersigned counsel has a 25% contingent attorney's fee in this matter.
11. Counsel has expended $35.10 in costs to pursue this claim. There are no other costs
to be paid. The costs represent the charge for the deposition transcript for the minor.
12. After a dutiful search, I am aware of no creditors or claimants of any kind against the
subject recovery.
13. It is hereby requested that distribution ofthe proposed settlement be made as follows:
The settlement proceeds of $2,000.00 for Katherine Dyer, as follows:
a)
The sum of $31.50 to the Law Offices of Dale E. Anstine for costs
advanced;
nAi{.J~l ~J. \\.i~~~')I'].N]"J, p, :('.
YORK, I'ENNHYISAlilA 17.~O:;
b)
The sum of $500.00 to the Law Offices of Dale E. Anstine for attorney's
fees; and
c) The sum of$I,464.90 to Cynthia M. Dyer and Robert W. Dyer as parents
and natural guardians of Katherine M. Dyer, with said funds to be secured
in a federally insured bank: or savings and loan association until the minor
reaches the age of majority. Proof of deposit to be filed with the Court.
WHEREFORE, it is respectfully requested that the Honorable Court enter an Order
approving the compromise and distribution as above stated.
RESPECTFULLY SUBMITTED:
LAW OFFICES OF DALE E. ANSTINE, P.c.
~~~
Attorney I.D. No. 34368
2 West Market Street
Post Office Box 952
York, Pennsylvania 17405
(717) 846-0606
BJ)A'Lili: no.:. ,'\N.~"J'il~""iJo:l, l'l,(',
TWO W~ST """,,,eT STREET
POST OFFICE !lO~ 9~Z
YORK, I'F.NNI.;YI.VANI... 17.H);";
H....",,;Lil<] JI'..L ,\.N.~"It'iISl'.]. ]i. o{',
TwO WEST "'''''KET 5T"EET
POST OFFICE BO~ 9"2
y"It.., l't;"''''NYINANIA 17 ~,):,",
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYL VANIA
CYNTHIA M. DYER AND ROBERT W.
DYER and CYNTHIA M. DYER AND
ROBERT W. DYER, as Parents and Natural
Guardians of KATHERINE M. DYER,
a Minor,
: NO. 04-3518 CIVIL
v.
GLENN C. KOONTZ and NEW ENTERPRISE
STONE AND LIME COMPANY, INC.
: JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
AND NOW, this.iL. day of .} LIne'.- ,2006, I Leah B. Graff, Esquire, a
11 ember ofthe Law Offices of Dale E. Anstine, P.C., hereby certify that I have, this date, served a
c >py of the within and foregoing document by first class United States Mail, postage pre-paid,
a dressed to the party or attorney of record as follows:
Dennis J. Bonetti, Esquire
CIPRIANI & WERNER, P.C.
1017 Mumma Road
Lemoyne, Pennsylvania 17043
RESPECTFULLY SUBMITTED:
LAW OFFICE OF DALE E. ANSTINE, P.C.
~Ag/j
Leah B. Graff, Esquire "
Attorney LD. No. 34368
2 West Market Street
Post Office Box 952
York, Pennsylvania 17405
(717) 846-0606
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LA~RE~CE JOEL ARMY HEALTH CLINiC
PERSONAL DATA - PRIVACY ACT OF 1974 (PL 93-579) (r-
SF600 ~
)2 Aug 2002 0
~------------------------------------------------------------; ---------------
~LINIC: 1#CJINT .HCP: CZARKOWS~~ G " 02 Aug 2002@~1f120 EST$ BAAQ
Age :-J..1Id-r~HT: in Wt : ..2:i-kg~ ~: ~ ~. P: ~ ~ BP:' 1-'\ 0 RR: -... J c:l
Tobacco Use: Yes No ~ pt~cate~~~essat1on.h/ TInItials)
Smoker in the house: Yes No~ Allergies: ^'~v~ ~
Nutrition: Do you have any concern about you diet, weight,
or nutricional status? Yes NO~
Immunization: Tetanus Booster in last 10 y~rs?Yes-L-No -
. .Hepatitis B? (10-18yo) Yes~No -.
pneumovax? (If age>50, COPD, Asthma, diabetes) YeS_No~Jt
Reason for Appointment: 10 y/o HA/BACK PAIN X ~ DAY~ ~ ./"'7. ~ U,.J
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. CURRENT MEDICATIONS
CETIRIZINE(ZYRTEC)--PO SMG/SML SOLN 0 14 Jun 2002
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========================================~ =====================
)YER,KATHERINE M USAF FAM MBR RET
JOB: 03 Jun 1992 RANK: MAJOF RR: LJAHC OUTPATIENT
Exhibit A
:;PON: _ UNIT: H: 770-978-1576
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PERSONAL DATA - PRIVACY ACT OF 1974 (PL 93-579)
SF600
18 Nov 2002
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19 Nov 2002@0940
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( Initials)
BDAQ
CLINIC: MCKID HCP: BEARD, CHARLENE H
Age: HT: in Wt: kg/lbs T:
Tobacco Use: Yes No ---- Pt~c
Smoker in the house: Yes No g1es:
Nutrition: Do you have any conc--- about you diet, weight,
or nutritional status?
ster in last 10 years?Yes No
Hepa . 1S B? (10-18yo) Yes____No --------
pn'umovax? (If age>50, COPD, Asthma, diabetes) Yes No
Reason for Appointment, lOY/O HAVING NIGHTMARES X3~OS~~~ ~ ~
CURRENT MEDICATIONS ?t ~O~~~
CETIRIZINE(ZYRTEC)--PO 5MG/5ML SOLN 0 14 Jun 200 ~{~ 7''J
IBUPROFEN--PO 100MG/5ML SUSR 1 02 Aug 2002 /
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DOB: 03 Jun 1992 RANK: MAJOR RR: LJAHC OUTPATIENT
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CYNTHIA M. DYER AND
ROBERT W. DYER and
CYNTHIA M. DYER AND
ROBERT W. DYER, as Parents
And Natural Guardians of
KATHERINE M. DYER, a Minor,
Plaintiffs
: IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
CIVIL ACTION - LAW
GLENN C. KOONTZ, and NEW
ENTERPRISE STONE AND LIME
COMPANY, INC.
Defendants
: No. 04-3518 CIVIL TERM
IN RE: PETITION FOR FINAL SETTLEMENT AND DISTRIBUTION
OF PROCEEDS OF A MINOR'S CLAIM
BEFORE OLER, J.
ORDER OF COURT
AND NOW, this 31st day of July, 2006, upon consideration of Plaintiffs' Petition for
"Final Settlement and Distribution of Proceeds of a Minor's Claim," and the attached
"Consent for Final Settlement and Distribution of Proceeds of a Minor's Claim," the Petition
is granted and it is ordered and directed that said settlement proceeds of $2000.00 for the
Minor Petitioner, Katherine M. Dyer, shall be distributed as follows:
A. $500.00 to be paid to Leah Graff, Esquire pursuant to a Twenty-Five Percent Fee
Agreement;
B. $35.10 to be paid to Dale E. Anstine, P.C., as reimbursement for costs of
litigation; namely, $35.10 for the Minor Petitioner's deposition transcript to
Pamela L. Packer;
C. $1464.90 to be paid to Cynthia M. Dyer and Robert W. Dyer, as parents and
natural guardians of the Minor Petitioner, Katherine M. Dyer, which sum is to be
placed in a savings account in a federally insured back or savings and load
association for the sole and exclusive use of said Minor Petitioner and said
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account shall not be used for any reason without court approval and shall be
distributed to the Minor upon her or him obtaining the age of majority.
D. Proof of deposit to be filed with the Court.
BY THE COURT,
J.
~ah B. Graff, Esquire
Law Offices of Dale E. Anstine, P.C.
2 West Market St.
Post Office Box 952
York, Pennsylvania 17405
Attorney for Plaintiffs
~nnis J. Bonetti, Esquire
CIPRIANI & WERNER, P,C.
1017 Mumma Road
Lemoyne, Pennsylvania 17043 ~
Attorney for Defendants
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II
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CML ACTION - LAW
CYNTIDA M. DYER AND ROBERT W. DYER
and CYNTHIA M. DYER AND ROBERT W.
DYER. as Parents and Natural Guardians of
KATHERINE M. DYER, a Minor,
PLAINTIFFS
. v.
GLENN C. KOONTZ, and
NEW ENTERPRISE STONE AND LIME
COMPANY, INC.
DEFENDANTS
NO. 04-3518 Civil
JURY TRIAL DEMANDED
CONSENT FOR FINAL SETTLEMENT AND DISTRIBUTION
OF PROCEEDS OF A MINOR'S CLAIM
The undersigned hereby consent to the settlement and distribution of proceeds of their
Minor daughter, Katherine M. Dyer's claim pursuant to the Petition for Final Settlement and
Distribution of Proceeds of a Minor's Claim attached hereto as Exhibit A. The undersigned also
agree to the settlement of this matter without the necessity of a Court hearing on the Petition.
~~
Ro ert W. Dyer
Dated: 12.. ~~ '2.~
~M~
Cynthia M. Dyer, as parent and natural
Guardian of Katherine M. Dyer, a Minor
Dated:~ I ~I ~DO ,
1
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYL VANIA
CYNTHIA M. DYER AND ROBERT W.
DYER and CYNTHIA M. DYER AND
ROBERT W. DYER, as Parents and Natural
Guardians of KATHERINE M. DYER,
a Minor,
: NO. 04-3518 CIVIL
v.
GLENN C. KOONTZ and NEW ENTERPRISE
STONE AND LIME COMPANY, INC.
: JURY TRIAL DEMANDED
PETITION FOR FINAL SETTLEMENT AND DISTRIBUTION
OF PROCEEDS OF A MINOR'S CLAIM
I. Cynthia M. Dyer and Robert W. Dyer are adult individuals, wife and husband,
residing at 2663 Marcia Drive, Lawrenceville, Georgia 30044 and are the parents and natural
guardians of Katherine M. Dyer, a minor, date of birth June 3,1992.
2. On July 31, 2002, the minor was a passenger in a vehicle owned and operated by her
mother, Cynthia Dyer, involved in a collision with a vehicle that was operated by Glenn Koontz
and insured by AIG Construction Risk Management Group.
3. The accident occurred on SROOII, Harrisburg Pike, at its intersection with Sunday
Drive in Middlesex Township, Cumberland County, Pennsylvania.
4. The minor Katherine M. Dyer sustained neck and shoulder pain in the accident. She
LAW O~~ICnO~
also experienced nightmares.
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5. The minor Katherine M. Dyer has made an excellent recovery from her injuries.
Y"M..I'~U"HV..,. 17"'.~
Attached hereto as Exhibit "A" are the notes from the office visit with Alan Czarkowski, D.O.,
Exhibit A
as well as Charlene H. Beard, M.D. The Minor, Katherine M. Dyer, has not required any
additional treatment for her injuries.
6. AIG has offered $2,000.00 in settlement of Katherine M. Dyer's claim.
7. The parents are aware that acceptance of this offer will waive the minor's right to a
jury trial.
8. The parents believe this settlement to be fair and reasonable under the circumstances
and in the minor's best interest, and have fully discussed this settlement with their counsel, Leah
B. Graff, Esquire.
9. All medical expenses for the minor's injuries have been paid by the parents' health
insurance carrier.
10. The undersigned counsel has a 25% contingent attorney's fee in this matter.
11. Counsel has expended $35.10 in costs to pursue this claim. There are no other costs
to be paid. The costs represent the charge for the deposition transcript for the minor.
12. After a dutiful search, I am aware of no creditors or claimants of any kind against the
subject recovery.
13. It is hereby requested that distribution of the proposed settlement be made as follows:
The settlement proceeds of$2,000.00 for Katherine Dyer, as follows:
a)
The sum of $31.50 to the Law Offices of Dale E. Anstine for costs
advanced;
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The sum of $500.00 to the Law Offices of Dale E. Anstine for attorney's
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fees; and
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c) The sum of$I,464.90 to Cynthia M. Dyer and Robert W. Dyer as parents
and natural guardians of Katherine M. Dyer, with said funds to be secured
in a federally insured bank or savings and loan association until the minor
reaches the age of majority. Proof of deposit to be filed with the Court.
WHEREFORE, it is respectfully requested that the Honorable Court enter an Order
approving the compromise and distribution as above stated.
RESPECTFULLY SUBMITTED:
LAW OFFICES OF DALE E. ANSTINE, P.C.
l<oh~dJ;IL
Attorney I.D. No. 34368
2 West Market Street
Post Office Box 952
York, Pennsylvania 17405
(717) 846-0606
(" to'"
LAwRE~CE JOEL ARMY HEALTH CLINIC
PERSONAL DATA - PRIVACY ACT OF 1974 (PL 93-579) (
SF600 ~
2 Aug 2002 I 0 I
------------------------------------------------____________~1_______________
:.,INIC:1#.t:;INT -HCP: CZARKOWS~ G d> 02 Aug 2002@l1i:!0 EST$ BAAQ
Age:::f:P::Jr~HT: in Wt:.2:i.kg~~: '1'1i' P: ~~ BP: I J..'\ t:I RR: -T/c:l
Tobacco Use: Yes No ~ Pt~cate~~~sat1on'~ 1!nItials)
Smoker in the house: Yes___ No~ Allergies: ^'~D~ ~
Nutrition: Do you have any concern about you d1et, weight,
. or nutri~ional status? Yes____ No~
Immunization: Tetanus Booster in last 10 y~rs?Yes~No
Hepatitis B? (10-18yo) Yes~No ----.
Pneumovax? (If age>SO, COPD, Asthma, diabetes) Yes____NO~1f
Reason for Appointment: 10 Y /0 HA/BACK PAIN X ~ DAY",. .r-:1. ~ U,J
. CURRENT MEDICATIONS
CETIRIZINE(ZYRTEC)--PO 5MG/SML SOLN 0 14 Jun 2002
s::- ~v-.e / ~&;~-~.-a':cf 2/f' "'1:'-'- .-- !<-t-/ lfL'a-r-(
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MPL reviewed/and updated Y N /
Patient educated on health preventio .
Patient educated on the purpose, use, ene
the following medications:
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:=========~-===--===-==-=========-======
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JYER, KATHERINE M
JOB: 03 Jun 1992
;PON:
RANK: MAJO
UNIT:
USAF FAM MBR RET
RR: LJAHC OUTPATIENT
H: 770-978-1576
Exhibit A
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,UTOMATED VERSION OF SF600
, .
LAWREh~E JOEL ARMY UEALTH CLI~~C
PERSONAL DATA - PRIVACY ACT OF 1974 (PL 93-579)
SF600
18 Nov 2002
--------------------------------------------------~---------------------------
:LINIC: MCKID HCP: BEARD, CHARLENE H
Age: HT: in Wt: kg/lbs T:
Tobacco Use: Yes No ---- Pt~c
Smoker in the house: Yes No g~es:
Nutrition: Do you have any con about you d~et, weight,
or nutritional status?
ster in last 10 years?Yes No
Hepa . ~s B? (10-18yo) Yes____No --------
Pn movax? (If age>50, COPD, Asthma, diabetes) Yes No
Reason for Appointment: 10Y/O HAVING NIGHTMARES x3~osl-J?1!J.r}.o ~ )
CURRENT MEDICATIONS ~ f\.n () . J /1
CETIRIZINE (ZYRTEC) --PO 5MG/5ML SOLN 0 14 Jun 200 ~(~' 7'\,J
IBUPROFEN--PO 100MG/5ML SUSR 1 02 Aug 2002 I
,
.
19 Nov 2002@0940
P: BP:
ROUT$ BDAQ
RR:
(In~tials)
n
Immunization:
Yes_
No
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Patient educated on health prevention
Patient educated on the purpose, use, benefit and risk of
the following medications:
===============-=---==-~======================================================
DYER, KATHERINE M 02/018-38-3359 USAF FAM MER RET
DOB: 03 Jun 1992 RANK: MAJOR RR: LJAHC OUTPATIENT
SPON: UNIT: H: 770-978-1576
~=========================~===================================================
AUTOMATED VERSION OF SF600
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYL VANIA
CYNTHIA M. DYER AND ROBERT W.
DYER and CYNTHIA M. DYER AND
ROBERT W. DYER, as Parents and Natural
Guardians of KATHERINE M. DYER,
a Minor,
NO. 04-3518 CIVIL
v.
GLENN C. KOONTZ and NEW ENTERPRISE
STONE AND LIME COMPANY, INC.
: JURY TRIAL DEMANDED
ORDER APPROVING MINOR'S SETTLEMENTS AND
DISTRIBUTION OF SETTLEMENT PROCEEDS
WHEREFORE, upon presentation ofthe within Petition and a hearing on the merits, the
Minor's Settlements are hereby approved by the Court and deemed to be in the best interests of
the Minor Petitioners.
Said settlement proceeds of $2,000 for the Minor Petitioner, Katherine M. Dyer, shall be
distributed as follows:
A. $500.00 would be paid to Leah Graff, Esquire pursuant to a
Twenty-Five Percent Fee Agreement;
B.
$35.10 would be paid to Dale E. Anstine, P.C., as reimbursement for costs of
litigation; namely, $35.10 for the Minor Petitioner's deposition transcript to
Pamela 1. Packer;
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C.
$1,464.90 would be paid to Cynthia M. Dyer and Robert W. Dyer, as parents and
natural guardians of the Minor Petitioner, Katherine M. Dyer, which sum is to be
placed in a savings account in a federally insured bank or savings and loan
association for the sole and exclusive use of said Minor Petitioner and said
account shall not be used for any reason without court approval and shall be
distributed to the Minor upon her or him obtaining the age of majority.
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Proof of deposit to be filed with the Court.
BY THE COURT,
J.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYL VANIA
CYNTHIA M. DYER AND ROBERT W.
DYER and CYNTHIA M. DYER AND
ROBERT W. DYER, as Parents and Natural
Guardians of KATHERINE M. DYER,
a Minor,
: NO. 04-3518 CIVIL
v.
GLENN C. KOONTZ and NEW ENTERPRISE
STONE AND LIME COMPANY, INC.
: JURY TRIAL DEMANDED
CERTIFICATE OF SERVICE
AND NOW, this /z....f'l'J.ay oL)L//J t'!--
, 2006, I Leah B. Graff, Esquire, a
ember of the Law Offices of Dale E. Anstine, P.C., hereby certify that I have, this date, served a
py of the within and foregoing document by first class United States Mail, postage pre-paid,
dressed to the party or attorney of record as follows:
Dennis J. Bonetti, Esquire
CIPRIANI & WERNER, P.C.
1017 Mumma Road
Lemoyne, Pennsylvania 17043
RESPECTFULLY SUBMmED:
TwO.."......<, ".<"
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LAW OFFICE OF DALE E. ANSTINE, P.C.
~A,g/j
Leah B. Graff, Esquire '
Attorney I.D. No. 34368
2 West Market Street
Post Office Box 952
York, Pennsylvania 17405
(717) 846-0606
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,
-
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
CIVIL DIVISION
CYNTHIA M. DYER AND ROBERT W. CASE NUMBER: 04-3518 Civil
DYER and CYNTHIA M. DYER AND
ROBERT W. DYER, as Parents and ISSUE NUMBER:
Natural Guardians of KATHERINE M.
DYER, a Minor,
PLEADING:
Plaintiffs
v.
PRAECIPE TO SETTLE, DISCONTINUE
AND END
GLENN C. KOONTZ and NEW
ENTERPRISE STONE AND LIME
COMPANY, INC.,
CODE AND CLASSIFICATION:
Defendants
FILED ON BEHALF OF:
Defendants.
COUNSEL OF RECORD:
DENNIS J. BONETTI, ESQUIRE
Pa.ID# 34329
CIPRIANI & WERNER, P.C.
lOll Mumma Road, Suite 201
Lemoyne, P A 17043
(717) 975-9600
,
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
CIVIL DIVISION
CYNTHIA M. DYER AND ROBERT W.
DYER and CYNTHIA M. DYER AND
ROBERT W. DYER, as Parents and Natural
Guardians of KATHERINE M. DYER, a
Minor,
Plaintiffs
v.
GLENN C. KOONTZ and NEW
ENTERPRISE STONE AND LIME
COMPANY, INC.,
Defendants
) CASE NO: 04-3518 Civil
)
)
)
)
)
)
)
)
)
)
)
)
)
)
PRAECIPE TO SETTLE. DISCONTINUE and END
TO: PROTHONOTARY OF CUMBERLAND COUNTY
Kindly mark the above-referenced matter settled, discontinued and ended.
BY:
Respectfully submitted,
DALE E. ANSTINE, P.C.
~~. JJ/t;
LEA B. GRA F, EsQUIRE
Attorney for the PLAINTIFF
J
-
CERTIFICATE OF SERVICE
That counsel for the Defendants hereby certifies that a true and correct copy ofits
PRAECIPE TO SETTLE, DISCONTINUE and END has been served on all counsel of
record, by first class maill postage pre-paid, according to the Pennsylvania Rules of Civil
Procedure, on the 81. day of d~ ,2006.
Leah B. Graff, Esquire
Dale E. Anstine, P.C.-York, PA
Two West Market Street
P.O. Box 952
York,PA 17405
Respectfully submitted,
BY:
WERNER, P.C.
E IS J. BONETTI, ESQUIRE
A omey for the Defendants
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