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Home My WebLink About12-6869Gregory M. Feather (PA 79456) HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road, Suite 2 Harrisburg, PA 17110 Ph. 717.238.2000 Fax 717.233.3029 feather@hhrlaw.com c ~ ; -r; .,~ ~ ~3 -~ . ~"~ ~"`~ . ~-~t ~~ ~ ,#3 Attorneys for Petitioner IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA BARBARA L. KUTZ, Administratrix of the Estate of DONALD E. KUTZ, JR., Petitioner NO.: lOC - f'p$(o9 Cjl vi !T:°rM CIVIL ACTION -LAW PETITION TO APPROVE SETTLEMENT OF WRONGFUL DEATH AND SURVIVAL ACTION TO THE HONORABLE .TUDGES OF THE COURT: The Petitioner, Barbara L. Kutz, Administratrix of the Estate of Donald E. Kutz, Jr. ("Mrs. Kutz"), by and through her attorneys, HANDLER, HENNING & ROSENBERG, LLP, by Gregory M. Feather, Esq., petitions this Honorable Court to enter an Order permitting settlement of this action, and in support thereof avers as follows: 1. Decedent, Donald E. Kutz, Jr., was born on December 27, 1941, and is survived by his wife, Barbara L. Kutz, and four (4) children, John D. Kutz, Ronald Kutz, Melissa Miller, and Paul Alexander. ~ 103. ~~ P~ ~`r7'y ~#~a~ e#~8a 9~~ 2. Petitioner, Barbara L. Kutz, is an adult individual currently residing at 415 North Baltimore Avenue, Mount Holly Springs, Cumberland County, PA 17065. She was appointed Administratrix of the Estate of Donald E. Kutz by Cumberland County Court of Common Pleas on March 9, 2011. A copy of the Short Certificate is attach hereto, made a part hereof, and marked "Exhibit A." 3. Decedent, Donald E. Kutz, Jr. was diagnosed with mesothelioma in 2010 by Dr. Philip D. Carey, M.D. 4. Decedent, Donald E. Kutz, Jr. died on December 27, 2010, as a result of acute respiratory-distress symptoms and acute renal failure, secondary to asbestos exposure. A copy of the Death Certificate is attached hereto, made a part hereof, and marked "Exhibit B." 5. Decedent, Donald E. Kutz, Jr., died intestate and proceeds of this settlement will be distributed under the intestacy laws of Pennsylvania. 6. Petitioner, Barbara L. Kutz, individually and as Administratrix of the Estate of Donald E. Kutz, Jr., brought claims against Johns Manville, National Gypsum Co., and Eagle- Picher Industries, as a result of the decedent's asbestos exposure. 7. Johns Manville, National Gypsum Co., and Eagle-Picher Industries, which are asbestos-insulation manufacturers, have offered $1,875.00, $675.00, and $2,946.00, respectively, to settle this matter, for a gross settlement in the amount of $5,496.00. 8. Counsel is of the professional opinion that the proposed settlement is reasonable and proper under the circumstances of this case. 9. Petitioner is also of the opinion that the proposed settlement is reasonable. 10. Petitioner, Barbara L. Kutz, retained the law firms of Handler, Henning & Rosenberg, LLP, and Cory, Watson, Crowder & DeGaris, P.C., to represent the Estate of Donald 2 E. Kutz, Jr., against the manufacturers of asbestos products that caused Decedent's injuries. A copy of the Contingency Fee Agreement is attached hereto, made a part hereof, and marked "Exhibit C." 11. Counsel has incurred general case expenses in the amount of $252.97 in obtaining all settlements. A copy of the Billing Summary for the settlement with is attached hereto, made apart hereof, and marked "Exhibit D." 12. Counsel has reduced his attorney fees to 25% of the John Mansville settlement, which amounts to $468.75. Counsel requests fees of 45% of the Eagle-Picher and National Gypsum Co. settlements, which amounts to $1,629.45. A copy of the Settlement Disbursement Sheet regarding the Johns Manville settlement is attached hereto, made a part hereof, and marked "Exhibit E;" a copy of the Settlement Disbursement Sheet for the Eagle-Picher and National Gypsum Co. settlements is attached hereto, made a part hereof, and marked "Exhibit F." 13. After deducting general case expenses and attorney's fees from the gross settlement of $5,496.00, a net settlement of $3,144.83 is left for disbursement between the Wrongful Death and Survival Beneficiaries. 14. The Department of Revenue has approved the proposed allocation of the net proceeds of the settlement and attorney's fees and expenses, as follows: (a) For the Wrongful Death Action, 50% of the net settlement proceeds to Decedent's statutory beneficiaries under the intestacy laws of Pennsylvania in the amount of $1,572.42; and (b) For the Survival Action, 50% of the net settlement proceeds to the Estate of Donald E. Kutz in the amount of $1,572.41. 3 Written approval from the Department of Revenue is attached hereto, made a part hereof, and marked "Exhibit G." 15. In accordance with 20 Pa. C.S.A. § 2103, the statutory beneficiaries of Decedent's Estate are Decedent's spouse, Barbara L. Kutz ,and Decedent's four children, John D. Kutz, Ronald Kutz, Melissa Miller, and Paul Alexander. 16. Pursuant to Pennsylvania's Survival Statute, 42 Pa. C.S.A. § 8302, $1,572.41, representing the proceeds of the Survival Action settlement, is to be distributed to Petitioner, Barbara L. Kutz, Administratrix of the Estate of Donald E. Kutz, Jr. 17. Under 20 Pa. C.S.A. § 2102, the first $30,000.00 and 50% of the Survival Action settlement proceeds will go to Decedent's spouse, Barbara L. Kutz, thereby leaving no additional funds to be divided between Decedent's children. 18. Pursuant to Pennsylvania's Wrongful Death Act, 20 Pa. C.S.A. § 8301, Decedent's adult children have no pecuniary interest and, therefore, are not entitled to recover proceeds under the Wrongful Death settlement. Therefore, $1,572.42, representing the proceeds of the Wrong Death settlement, is to be distributed to Decedent's spouse, Barbara L. Kutz. 4 WHEREFORE, Petitioner respectfully requests this Honorable Court to: (a) Authorize the payment of counsel fees in the amount of $2,098.20, and costs in the amount of $252.97, to the law firms of Handler, Henning & Rosenberg, LLP, and Cory, Watson, Crowder & DeGazis, P.C., from the funds due; (b) Approve allocation of the net settlement as accepted by the Department of Revenue as follows: (i) $1,572.42 (50%) to the Wrongful Death Action; and (ii) $1,572.41 (50%) to the Survival Action. (c) Direct distribution of the net proceeds of the settlement of $3,144.83, as follows: (i) Wrongful Death Action: (A) Bazbaza L. Kutz, Decedent's spouse - $1,572.42 (ii) Survival Action: (A) Petitioner, Bazbaza L. Kutz, Administratrix of the Estate of Donald E. Kutz - $1,572.42. Respectfully submitted, HANDLER, IN RQ ' RG. LLP Date: November ~ , 2012 By: Grego M. Fea (P Ph.7 7.238.2000 feather@hhrlaw.co Attorneys for Petitioner Barbara L. Kutz, Administratrix of the Estate of Donald E. Kutz 5 COMMONWEALTH OF PENNSYLVANIA SHORT CERTIFICATE COUNTY OF CUMBERLAND I, GLENDA EARNER STRASBAUGH Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 9th day of March, Two Thousand and Eleven, Letters of ADMINISTRATION in common form were granted by the Register of .said County, on the estate of DONALDEKUTZJR late of MT HOLLY SPRINGS BOROUGH (Finaf, Mkld/eb Lard in said county, deceased, to BARBARA L KU7Z ran M.ddi, tug and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 9th day of March Two Thousand and Eleven. File No. 2071-00313 PA File No. 21- 11- 0313 Date of Dea th ~ 11/27/2010 S . S . # 164-34-8552 J 4 eg~ster ep NOT VALID WITHOUT ORIGINAL• SIGNATURE AND IMPRESSED SEAL ~x xio~.sos R8v roman LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is Illegal to duplicate this copy by photostat or photograph. > , ... ~ •a • Et ;< >. 4,x .. ~? r. .. :, .., ~ ~ x; 3< r. „h .G• .. :` .•. .., .a.: '.~, .:. a.. .;. ;.,. .~. :t k. ~i°ii~i~ ro ~'s 'x' .? ; w.. ` E~ COMMI~,NG(EALIHOFPENIJ~IF1;'V#llq~ Y1PP ~1EAI,TH~:VITALRECOHO$;:, J s , < c ~s ~ s ~ •. CER~17rE Q .D • ~•^ x ~S ~ ,: . ~ d': ' <x ~ s ac ~s ~, ~ a '..,{'' ~ (Sw ins6vatl~ip 71~• dY mta~st) '~: A7! K I E ~ i# t ~`y: %i~' .~;~ ' .. '=w<° s ~~ .F k! r £~,+ ~ ~'. •<> O .: +f ~U,i .~'. t ~~k •' ~~' iY :Yr . ;v~~: i •~5 .. .. . 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F`:<::,. ~ rrr dMIMM~N~M~Md:.+Wrr'PnI ;:. ... .. a __~ ~3~~Z.~._______.~. ^ rb~~~~ ~~ w~ ,~d76 (r':Irr. . +, . ! ~ ~~i' G.~ e'p~.'~1 .. ~h'~r1M- ~MYk0.Yi~lb~p 4t •rnldWra~awd7Y~,is11~MMor{~NiiiSea WYil;•_ 6____ _______. .•q)~" y ~.. .. .. •~~'. . _ ._ WYIII~rRI 00.1 r6~ r iC Z ~ ~•.7 2.ore r m u~Mi/rim'rwM64rgWM441W~www/ggeMn4MMr~IMOrr.WMbNeaow(~Mnuw~OaL ^ it 7MwMPw10.MA0a:~YMCiM/ ~~~ 1~lPA7 C r" . _. . r. _ _ . •'~ .__ ..._.._ld-•1•L-I-a.d•-l•-4d-I_.. Gr.17ro7s74~,i~d .:_. _. .r f• !: y: T'~... .~ . R Crll -,-ls~. r dgdknhotN0. ~y1:S 1r^••.f ~`- j:~~ - - ~ . ~ i i-s `t ~x ~ S LTTIGATIO i POWER OF ATTORNEY AND CONTINGENCY FEE AGREEMENT ' This agreement is made betwe~ hereinafter referred to as "Client" end the law firm of HANDLER, HENNING & ROSENBERG, LLP, and the Professional Corporation of CORY, WATSON, CROWDER & DeGARIS, P.C. hereinafter referred to as "Attorneys" or `°The Firm." IMPORTANT PROVISIONS 1. FREE CASE EVALUATION 2. NO RETAINER FEE 3. CLIENT WILL NEVER BE CHARGED ANY CASE EXPENSES 4. CLIENT MUST APPROVE ANY SETTLEMENT 5. WE PROVIDE A WRTTTEN SETTLEMENT SUMMARY AND ITEMIZED EXPENSE REPORT 6. THERE l:S NO FEE UNLESS WE RECOVER FOR YOU In wnsideration of the mutual promises herein contained, the parties hereto agree as follows: I. PURPOSE OF REPRESENTATION 1.1 Purpose of Representation. The Client hereby retains and employs Attorneys to recover all damages and compensation to which the Client may be entitled as wall as to compromise and settle all claims as a result of injuries suffered by _- , hereinat>xr referred to as `injured Party," fcom~ASBESTOS EXPOSURE. 1Z Scope of Representation. It is specifically agreed and understood that Attorneys' representation is limited to specific persons and/or companies named as clients, and that Attorneys are not representing or expec~eti to represent any offer person or entity not named herein as a.client. II. POWER OF ATTORNEY 2.1 Power of Attorney. Attorneys are hereby granted a Power of Attorney so that they have full authority to prepare, sign, and file all legal inshvmentc, pleadings,'drafts, set#lemant checks, authorizations and papers as shall be reasonably necessary to commence, conduct and conclude this representation, including reducing to possession any and all monies and other things of value due Client under this claim as fully as Client could do in person. The Attorneys, are authorized and empowered to act as Client's negotiator in any and all settlement negotiations. • III. ATTORNEYS' DUTIES 3.1 Duties as Advocate. Attorneys hereby agree to represent Client in a diligent manner and to act in Client's best interest. It is understood and agreed however, that Attorneys cannot warrant or guarantee the outcome of the case. Attorneys have not represented to the Client that the Client will recover any particular sum of money, and have advised the Client that, despite their best efforts, a Court or Jury may ultimately determine that Client is not entitled to any recovery for Client's Maims. 3.2 Approval Necessary for Settlement Attorneys agree not to settle Client's claims without CIient's consent 3.3 Meritorious Claims. Client understands that Attorneys are obligated to pursue only meritorious claims. Thus, Client understands that if, af3er investigation of the facts and research of the applicable law, Attorneys believe that Client's claims are of insufficient merit, Attorneys will so advise Client and may terminate this agreement with Client Upon said termination, Client will be fret to seek other legal counsel to pursue Client's claims. Any such termination will be effected via mail to the last address provided by Client to Attorneys. 3.4 Group Litigation and/or Settlement Client understands that Attorneys may determine that it is in Client's best interests for Client's case to be filed, settled, and/or go to trial with one or more other claimants. Client gives ................. ... .. .. ... P.age.2 of4......_ . l ~ ~/~~{ permission to Attorneys to disclose Client's injuryldisease csitegory, gross settlement offer amount, net settlement offer amount, name and any other material terms of Client's settlemart to other claimants also represented by Attorneys whose cases may be settled at the same time, if such disclosure is necessary to comply with any court orders, and/or applicable state disciplinary and ethics rules. Additionally, Client understands that if a dispute subsequently arises between clients represented by Attorneys, that the attomay-client privilege may not be available for assertion by Client against other(s) on certain issues, such as commonly given advice. IV. ATTORNEYS' FEES AND EXPENSES 4.1 Attorneys' Fees to be Contingent. Client and Attorneys agree that the payment of Attorneys' fees will be corfingent upon the outcome of the lawsuit. This means that the Attorneys agree that they will receive a fee for their services only if they are successful in obtaining a recovery for the Client. 4.2 Amount of Attorneysx Fees. Client hereby agrees to pay forty-five percent (45%) of the GROSS settlement or recovery as a reasonable Attorneys' fee 8or said Attorneys services. Client understands that some portions.of Client's case may be handled through court-approved s~tlaments, administrative claims processing, class actions, or as a result of banlo-~iptcy proceedings. Client hereby agrees that the Attorneys' fees to be paid in those situations may be deteatnined or awarded by order of the court or under the provisions of the court approved settlemart or administrative process. The amount of Attorneys' fees perautted under such group recovery may vary in each instance, end Attorneys agree to be bound by the amount of Attorneys' fees awarded by the court or through the administrative claims procedure. In no event shall Attorneys' fees exceed the agreed upon percer~ges set forth in the preceding paragraph. 4.3 Amount bf Expenses. CLIENT HEREBY UNDERSTANDS .THAT ATTORNEYS SHALL INCUR A, z,I COSTS AND E7G'ENSES ASSOCIATED WITH PROSECUTING' CLTENT''S CASE. CLIENT WILL ~ $E RLSPONS$LB FOR PAYING OR REIMBURSING ANY EXPENSES ASSOCIATED WITH THB PROSECUTION OF CLIENT'S CASE. Any expenses deemed necessary by Attorneys sh_ all be paid by Attorneys out of their share of the recovery. 4.4 Special Counsel (s). Client understands that it may be necessary for Attorneys to retain Special Outside Counsel to assist, pursue, negotiate, or resolve matters other than prosecuting Client's claim for damages as a result of injuries suffered by the Injured Party. Such matters include but are not limited to Bstates, Conservatorships, Guardianships, Trusts, other probate proceedings, and any other reasonably necessary matters. Client agrees that Attorneys may retain such Special Outside Counsel to represart Client when Attorneys deem such assistance to be reasonably necessary. Client unders~nds and agrees that any attorneys' fees and expenses incurred by Special Outside Counsel shall be treated as an expense end shall NOT be deducted from Client's net recovery of any settlement or verdict in the same manner as othercase expenses as outlinedut this agreement. (b). Client understands that current law and regulations regarding Medicare, Medicaid, or private health insurance plans (Healthcare Providers) may require all parties involved in this matter (Chart, Attorneys, Defendant, and any insurance company) to compromise, settle or execute a release of Healthcare Providers' separate claim for reirnbursemart/lien for past and future payments prior to distributing any verdict or settlement proceeds. Client ages that Attorneys may take all steps in this matter deemed reasonably necessary for the handling of any such claim, including hiring Special Outside Counsel, exports, and case workers to assist with resolving any Healthcare Providers' reimbursement claims and/or liens for past and/or future injury-related medical care. The expanse of any such service shall be treated as a case expense and shall NOT be deducted from Client's net recovery of any settlement or verdict in the same manner as other case expanses as outlined in this agreement 4.5 Interest. Client agrees that Attorneys may borrow fiords from a commercial bank to finance or pay any bankruptcy costs and litigation expenses on Client's behalf. The reasonable interest charged by the bank on such borrowed fiords will be added to the court costs and case expenses and shall NOT be deducted from Client's ultimate settlement or recovery, if any. Client will be provided with a settlement summary and an itemized expense sheet at the close of Client's case. V. CLIENT'S DUTIES .. ... .. ..: P,pne 2.0£.4.. 5.1 Cooperation of Client Client agrees to cooperate with Attorneys at all times and to comply with all reasonable requests of Attorneys needed in preparation of Client's case, including, but not limited to, executing documents, and attending meetings and depositions. Chart further agrees to keep Attorneys advised of his/her whereabouts at all times, and to notify Attorneys promptly of any changes of address, phone number, or business affiliation. Client agrees to cooperate fully with Attorneys to update and/or obtain nay and aA information requested in order to assist in the handling of his/her case. Client understands that failure to notify Attorneys of his/her whereabouts could delay or adversely affect Client's case and possibly bar certain claims if deadlines are sussed as a result of Attorneys' inability to locate Client. 5.2 Disclosure •by Client Client agrees to inform Attorneys of any canrent or future bankruptcy or Debtor's Court proceedings of which Client is involved either personally or jointly. Client further agrees to inform Attorneys of any Medicaid or SSI benefits that helshe receives. Additionally, Client understands that Medicaid, SSI and other financially need-based benefits could be adversely affected by receipt of settlement proceeds from taus lawsuit. Further, Client agrees to inform Attorneys of any sudden changes in Client's medical or physical health including, but not limited to, making arrangements for notification to Attorneys of Client's death. Client should immediately inform Attorneys of any of the aforementioned circumstances. 5.3 Subrogaiion/Liens. Client understands that hospitals, other medical providers, insurers and/or certain government providers may have subrogation claims and/or a legal claim ("lien") on some portion of any settlement or recovery obtained by Client Client agrees to cooperate with Attorneys in resolving any such subrogation claims or liens at the appropriate time, and understands that the payment of Chart's portion of any recovery may be delayed until airy •such subrogation claims or liens are resolved. Client agrees to inform Attorneys of any notices Client receives from a potential subrogation claimant or liar holder regarding any such potential subrogation or Lien on Client's recovery, if any. 'Client understands and agrees that any such subrogation and/or lien payment shell be deducted from Client's net recovery. VI. ASSOCIATION OB OTHER ATTORNEYS 6.1 Association of Other Attorneys. Client understands that HANDLER, HENNING & ROSEN'BERG, LLP and CORY, WATSON, CROWDER & DeGARIS, P.C. is a professional corporation with a number of attorneys, and that any of The Firm's Attorneys may assist is the work on Client's case. Attorneys may, at their own expense, use or associate outside attorneys in the representation of the aforesaid claims of Client Ia that eveirt, Client will be advised of the participation of all the lawyers involved. Unless the Cliart is notified fA the contrary, any such outside attorneys retained on Client's behalf will assume joint responsibility for.Cliart's represarta2ion. The fact that other attorneys work on Client's case will not increase the foist attorneys' fees due under this agreement, nor otherwise change the terms of this agreement. . 6.2 Referring Attorneys. In the event that this case was referred to HANDLER, HENNING & ROSENBERG, LLP, and CORY, WATSON, CROWDER & DeGARIS, P.C., by another attorney(s), Client understands that this contract supersedes all prior contracts, agreements and/or understandings that may have been entered into with any grid all rafening attorneys in this case. The Client understands that all attorneys will be compensated by HANDLER, HENNING & ROSENBERG, LLP, and CORY, WATSON, CROWDER & DeGARIS, P.C., pursuant to the firms of this arntract VII. NO OTHER REPRESENTATION 7.1 No Other Representation. Client affirmatively states to Attorneys that Chart is not cwrently represented by any other attorney or law firm for any claims or lawsuits covered by this agreement VIII. DEATH OF CLIENT 8.1 Death of Client The provisions of this agreement will not terminate upon death of Client whose signature appears below. In the event of the death of Client, any duly appointed Reprosentative of Client's Heirs and/or Estate will be bound by this agreement to the extent allowed by applicable law. In particular, any such Representative wilt be bound by the provisions of this agreement relating to the recovery of attorney's fees and costs and other expenses. IX. CHOICE OF LAW 9.1 Choice of Law. This Contract will be interpreted pursuant to the taws of the state of Pennsylvania. .. ....._ ..a8e..of4. .. X. CONFLICT Off' LAW 10.1 Conflict of Law. if any of the contract provisions contained in this Agreement are inconsistent or conflict with any applicable laws, statutes, rules, or court orders of the state where the Client is domiciled or the jurisdiction where the lawsuit is f led, then the inconsistent or conflicting provisions sha[1 be deemed stricken from this Agreement and this Agreement shall conform to the applicable laws, statutes, rules, or court orders. SIGNED and ACCEPTED ti~is ~~ ~ day of~~Q~_~~_. J Client Signature ~~r- ~-- • ~ ~z- PrintFull Name CORY, WATSON, CROWDER & DeGARIS, P.C. BY: LP . Pege.,4 of_4..,.. CORY WATSON CROWDER AND DEGARIS February 8, 2012 Donald Kutz Prebill# 82430 Hl Our file# 0117 04212 Billing through 02/29/2012 EXPENSES d'.S~FT~ ` " 2a ' 02/,~~/2O~r2:~ - ~~, ,~, ~' ~ kit' ,~:+: . ~_:~,, ' ~*. ~ , ., mac....<_., ._.. ,G.,::se.. _ . . 02/29/2012 Copies, faxes, scanning, postage, fedex 75.00 i T 4 03/23/2011 OUTSIDE COPYING 26.16 ,All _ µ 04/08/2011 ; .tom t . ~ . ~; . 04!06/2011 Healthport; Invoice # 0088721039; MEDICAL RECORDS from Carlisle 44.70 Regional. . ~ 4' :xxa, .. ~ ,. .. ~ ~ 04/12/2011 Healthport; Invoice # 0088824973; MEDICAL RECORDS from Carlisle 27.11 Regional Medical Center. PJII ~`' 05/11`/2011 ;; _ ,', ~ . ~. .... ~.. ~~~r~i` 05/11/2011 Medical Test Interpretation -Breyer Inv OS/11/11 B Reads 75.00 LD --~ 02/29/2012 = ~ ~~:~° : - `~~ ter. , 02!29/2012 LONG DISTANCE TELEPHONE CHARGES 5.00 $252.97 _. _~ .. . - ..> -~~~ ?.. 0.00'- a ~ r Billing_,Summary Total expenses incurred $252.97 Total of new charges for this invoice $252.97 $252.97 ~~ .~ ,. _ , (_ . ASBESTOS CONFIDENTIAL SETTLEMENT DISBURSEMENT SHEET __ Client Name: Estate of Donald Edward Kurz, Jr. CWCD File No.: 0117-04212 A. Total Settlement Paymen# Johns Manville... .. - -$ 1,875.00 ~ '- ' : ..; ; -B: ~ Attorneys Fees , . ~ '. ~~~' ' " 'Fee is 25% on Johns Manville- expenses deducted up to 45% $- 468.75 C. Litigation Costs ,' ' CWCD Expenses $- 252.97 TOTAL AMOUNT TO CLIENT .. ,_ $ 1,153.28 r Please review the settlement breakdown. Then read and initial each statement below. si¢a at the bottom. and re~~tu~`rin it to us. If you have questions, contact us by telephone, letter, or email before signi~ug this farm. 6g7ti' I have reviewed the settlement figures above, and I understand and agree to the above distribution of settlement proceeds, and authorize the disbursements. I have reviewed the expense sheet and acknowledge that the expenses incurred by CWCD to handle my claim and any loans, liens or subrogation claims have been explained and I understand same. I understand that costs for "copies, faxes, scanning, postage, fedex" is not the actual cost for these services, but is the cost calculated from a survey of over 100 asbestos bankruptcy trust cases handled by CWCD. I understand that I may review the cost survey upon request. In the event that additional expenses should be incurred by CWCD after the time of my execution of Disbursement eet, I authorize CWCD to reduce their attorney fee stated above and reapply their fee to expenses so long as the Total Amount to Client stated above remains the same. I understand that I am responsible for any medical bills, other than those listed on the expense sheet, that I have incurred in the past or may incur in the future that relate to this case. ~~ I understand that this settlement will end any past, present or future asbestos related claim that I have or may ever ve against the paying trust or company. I understand that my file will be retained by CWCD for six (~ years, and I give CWCD permission to destroy the entire contents of the file after six (6) years. Should I desire to take personal custody of my file (or any part of my file) before it is destroyed, I understand that I must notify CWCD in writing within.the next-six (6) years. I understand that the attorney fees may be reduced on some settlements or recoveries by order of a court, claims administrator, special master, or bankruptcy trustee. If there is an ordered reduction in the attorney fee, and my contingency fee contract provides for expenses to be included in the attorney fees, I agree that my attorneys may deduct case expenses from my share of that settlement or recovery, but in no event will the total deduction for attorneys fees and expenses for that settlement exceed the fee percentage set in my contingency fee contract. '~ I understand and acknowledge that the settlement is expected to be paid within a reasonable length of time from the date the Defendant receives my signed release. I understand that payment of my portion ("Total Amount To Client") is contingent on my attorneys receiving the settlement money from the Defendants, and that payments will be made to me hin 4 to 6 weeks after y attorneys receive this signed Settlement Disbursement Sheet. ~l ~ ~~~ gent Signature Date Rev.l/6/2012/lhw fix. ~ ASBESTOS CONFIDENTIAL SETTLEMENT DISBURSEMENT SHEET Client Name: Donald Edward Kutz, Jr. A. Total Settlement Payment Eagle-Picher National Gypsum Co. B. Attorneys Fees Fee is 45% of Total Settlement Payment C. Litigation Costs CWCD Expenses TOTAL AMOUNT TO CLIENT CWCD File No.: 0117-04212 $ 2,946.00 675.00 $ 3,621.00 $- 1,629.45 $ -0- $ 1,991.55 Please review the settlement breakdown. Read each statement below. si¢n at the bottom and return it to us If you have questions, contact us by telephone, letter, or email before signing this form. I have reviewed the settlement figures above, and I understand and agree to the above distribution of settlement proceeds, and authorize the disbursements. I have reviewed the expense sheet and acknowledge that the expenses incurred by CWCD to handle my claim and any loans, liens or subrogation claims have been explained and I understand same. I understand that costs for "copies, faxes, scanning, postage, fedex" is not the actual cost for these services, but is the cost calculated from a survey of over 100 asbestos bankruptcy trust cases handled by CWCD. I understand that I may review the cost survey upon request. In the event that additional expenses should be incurred by CWCD after the time of my execution of this Disbursement Sheet, I authorize CWCD to reduce their attorney fee stated above and reapply their fee to expenses so long as the Total Amount to Client stated above remains the same. I understand that I am responsible for any medical bills, other than those listed on the expense sheet, that I have incurred in the past or may incur in the future that relate to this case. I understand that this settlement will end any past, present or future asbestos related claim that I have or may ever have against the paying trust or company. I understand that my file will be retained by CWCD for six (6) years, and I give CWCD permission to destroy the entire contents of the file after six (6) years. Should I desire to take personal custody of my file (or any part of my file) before it is destroyed, I understand that I must notify CWCD in writing within the next six (6) years. If you are receiving Medicaid, Food Stamps, SSI or any other government assistance, it is your responsibility to report this settlement to the proper government agency. I understand and acknowledge that the settlement is expected to be paid within a reasonable length of time from the date the Defendant receives my signed release. I understand that payment of my portion ("Total Amount To Client") is contingent on my attorneys receiving the settlement money from the Defendants, and that payments will be made to me within 4 to 6 weeks after my attorneys receive this signed Settlement Disbursement Sheet. ~' Client Signature Date Rev.6/25/2012/Ihw ~. .`,f~ ~,.~:, pennsylvania DEPARTMENT 4F REVENUE Septcneber 14, 2012 Gregory Feather, Esquire Handler Henning Rosenberg, LLP 1300 Lingiestown Rd Harrisburg, PA 17110 Re: Estate of Donald Kutz File Number 2111-0313 Court of Common Pleas Cumberland County Dear Mi•. Feather: 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 Common~veaith's approval of the allocation of the proceeds paid to settle the actions. Pursuant to the Petition, the 68 year old decedent died as a result of mesothelioma. Decedent is survived by his wife and four 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, $1,513.28 to the wrongful death claim and $1,513.27 to the survival claim. Proceeds of a survival action are an asset included in the decedent's estate and are subject to the imposition of Pennsylvania inheritance tax. 42 Pa.C.S.A. §8302; 72 P.S. §9106, 9107. Costs and fees must be deducted in the same percentages as the proceeds are allocated. In re Estate of Merryman, 669 A.2d 1059 {Pa. Cmwlth. 1995). I trust that this letter is a sufficient representation of the Department's position on this matter. As the Department has no objections to the Petition, an attorney from the Department of Revenue will not be attending any hearing regarding it. Please contact me if you or the Court has any questions or requires anything additions! from this Bureau. Sri cerelyJ,!/ ~~/~/ /~//Cy~ ran on E. Baker Trust Valuation Specialist Inheritance Tax Division _.. Bureau of Individual Taxes ~ PO Box 280501 ~ Harrisburg, PA 17128 ~ 717.783.5824 ~ shabaker@pa.gov ~x.~G ~/ /~ IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA BARBARA L. KUTZ, Administratrix of the Estate of DONALD E. KUTZ, JR., Petitioner NO.: /oZ - (x$(09 lilv~ / T (h7 CIVIL ACTION -LAW ORDER AND NOW, this '~~1 day of ~ d~ 2012, upon consideration of the foregoing petition, IT IS HEREBY ORDERED that Petitioner is authorized to enter into a settlement in the gross sum of $5,496.00. Petitioner is authorized to sign a release and to mark the matter settled, discontinued, and ended as to the Defendants. The settlement proceeds shall be distributed as follows: (a) Payment of counsel fees in the amount of $2,098.20 to the law firms of Handler, Henning & Rosenberg, LLP, and Cory, Watson, Crowder &DeGaris, P.C., from the funds due; (b) Payment of costs in the amount of $252.97, to the law firms of Handler, Henning & Rosenberg, LLP, and Cory, Watson, Crowder &DeGaris, P.C., from the funds due; and 6 (b) The balance of the settlement is apportioned as follows: (i) Wrongful Death Action: (A) Barbara L. Kutz, Decedent's spouse - $1,572.42 (ii) Survival Action: (A) Petitioner, Barbara L. Kutz, Administratrix of the Estate of Donald E. Kutz - $1,572.41 BY THE COURT J. w~ ~> -; ~_ t-:=~ t z~ ~ ~-_~ ~~ ~ ~ ~ ~ ~ --"~ `-~ ~ •~ , a.) ,~ -` ~1'y N1a~ lc~ i/~j~/~~~