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HomeMy WebLinkAbout05-0305F:\WP DirectoriesWFUrninor's comp\matt\nicholson.wpd Matthew S. Crosby, Esq. I.D.#69367 HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road Harrisburg, PA 17110 Telephone: (717) 238-2000 Attorneys for Petitioner Fax: (717) 233-3029 E-mail: Crosby@hhrlaw.com JORDAN NICHOLSON, a minor : IN THE COURT OF COMMON PLEAS OF by and through his natural parent : CUMBERLAND COUNTY, PENNSYLVANIA and guardian, LEELA SMITH, Petitioner : NO. 2005- 30S CIVIL V. CIVIL ACTION - LAW JENNA M. BUSBY, Respondent MINOR'S COMPROMISE PETITION FOR LEAVE TO COMPROMISE MINOR'S ACTIONS Pursuantto Pennsylvania Rule of Civil Procedure No. 2039, Leela Smith, the natural parent and legal guardian of minor, Jordan Nicholson, by her attorneys, HANDLER, HENNING & ROSENBERG, LLP, by Matthew S. Crosby, Esq., petitions this Honorable Court to enter an Order permitting settlement and compromise of this action, and in support thereof, avers: 1. Jordan Nicholson was born on July 15, 1992, and is, therefore, 12 years old and a minor. He currently resides at 2310 Berryhill Street, Harrisburg, Dauphin County, PA 17104. 2. Petitioner, Leela Smith, is an adult individual and said minor's natural mother and legal guardian; she currently resides with Jordan at 2310 Berryhill Street, Harrisburg, Dauphin County, PA 17104. 3. Respondent, Jenna M. Busby, is an adult individual currently residing at 702 East Simpson Street, Mechanicsburg, Cumberland County, PA 17055. 4. At all times material hereto, the minor, Jordan Nicholson, was a passenger in a 1993 Chevrolet Cavalier owned and being operated by Michael L. Myers bearing Pennsylvania registration number FCX 5298 (hereinafter "minor's vehicle°). 5. At all times material hereto, Respondent, Jenna M. Busby, was the operator of a 1993 Mercury Sable, owned by Peter Busby, bearing Pennsylvania registration number EJT 7535 (hereinafter "Respondent's vehicle"). 6. On or about July 20, 2003, at approximately 05:30 a.m., minor's vehicle was traveling southbound on Steven Road in Newberry Township, York County, Pennsylvania. 7. On or about July 20, 2003, at approximately 05:30 a.m., Respondent's vehicle was traveling westbound on Sheep Bridge Road in Newberry Township, York County, Pennsylvania, approaching the intersection with Stevens Road. 8. At approximately the same time and place, Respondent, Jenna Busby, failed to stop at the properly posted Stop sign controlling westbound Sheep Bridge Road traffic and, as a result, Respondent's vehicle violently struck minor's vehicle in the intersection. 9. As a result of the crash, Respondent, Jenna M. Busby, was cited for, inter alia, Aggravated Assault While Driving under the Influence of Alcohol, Reckless Driving, Reckless Endangerment, and Driving at an Unsafe Speed. 2 10. As a direct and proximate result of the negligence of the Respondent, the minor, Jordan Nicholson, suffered multiple injuries including, but not limited to, a laceration to his face beneath his left eyebrow and across his forehead requiring approximately 18 stitches, two black eyes, and frequent headaches. Said scarring is permanent and is in a prominent location on Jordan's face. (See two pictures of Jordan's facial scarring taken on April 19, 2004, attached hereto, made a part hereof, and marked "Exhibit A.") 11. At the time of this collision, the minor, Jordan Nicholson, was insured under Petitioner's automobile insurance policy with Donegal Mutual Insurance Company. To date, all of said minor's collision-related medical bills have been paid by Donegal Mutual Insurance Company. 12. Also, at the time of this collision, Respondent's vehicle was insured under a policy of motor vehicle insurance issued by Allstate Insurance Company. 13. After protracted negotiations, Allstate Insurance Company has offered to settle the minor's claim against the Respondent, Jenna M. Busby, for $50,000.00. 14. Although the $50,000.00 settlement does not represent the Respondent's bodily-injury liability policy limits, the total proposed settlement does exhaust the $300,000.00 policy limit, because there are five other claimants in this matter and the total proposed settlement of all six claimants equals $300,000.00. The proposed settlement amounts are as follows: 1) Minor, Jordan Nicolson: $50,000.00 2) Michael Myers; (driver-minor's vehicle): $22,500.00 3) Albert Maxson; (passenger-minor's vehicle): $70,000.00 4) Mark Nissel, (passenger-Respondent's vehicle): $55,000.00 3 5) Tyler Masonheimer; (passenger-Respondent's vehicle): $85,000.00 6) Taryn Castner; (passenger-Respondent's vehicle): $17,500.00 TOTAL: $300,000.00 (See attached hereto, made a part hereof, and marked "Exhibit B," a letter from Chris Marzzacco, Esq., counsel for claimant Masonheimer, dated November 16, 2004, outlining the distribution of the proposed settlement). 15. Petitioner believes said settlement is in the best interests of her minor son and proposes to accept said settlement offer of $50,000.00, thereby releasing Respondent from any and all claims, suits, and/or actions in the future. 16. Petitioner, Leela Smith, through her counsel, Matthew S. Crosby, Esq., intends to pursue additional settlement monies via Underinsured Motorist claims with both Safe Auto Insurance Company (the insurer of the vehicle in which minor was an occupant) and Donegal Mutual Insurance Company (the insurer of minor's resident relative mother, Leela Smith). 17. Matthew S. Crosby, Esquire, of HANDLER, HENNING & ROSENBERG, LLP, has been the attorney for the minor in this action and he requests reasonable counsel fees of $12,500.00 for services rendered plus costs and expenses of $494.31 pursuant to a Contingent Fee Agreement signed by Petitioner. The 25% represents a reduction from the 33-1/3% fee agreement signed by the Petitioner. Thus, the total amount requested for attorney's fees and costs is $12,994.31. See the Contingent Fee Agreement, attached hereto, made a part hereof, and marked "Exhibit C," as well as a true copy of the billing summary, attached hereto, made a part hereof, and marked "Exhibit D." Also attached 4 hereto, made a part hereof, and marked "Exhibit E," is a copy of the proposed settlement release. 18. Petitioner requests this Honorable Court order a payment of said balance of $37,005.69 to be placed in an account investing only in securities guaranteed by the United States government or a Federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until minor reaches the age of 18 or without the Order of a Court of Competent jurisdiction." WHEREFORE, Petitioner requests this Honorable Court to: a. Approve the Compromise above-stated; b. Authorize the payment of fees above-stated from funds due the minor; and c. Direct payment of the net funds due, in accordance with the Compromise above-stated. Date: 13d? Respectfully submitted, HANDLER, HENNING & ROSENBERG, LLP Crosby, Esq. 5 fN Jan M. Wiley -David 1. Lenox Timothy J. Colgan Christopher ). Marzzacco THE WILEY GROUP Attorneys at Law Wiley, Lenox, Colgan & Marzzacco, P.C. November 16, 2004 Matthew Crosby, Esquire 1300 Linglestown Road Harrisburg, PA 17110 Howard B. Krug, Esquire 1719 N. Front Street Harrisburg, PA 17102 Jonathan Ostroff, Esquire 527 Plymouth Road Plymouth Meeting, PA 19462-1641 Girard Rickards, Esquire P.O. Box 1389 York, PA 17405 P. Richard Wagner, Esquire 2233 N. Front Street Harrisburg, PA 17110 Re: My Client: Tyler Masonheimer Insured: Peter Busby/Progressive Insurance Company Date of Loss: July 20, 2003 Dear Gentlemen: David E. Hershey - Diana Woodside Bradley A. Winnick Thomas M. Clark I am writing to indicate that I have confirmed that all plaintiffs' counsel in this matter have agreed to an allocation of the proceeds of the applicable policy in this case. Specifically, after long negotiations and great compromise by many in this matter, the following allocation of the $300,000 policy will take place: 1. Tyler Masonheimer represented by me $85,000.00 2. Mark Nissley represented by Richard Wagner, Esquire $55,000.00 3. Jordan Nicholson represented by Matthew Crosby, Esquire $50,000.00 4. Albert Maxson represented by Jonathan Ostroff, Esquire $70,000.00 5. Michael Myers represented by Girard Rickards, Esquire $22,500.00 6. Taryn Casner represented by Howard Krug, Esquire $17,500.00 TOTAL: $300,000.00 I have already obtained consent to settle from my UIM provider and actually have settled Mr. Masonheimer's claim. I ask that everyone contact their UIM providers to do the same. Additionally, Mr. Crosby represents Jordan Nicholson, a minor, and will need court approval of his settlement. Finally, Attorney Rich Wagner has indicated that his UIM providers will need a copy of 130 W. Church Street, Suite 100 • Dillsburg, PA 17019 • Phone: (717) 432-9666 • (800) 6 Offices in Harrisburg • York • Carbondale www.wi leygrouplaw.COM r-% Page 2 November 16.2004 this correspondence and will also need a summary of each plaintiff's medical condition. To that end, I have forwarded a copy of a two-page opinion letter authored by Mr. Masonheimer's treating physician. I ask that each of you send Attorney Wagner similar letters and/or medical records to support your client's injuries. If you have already provided Mr. Wagner with medical records at our original meeting in May, please make sure he still has copies of the same. I suggest that we request individual releases from James Nealon, Esquire. I believe that we should have our clients sign the same and keep them until all plaintiffs have obtained consent to settle from their UIM carriers and until Attorney Crosby obtains court-approval for his client's settlement. I believe the releases should be signed now to prevent any problems from "hard-to handle" plaintiffs. I ask that each of you call me to acknowledge receipt of this letter and to share thoughts on how to contact Mr. Nealon to obtain releases. I sincerely thank all of you for the effort put forth toward resolving this matter. It has been a pleasure and I look forward to finalizing this matter with you in the near future. Very truly yours, WILEY, LENOX, COLGAN & MARZZACCO, P.C. by Christopher J. Marzzacco CJM/Ims Enclosures cc: Tyler Masonheimer CONTINGENT FEE AGREEMENT I, LEELA SMITH, natural parent and guardian of Jordan Nicholson, a minor, do hereby retain HANDLER, HENNING & ROSENBERG, LLP., of Harrisburg, Pennsylvania, as my attorneys in this matter to represent me and to process, negotiate, arbitrate a settlement or to institute in my name, any legal proceedings or actions that, in theirjudgment are necessary, against AN AS-YET UNIDENTIFIED PARTY OR PARTIES as a result of injuries and damages my son sustained in an incident that occurred on July 20, 2003. 1 agree not to settle, negotiate or adjust the above claim or any proceedings based thereon without the written consent of my said attorneys. In consideration of the services so to be rendered by Handler, Henning & Rosenberg, LLP, I hereby covenant, promise and agree to pay them for their professional services rendered, THIRTY-THREE AND ONE-THIRD PERCENT (331/3%) of whatever sum is recovered as a result of settlement without lawsuit; or FORTY PERCENT (40%) of whatever sum is recovered after lawsuit is filed or in the event of arbitration or mediation. I will reimburse Handler, Henning & Rosenberg, LLP. for any necessary expenses advanced on my behalf in pursuing my claim. Examples of typical expenses include Court filing fees, investigation, auto mileage, photocopies, court reporters, medical records, expert witness fees, etc. If no money is obtained, client will not owe a legal fee or expenses. I also agree to take possession of my medical files at the conclusion of this case. My failure to take possession of these files within 60 days after the conclusion of the case will authorize my lawyers to destroy said files. I agree that HANDLER, HENNING & ROSENBERG, LLP. may associate additional lawyers to assist with this case and I agree to the sharing of fees between lawyers. I understand the terms herein apply to other lawyers associated on this case. )understand that the association of other lawyers does not increase the amount of the attorney fees at the conclusion of the case. Counsel reserves the right to withdraw if they desire to do so, for any reason(s) they deem proper. I acknowledge that I have read, approved and understood the above Contingent Fee Agreement and I acknowledge having received a copy of the same. The terms set forth herein are accepted. WITNESS WHEREOF, I have hereunto set my hand and seal this day of 2003. !I D ?QtP rh (SEAL) LEELA SMITH, natural parent and guardian of JORDAN NICHOLSON andlar, anningb i Client No: 208556 osanbargALP Matter: 00000 ATTORNEYS AT LAW Attorney: MSC 1300 Linglestown Road, Harrisburg, PA 17110 MV Pre-Bill No: 12525 Jordan Nicholson Bill Date: November 18, 2004 c/o Leela Smith 2310 BerryHill Street Harrisburg, PA 17104 INVOICE PAYMENT DUE UPON RECEIPT EXPENSES 07/30/2003 CASE Vendor NEWBERRY TOWNSHIP POLICE, General Case Ex ense- p Q7/3o/2003 $15 00 15.00 07/31/2003 . Photography Costs PHOT 07131/2003 $4 50 4.50 08/01/2003 . Mileage M14E 0810/12003 $2 76 2.76 08/08/2003 ' . Vendor YORK HOSPITAL, General Case Expense CASE , 48/08/2003 $62 50 62.50 09/29/2003 CASE . Vendor PA DEPT OF TRANSPORTATION, General Case Ex ens p e 0912912003 $5 00 5.00 10/09/2003 CASE . Vendor COLONIAL PARK PEDIATRIC General Case Expense 10/09/2043 $16 37 16 37 12/04/2003 r.A.qr . Vendor WELLSPAN MEDICAL GROUP; General Case EXDPnaa 1?/AAIMmA. 11/18/2004 wcvauu":. Vendor PROTH OF CUMBERLAND CO, General Case Expense CASE 1 1 /1 812004 ' $55 50 11/30/2004 Document Reoroductinn u V r x 11/30/2004. $3 20:' 3.20 11/30/2004 Fax Charges . FAX 11/30/2004 $140 00 1 140.00 11/30/2004 Federal Express Costs . FEDX 11/30/2Q04 $100-' 100 11/30/2004 Document Reproduction Isl 11130/2004 $64 00 64.00 11/30/2004 Milaana . 208556 Nicholson, Jordan 11/30/2004 Long Distance Pre-Bill # 12525 TOTAL EXPENSES Total due this invoice TOTAL BALANCE DUE Page 2 1.14 $494.31 $494.31 $494.31 CLAIM NUMBERS: 1554671097 RELEASE OF ALL CLAIMS THIS INDENTURE WITNESSETH that, in consideration of the sum of Fifty Thousand and 001100 dollars ($50,000.00), receipt whereof is hereby acknowledged, for myself individually and as parent to natural guardian of Jordan Nicholson, and for my heirs, personal representatives and assigns, I do hereby release and forever discharge Jenna Margaret Busby, Peter C. Busby and the Allstate Insurance Company, and any other person, firm or corporation charged or chargeable with responsibility or liability, their heirs, representatives and assigns, from any and all claims, demands, damages, costs, expenses, loss of services, actions and causes of action, &? claims for bad faith damages, punitive damages, arising from any act or occurrence up to the present time and particularly on account of all personal injury, disability, property damage, loss or damages of any kind already sustained or that I may hereafter sustain, arising out of an accident that occurred on the 20th day of July, 2003 at the intersection of Sheep Bridge Road (S.R. 4021) and Stevens Road (T-837), Newberry Township, York County, Pennsylvania. It is expressly understood that I am accepting the above compensation not only to compensate me for any claims that I may assert in a civil action but any claims for restitution that have been or will be awarded in connection with the criminal case against Jenne Margaret Bubsy. I agree to notify the court officials of the Court of Common Pleas of York County that the restitution claim has been satisfied. I further agree, if necessary, to cooperate in the filing of any Petitions or Motions in the criminal proceeding to have the restitution awards satisfied. Notwithstanding the foregoing, the undersigned hereby reserve all claims against Allstate Insurance Company for any medical bills that have been incurred as a result of the automobile accident and which would be covered under the policy issued by Allstate to us, Policy Number 1554671097. Allstate reserves any and all policy defenses it may have to any claims for additional medical bills and restitution. To procure payment of the said sum, I hereby declare that I am more than 18 years of age; that no representations about the nature and extent of said injuries, disabilities or damages made by any physician, attorney or agent of any party hereby released, nor any representations regarding the nature and extent of legal liability or financial responsibility of any of the parties hereby released, have induced me to make this settlement; that in determining said sum there has been taken into consideration not only the ascertained injuries, disabilities and damages, but also the possibility that the injuries sustained may be permanent and progressive and recovery therefrom uncertain and indefinite, so that consequences not now anticipated may result from the said accident. Notwithstanding the foregoing, this Release does NOT apply to any Underinsured Motorist claims, first-party automobile insurance claims, and/or any potential claims against any person or party not identified in this Release. EQ HWT f E- I hereby agree that, as a further consideration and inducement for this compromise settlement, that it shall apply to all unknown and unanticipated injuries and damages resulting from said accident, casualty or event, as well as to those now disclosed. I understand that the parties released admit no liability of any sort by reason of said accident and that the said payments and settlements in compromise are made to terminate further controversy respecting all claims for damages that have heretofore asserted or that our personal representatives might hereafter assert because of said accident. Signed and sealed this day of January, 2005. CAUTION - READ BEFORE SIGNING Witnessed by STATE OF PENNSYLVANIA COUNTY OF (SEAL) LEELA SMITH, Individually and as parent to natural guardian of Jordan Nicholson SS On this _ day of January, 2005 before me personally appeared Leela Smith, individually and as parent to natural guardian of Jordan Nicholson known to be the person who executed the foregoing instrument, acknowledged that he executed the same as his free act and deed. NOTARY PUBLIC My Commission Expires: VERIFICATION I, LEELA SMITH, natural parent and guardian of JORDAN NICHOLSON, minor, hereby verify that the statements made in the foregoing pleading are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A., Section 4904 relating to unsworn falsification to authorities. LEE A SMITH, natural parent and guardian of JORDAN NICHOLSON, minor DATE: , Ira iZOO,5 _i K W V r; n ? i r 1 i Gl JAN 1 9 200; JORDAN NICHOLSON, a minor : IN THE COURT OF COMMON PLEAS OF by and through his natural parent : CUMBERLAND COUNTY, PENNSYLVANIA and guardian, LEELA SMITH, Petitioner NO. 2005 -30,' CIVIL V. CIVIL ACTION - LAW JENNA M. BUSBY, Respondent MINOR'S COMPROMISE ORDER AND NOW, this Zy" day of ! a2w" 2005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursement of funds, including counsel fees and expenses, is approved as set forth in said Petition and the funds shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $12,994.31 to Matthew S. Crosby, Esq., representing reasonable attorneys' fees of $12,500.00 and $494.31 for reimbursement of costs; B. Direct the remaining $37,005.69 to be placed in an account investing in securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. BY THE COURT: J. C?,? rp :C P,8 ' 7 N Vf S 0 2 Z F'.\WP Directories\JFL\minor's comp\matt\nicholson.wpd Matthew S. Crosby, Esq. I.D.#69367 HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road Harrisburg, PA 17110 Telephone: (717) 238-2000 Attorneys for Petitioner Fax: (717) 233-3029 E-mail: Crosby@hhrlaw.com JORDAN NICHOLSON, a minor : IN THE COURT OF COMMON PLEAS OF by and through his natural parent : CUMBERLAND COUNTY, PENNSYLVANIA and guardian, LEELA SMITH, Petitioner : NO. 2005- 30S CIVIL V. CIVIL ACTION - LAW JENNA M. BUSBY, Respondent MINOR'S COMPROMISE PETITION FOR LEAVE TO COMPROMISE MINOR'S ACTIONS Pursuantto Pennsylvania Rule of Civil Procedure No. 2039, Leela Smith, the natural parent and legal guardian of minor, Jordan Nicholson, by her attorneys, HANDLER, HENNING & ROSENBERG, LLP, by Matthew S. Crosby, Esq., petitions this Honorable Court to enter an Order permitting settlement and compromise of this action, and in support thereof, avers: 1. Jordan Nicholson was born on July 15, 1992, and is, therefore, 12 years old and a minor. He currently resides at 2310 Berryhill Street, Harrisburg, Dauphin County, PA 17104. 2. Petitioner, Leela Smith, is an adult individual and said minor's natural mother and legal guardian; she currently resides with Jordan at 2310 Berryhill Street, Harrisburg, Dauphin County, PA 17104. 3. Respondent, Jenna M. Busby, is an adult individual currently residing at 702 East Simpson Street, Mechanicsburg, Cumberland County, PA 17055. 4. At all times material hereto, the minor, Jordain Nicholson, was a passenger in a 1993 Chevrolet Cavalier owned and being operated by Michael L. Myers bearing Pennsylvania registration number FCX 5298 (hereinafter "minor's vehicle"). 5. At all times material hereto, Respondent, Jenna M. Busby, was the operator of a 1993 Mercury Sable, owned by Peter Busby, bearing Pennsylvania registration number EJT 7535 (hereinafter "Respondent's vehicle") 6. On or about July 20, 2003, at approximately 05:30 a.m., minor's vehicle was traveling southbound on Steven Road in Newberry Township, York County, Pennsylvania. 7. On or about July 20, 2003, at approximately 05:30 a.m., Respondent's vehicle was traveling westbound on Sheep Bridge Road in Newberry Township, York County, Pennsylvania, approaching the intersection with Stevens Road. 8. At approximately the same time and place, Respondent, Jenna Busby, failed to stop at the properly posted Stop sign controlling westbound Sheep Bridge Road traffic and, as a result, Respondent's vehicle violently struck minor's vehicle in the intersection. 9. As a result of the crash, Respondent, Jenna M. Busby, was cited for, inter alia, Aggravated Assault While Driving under the Influence of Alcohol, Reckless Driving, Reckless Endangerment, and Driving at an Unsafe Speed. 2 10. As a direct and proximate result of the negligence of the Respondent, the minor, Jordan Nicholson, suffered multiple injuries including, but not limited to, a laceration to his face beneath his left eyebrow and across his forehead requiring approximately 18 stitches, two black eyes, and frequent headaches. Said scarring is permanent and is in a prominent location on Jordan's face. (See two pictures of Jordan's facial scarring taken on April 19, 2004, attached hereto, made a part hereof, and marked "Exhibit A.") 11. At the time of this collision, the minor, Jordan Nicholson, was insured under Petitioner's automobile insurance policy with Donegal Mutual Insurance Company. To date, all of said minor's collision-related medical bills have been paid by Donegal Mutual Insurance Company. 12. Also, at the time of this collision, Respondent's vehicle was insured under a policy of motor vehicle insurance issued by Allstate Insurance Company. 13. After protracted negotiations, Allstate Insurance Company has offered to settle the minor's claim against the Respondent, Jenna M. Busby, for $50,000.00. 14. Although the $50,000.00 settlement does not represent the Respondent's bodily-injury liability policy limits, the total proposed settlement does exhaust the $300,000.00 policy limit, because there are five other claimants in this matter and the total proposed settlement of all six claimants equals $300,000.00. The proposed settlement amounts are as follows: 1) Minor, Jordan Nicolson: $50,000.00 2) Michael Myers; (driver-minor's vehicle): $22,500.00 3) Albert Maxson; (passenger-minor's vehicle): $70,000.00 4) Mark Nissel, (passenger-Respondent's vehicle): $55,000.00 3 5) Tyler Masonheimer; (passenger-Respondenit's vehicle): $85,000.00 6) Taryn Castner; (passenger-Respondent's vehicle): $17,500.00 TOTAL: $300,000.00 (See attached hereto, made a part hereof, and marked "Exhibit B," a letter from Chris Marzzacco, Esq., counsel for claimant Masonheimer, dated November 16, 2004, outlining the distribution of the proposed settlement). 15. Petitioner believes said settlement is in the best interests of her minor son and proposes to accept said settlement offer of $50,000.00, thereby releasing Respondent from any and all claims, suits, and/or actions in the future. 16. Petitioner, Leela Smith, through her counsel, Matthew S. Crosby, Esq., intends to pursue additional settlement monies via Underinsured Motorist claims with both Safe Auto Insurance Company (the insurer of the vehicle in which minor was an occupant) and Donegal Mutual Insurance Company (the insurer of minor's resident relative mother, Leela Smith). 17. Matthew S. Crosby, Esquire, of HANDLER, HENNING & ROSENBERG, LLP, has been the attorney for the minor in this action and he requests reasonable counsel fees of $12,500.00 for services rendered plus costs and expenses of $494.31 pursuant to a Contingent Fee Agreement signed by Petitioner. The 25% represents a reduction from the 33-1/3% fee agreement signed by the Petitioner. Thus, the total amount requested for attorney's fees and costs is $12,994.31. See the Contingent Fee Agreement, attached hereto, made a part hereof, and marked "Exhibit C," as well as a true copy of the billing summary, attached hereto, made a part hereof, and marked "Exhibit D." Also attached 4 hereto, made a part hereof, and marked "Exhibit E," is a copy of the proposed settlement release. 18. Petitioner requests this Honorable Court order a payment of said balance of $37,005.69 to be placed in an account investing only in securities guaranteed by the United States government or a Federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until minor reaches the age of 18 or without the Order of a Court of Competent jurisdiction." WHEREFORE, Petitioner requests this Honorable Court to: a. Approve the Compromise above-stated; b. Authorize the payment of fees above-stated from funds due the minor; and c. Direct payment of the net funds due, in accordance with the Compromise above-stated. Respectfully submitted, HANDLER, Date: 13 WO?- NING & ROSENBERG, LLP Urosby, Esq. 5 )an M. Wiley David J. Lenox Timothy J. Colgan Christopher T Marzzacco THE W ILEY GRC LJP Attorneys at Law Wiley, Lenox, Colgan & Marzzacco, P.C. November 16, 2004 Matthew Crosby, Esquire 1300 Linglestown Road Harrisburg, PA 17110 Howard B. Krug, Esquire 1719 N. Front Street Harrisburg, PA 17102 Jonathan Ostroff, Esquire 527 Plymouth Road Plymouth Meeting, PA 19462-1641 Re: My Client: Insured: Date of Loss: Dear Gentlemen: Girard Rickards, Esquire P.O. Box 1389 York, PA 17405 P. Richard Wagner., Esquire 2233 N. Front Street Harrisburg, PA 17110 Tyler Masonheimer Peter Busby/Progressive Insurance Company July 20, 2003 David E. Hershey- Diana Woodside Bradley A. Winnick Thomas M. Clark I am writing to indicate that I have confirmed that all plaintiffs' counsel in this matter have agreed to an allocation of the proceeds of the applicable policy in this case. Specifically, after long negotiations and great compromise by many in this matter, the following allocation of the $300,000 policy will take place: 1. Tyler Masonheimer represented by me $85,000.00 2. Mark Nissley represented by Richard Wafer, Esquire $55,000.00 3. Jordan Nicholson represented by Matthew Crosby, Esquire $50,000.00 4. Albert Maxson represented by Jonathan Ostroff, Esquire $70,000.00 5. Michael Myers represented by Girard Rickards, Esquire $22,500.00 6. Taryn Casner represented by Howard Krug, Esquire $17,500.00 TOTAL: $300,000.00 I have already obtained consent to settle from my UIM provider and actually have settled Mr. Masonheimer's claim. I ask that everyone contact their UIM providers to do the same. Additionally, Mr. Crosby represents Jordan Nicholson, a minor, and will need court approval of his settlement. Finally, Attorney Rich Wagner has indicated that his UIM providers will need a copy of 130 W. Church Street, Suite 100 • Dillsburg, PA 17019 • Phone: 1717) 432-9666 • (800) 682-4250PCA1it WPS Offices in Harrisburg • York • Carbondale X EXR www.wileygrouplaw.com Page 2 November 16, 2004 this correspondence and will also need a summary of each plaintiff s medical condition. To that end, I have forwarded a copy of a two-page opinion letter authored by Mr. Masonheimer's treating physician. I ask that each of you send Attorney Wagner similar letters and/or medical records to support your client's injuries. If you have already provided Mr. Wagner with medical records at our original meeting in May, please make sure he still has copies of the same. I suggest that we request individual releases from James Nealon, Esquire. I believe that we should have our clients sign the same and keep them until all plaintiffs have obtained consent to settle from their UIM carriers and until Attorney Crosby obtains court-approval for his client's settlement. I believe the releases should be signed now to prevent any problems from "hard-to handle" plaintiffs. I ask that each of you call me to acknowledge receipt of this letter and to share thoughts on how to contact Mr. Nealon to obtain releases. I sincerely thank all of you for the effort put forth toward resolving this matter. It has been a pleasure and I look forward to finalizing this matter with you in the near future. Very truly yours, WILEY, LENOX, COLGAN & MARZZACCO, P.C. by Christopher J. Marzzacco CJM/lms Enclosures cc: Tyler Masonheimer CONTINGENT FEE AGREEMENT I, LEELA SMITH, natural parent and guardian of Jordan Nicholson, a minor, do hereby retain HANDLER, HENNING & ROSENBERG, LLP., of Harrisburg, Pennsylvania, as my attorneys in this matter to represent me and to process, negotiate, arbitrate a settlement or to institute in my name, any legal proceedings or actions that, in theirjudgment are necessary, against AN AS-YET UNIDENTIFIED PARTY OR PARTIES as a result of injuries and damages my son sustained in an incident that occurred on July 20. 2003. I agree not to settle, negotiate or adjust the above claim or any proceedings based thereon without the written consent of my said attorneys. In consideration of the services so to be rendered by Handler, Henning & Rosenberg, LLP, I hereby covenant, promise and agree to pay them for their professional services rendered, THIRTY-THREE AND ONE-THIRD PERCENT (331/3%) of whatever sum is recovered as a result of settlement without lawsuit; or FORTY PERCENT (40%) of whatever sum is recovered after lawsuit is filed or in the event of arbitration or mediation. I will reimburse Handler, Henning & Rosenberg, LLP. for any necessary expenses advanced on my behalf in pursuing my claim. Examples of typical expenses include Court filing fees, investigation, auto mileage, photocopies, court reporters, medical records, expert witness fees, etc. If no money is obtained, client will not owe a legal fee or expenses. I also agree to take possession of my medical files at the conclusion of this case. My failure to take possession of these files within 60 days after the conclusion of the case will authorize my lawyers to destroy said files. I agree that HANDLER, HENNING & ROSENBERG, LLP. may associate additional lawyers to assist with this case and I agree to the sharing of fees between lawyers. I understand the terms herein apply to other lawyers associated on this case. I understand that the association of other lawyers does not increase the amount of the attorney fees at the conclusion of the case. Counsel reserves the right to withdraw if they desire to do so, for any reason(s) they deem proper. I acknowledge that I have read, approved and understood the above Contingent Fee Agreement and I acknowledge having received a copy of the same. The terms set forth herein are accepted. IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of A .2003. I / GC2 ll7N/? (SEAL) LEELA SMITH, natural parent and guardian of JORDAN NICHOLSON EXHIBIT andlar, anningfi osanberg,uP ATTORNEYS AT LAW 1300 Linglestown Road, Harrisburg, PA 17110 Jordan Nicholson c/o Leela Smith 2310 BerryHill Street Harrisburg, PA 17104 INVOICE PAYMENT DUE UPON RECEIPT EXPENSES Client No: 208556 Matter: 00000 Attorney: MSC MV Pre-Bill No: 12525 Bill Date: November 18, 2004 07/30/2003 Vendor NEWBERRY TOWNSHIP POLICE; General Case Expense- 15.00 CASE 07/30/2003 $15.04 07/31/2003 Photography Costs 4.50 PHOT 07/311200K50 08/0112003 Mileage 2.76 MILE 08/0112008 $2.76 08/08/2003 Vendor YORK HOSPITAL, General Case Expense 62.50 CASE 08/08/2003 $62.50 09/29/2003 Vendor PA DEPT OF TRANSPORTATION; General Case Expense 5.00 CASE 09/2912003 $5.00 10/09/2003 Vendor COLONIAL PARK PEDIATRIC, General Case Expense 16.37 CASE 10/0912003 $16X 12/04/2003 Vendor WELLSPAN MEDICAL GROUP; General Case Expense 18.42 CASE 12/04/2003 $18.42 04/20/2004 Vendor AFFILIATED PROFESSIONAL SERVICES, INC., General Case 20.00 CASE 0412012004' $20,00 11/18/2004 Vendor FROTH OF CUMBERLAND CO; General Case Expense 55.50 CASE ' 1111$/2004 $56., 11/30/2004 Document Reproduction 3.20 COPY 1,1/30/20.04:' $120 11/30/2004 Fax Charges 140 00 FAX 11130/2004 $140.00 11/30/2004 Federal Express Costs 1.00 FEDX ` 11/301,2004, $1.00 11/30/2004 Document Reproduction 64.00 ISI 11/30/2004 $64:00 11/30/2004 Mileage 10.70 MILE !. 11/3012004 $10.70 11/30/2004 Postage Costs POS 11/30/2604 $23.68 11/30/2004 Postage Costs POST`' 11/30/11260* 208556 Nicholson, Jordan Pre-Bill # 12525 Page 2 11/30/2004 Long Distance Telephone Charges 1.14 TELE 11/30/2004 $1.14 TOTAL EXPENSES Total due this invoice TOTAL BALANCE DUE $494.31 $494.31 $494.31 CLAIM NUMBERS: 1554671097 RELEASE OF ALL CLAIMS THIS INDENTURE WITNESSETH that, in consideration of the sum of Fifty Thousand and 00/100 dollars ($50,000.00), receipt whereof is hereby acknowledged, for myself individually and as parent to natural guardian of Jordan Nicholson, and for my heirs, personal representatives and assigns, I do hereby release and forever discharge Jenna Margaret Busby, Peter C. Busby and the Allstate Insurance Company, and any other person, firm or corporation charged or chargeable with responsibility or liability, their heirs, representatives and assigns, from any and all claims, demands, damages, costs, expenses, loss of services, actions and causes of action, ; yak claims for bad faith damages, punitive damages, arising from any act or occurrence up to the present time and particularly on account of all personal injury, disability, property damage, loss or damages of any kind already sustained or that I may hereafter sustain, arising out of an accident that occurred on the 20th day of July, 2003 at the intersection of Sheep Bridge Road (S.R. 4021) and Stevens Road (T-837), Newberry Township, York County, Pennsylvania. It is expressly understood that I am accepting the above compensation not only to compensate me for any claims that I may assert in a civil action but any claims for restitution that have been or will be awarded in connection with the criminal case against Jenna Margaret Bubsy. I agree to notify the court officials of the Court of Common Pleas of York County that the restitution claim has been satisfied. I further agree, if necessary, to cooperate in the filing of any Petitions or Motions in the criminal proceeding to have the restitution awards satisfied. Notwithstanding the foregoing, the undersigned hereby reserve all claims against Allstate Insurance Company for any medical bills that have been incurred as a result of the automobile accident and which would be covered under the policy issued by Allstate to us, Policy Number 1554671097. Allstate reserves any and all policy defenses it may have to any claims for additional medical bills and restitution. To procure payment of the said sum, I hereby declare that I am more than 18 years of age; that no representations about the nature and extent of said injuries, disabilities or damages made by any physician, attorney or agent of any party hereby released, nor any representations regarding the nature and extent of legal liability or financial responsibility of any of the parties hereby released, have induced me to make this settlement; that in determining said sum there has been taken into consideration not only the ascertained injuries, disabilities and damages, but also the possibility that the injuries sustained may be permanent and progressive and recovery therefrom uncertain and indefinite, so that consequences not now anticipated may result from the said accident. Notwithstanding the foregoing, this Release does NOT apply to any Underinsured Motorist claims, first-party automobile insurance claims, and/or any potential claims against any person or party not identified in this Release. EXHIMT E .., I hereby agree that, as a further consideration and inducement for this compromise settlement, that it shall apply to all unknown and unanticipated injuries and damages resulting from said accident, casualty or event, as well as to those now disclosed. I understand that the parties released admit no liability of any sort by reason of said accident and that the said payments and settlements in compromise are made to terminate further controversy respecting all claims for damages that have heretofore asserted or that our personal representatives might hereafter assert because of said accident. Signed and sealed this day of January, 2005. CAUTION - READ BEFORE SIGNING Witnessed by STATE OF PENNSYLVANIA COUNTY OF (SEAL) LEELA SMITH, Individually and as parent to natural guardian of Jordan Nicholson SS On this day of January, 2005 before me personally appeared Leela Smith, individually and as parent to natural guardian of Jordan Nicholson known to be the person who executed the foregoing instrument, acknowledged that he executed the same as his free act and deed. NOTARY PUBLIC My Commission Expires: VERIFICATION I, LEELA SMITH, natural parent and guardian of JORDAN NICHOLSON, minor, hereby verify that the statements made in the foregoing pleading are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A., Section 4904 relating to unsworn falsification to authorities. LEELA SMITH, natural parent and guardian of JORDAN NICHOLSON, minor DATE: ! to f Zb0S WA . Cri JORDAN NICHOLSON, by and through his natural parent and guardian, LEELA SMITH, Petitioner IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 2005-305 CIVIL V. JENNA M. BUSBY, Respondent CIVIL ACTION - LAW MINOR'S COMPROMISE PROOF OF DEPOSIT AND NOW, comes the Petitioner, by and through his attorneys, HANDLER, HENNING and ROSENBERG, LLP by Matthew S. Crosby, Esq., and attaches the Proof of Deposit of the minor's settlement proceeds that were deposited for the minor on February 28, 2005 into the Fulton Bank, as evidenced by Fulton Bank's Certificate of Deposit Terms and Conditions - Summary, and pursuant to the January 27, 2005, Court Order signed by The Honorable Kevin A. Hess, Judge, both made a part hereof and marked, "Exhibit A." Respectfully submitted, HANDLER, N I IG & ROSENBERG, LLP BY: LMilThew S. Crosby, Esq. Atty. ID No. 69367 1300 Linglestown Rd. Harrisburg, PA 17108 717-238-2000 Attorneys for Petitioner DATE: jl 111 Zoos ?, i? Fulton Bank C1rnAE Division - L NusTEIIIGOESTER DIVism DROVERS BANK DWIMN - GREAT VALL" DIVISION CERTIFICATE OF DEPOSIT TERMS AND CONDITIONS - SUMMARY Certificate of Deposit Type: Renewed CD #: x Account No.: Principal Amount: Registered Holder Name(s) and Address: JORDAN NICHOLSON, COURT ORDERED LEELA SMITH, GUARDIAN NO WD TILL MAJ 517/15/2010 CASE NO 2005-305 2310 BERRYHILL STREET HARRISBURG, PA 17104 Maturity Date: Annual Percentage Yield: Interest Distributior Deposit to Account Savings Add to Principal Issue Check Frequency of Payment: Tax ID Number(s): o D 169-74-0192 LEELA 207-54-4107 ndividuaI s) Sole Proprietor Partnership Corporation Lodge/Similar Ong Method: Checking Bus. Trust Ltd. Liability Co. ^exSystems ? No Record `:;S Issuance AC Verification .,ornpleted ? % Ranked on OFAC Issue Date: Interest Rate: ? No Inquiries Previous States ui :)n Bank acknowledges receipt of the above-described deposit, subject to collection of any portion thereof de in other than cash, in accordance with the Rules and Regulations for Certificates of Deposit. Fulton Bank Authorized Signature Asma M. Malik ,?/n have received a copy of the Rules and Regulations For Certificates of Deposit and agree, on behalf of all i!jistered Holders, to the terms and conditions of the certificate of deposit. 12 ividuals a d Sole Proprietorships: 3ign?atur? rimary)' ? - `mature (secondary) Non-Individuals: Name Title Signature Name Title Signature ;nature (secondary) Name Title Signature I .rider penalties of perjury. I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, of (b) I have not been notified by the Internal Revenue Service that I am subject to backup withholding as a result of a 'ailure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup .,i1V. L.nI.J ?.... must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup w.nold.ing withholding becauseof underreporting interest or dividends on your tax return. because of underreporting nt tior dividend/ on your tax return. EXHIBIT A St c! a ure (PrlmaryAndividuay Title (if Non-Individual) Date n JAN 1 9 2005 JORDAN NICHOLSON, a minor IN THE COURT OF COMMON PLEAS OF by and through his natural parent CUMBERLAND COUNTY, PENNSYLVANIA and guardian, LEELA SMITH, Petitioner NO. 2005 - -?Q-5 CIVIL V. CIVIL ACTION - LAW JENNA M. BUSBY, Respondent MINOR'S COMPROMISE ORDER AND NOW, this.2?+h day of U 2005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursem nt of funds, including counsel fees and expenses, is approved as set forth in said Petition and the funds shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $12,994.31 to Matthew S. Crosby, Esq., representing reasonable attorneys' fees of $12,500.00 and $494.31 for reimbursement of costs; B. Direct the remaining $37,005.69 to be placed in an account investing in securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. BY THE C URT: - y S -t J. TRUE COPY r&;olyl RECORD in Testimony whereof, I here unto set my hand, e the sea of s id curt 4d Carlisle, Pa. T Jam rothonast ".id " JORDAN NICHOLSON, a minor : IN THE COURT OF COMMON PLEAS OF by and through his natural parent : CUMBERLAND COUNTY, PENNSYLVANIA and guardian, LEELA SMITH, Petitioner NO. 2005 - 305 CIVIL V. CIVIL ACTION - LAW JENNA M. BUSBY, Respondent MINOR'S COMPROMISE ORDER AND NOW, this day of 2005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursement of funds, including counsel fees and expenses, is approved as set forth in said Petition and the funds shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $3,853.77 to Matthew S. Crosby, Esq., representing reasonable attorneys' fees of $3,750.00 and $103.77 for reimbursement of costs; B. Direct the remaining $11,146.23 to be placed in an account investing in securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. BY THE COURT: J. F:\WP Directories\JFL\minors comp\matt\nicholson2.wpd Matthew S. Crosby, Esq. I.D.#69367 HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road Harrisburg, PA 17110 Telephone: (717) 238-2000 Fax: (717) 233-3029 E-mail: Crosby@hhrlaw.com JORDAN NICHOLSON, a minor by and through his natural parent and guardian, LEELA SMITH, - Petitioner V. JENNA M. BUSBY, Respondent Attorneys for Petitioner IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2005 - 305 CIVIL CIVIL ACTION - LAW MINOR'S COMPROMISE PETITION FOR LEAVE TO COMPROMISE MINOR'S ACTIONS Pursuantto Pennsylvania Rule of Civil Procedure No. 2039, Leela Smith, the natural parent and legal guardian of minor, Jordan Nicholson, by her attorneys, HANDLER, HENNING & ROSENBERG, LLP, by Matthew S. Crosby, Esq., petitions this Honorable Court to enter an Order permitting settlement and compromise of this action, and in support thereof, avers: 1. Jordan Nicholson was born on July 15, 1992, and is, therefore, 13 years old and a minor. He currently resides at 2310 Berryhill Street, Harrisburg, Dauphin County, PA 17104. 2. Petitioner, Leela Smith, is an adult individual and said minor's natural mother and legal guardian; she currently resides with Jordan at 2310 Berryhill Street, Harrisburg, Dauphin County, PA 17104. 3. Respondent, Jenna M. Busby, is an adult individual currently residing at 702 East Simpson Street, Mechanicsburg, Cumberland County, PA 17055. 4. At all times material hereto, the minor, Jordan Nicholson, was a passenger in a 1993 Chevrolet Cavalier owned and being operated by Michael L. Myers bearing Pennsylvania registration number FCX 5298 (hereinafter "minor's vehicle"). 5. At all times material hereto, Respondent, Jenna M. Busby, was the operator of a 1993 Mercury Sable, owned by Peter Busby, bearing Pennsylvania registration number EJT 7535 (hereinafter "Respondent's vehicle"). 6. On or about July 20, 2003, at approximately 05:30 a.m., minor's vehicle was traveling southbound on Steven Road in Newberry Township, York County, Pennsylvania. 7. On or about July 20, 2003, at approximately 05:30 a.m., Respondent's vehicle was traveling westbound on Sheep Bridge Road in Newberry Township, York County, Pennsylvania, approaching the intersection with Stevens Road. 8. At approximately the same time and place, Respondent, Jenna Busby, failed to stop at the properly posted Stop sign controlling westbound Sheep Bridge Road traffic and, as a result, Respondent's vehicle violently struck minor's vehicle in the intersection. 9. As a result of the crash, Respondent, Jenna M. Busby, was cited for, inter alia, Aggravated Assault While Driving Under the Influence of Alcohol, Reckless Driving, Reckless Endangerment, and Driving at an Unsafe Speed. 2 10. As a direct and proximate result of the negligence of the Respondent, the minor, Jordan Nicholson, suffered multiple injuries including, but not limited to, a laceration to his face beneath his left eyebrow and across his forehead requiring approximately 18 stitches, two black eyes, and frequent headaches. Said scarring is permanent and is in a prominent location on Jordan's face. (See pictures of Jordan's facial scarring taken on April 19, 2004, attached hereto, made a part hereof, and marked "Exhibit A.") 11. At the time of this collision, the minor, Jordan Nicholson, was insured under Petitioner's automobile insurance policy with Donegal Mutual Insurance Company. To date, all of said minor's collision-related medical bills have been paid by Donegal Mutual Insurance Company. 12. Also, at the time of this collision, Respondent's vehicle was insured under a policy of motor vehicle insurance issued by Allstate Insurance Company. 13. After protracted negotiations, Allstate Insurance Companysettled the minor's claim against Jenna M. Busby, for $50,000.00. (Although there was a $300,000.00 policy limit, the monies were divided among a total of six (6) claimants.) Attached hereto, made a part hereof, and marked, "Exhibit B," is a copy of this Honorable Court's Order approving said settlement on January 27, 2005. 14. Petitioner, Leela Smith, through her counsel, Matthew S. Crosby, Esq., has pursued additional settlement monies via Underinsured Motorist benefits available through Safe Auto Insurance Company, the insurer of the vehicle in which minor was an occupant. 4 15. After protracted negotiations, Safe Auto Insurance Company, has offered to settle Jordan Nicholson's Underinsured Motorist claim for $15,000.00, which represents its single-person Underinsured Motorist policy limit. 3 16. Petitioner believes said settlement is in the best interests of her minor son and proposes to accept said settlement offer of $15,000.00, thereby releasing Safe Auto Insurance Company from any and all claims, suits, and/or actions in the future. 17. Petitioner, Leela Smith, through her counsel, Matthew S. Crosby, Esq., intends to pursue additional settlement monies via an Underinsured Motorist claim with Donegal Mutual Insurance Company (the insurer of minor's mother, Leela Smith). 18. Matthew S. Crosby, Esquire, of HANDLER, HENNING & ROSENBERG, LLP, has been the attorneyforthe minor in this action and he requests reasonable counsel fees of $3,750.00 for services rendered plus costs and expenses of $103.77, pursuant to a Contingent Fee Agreement signed by Petitioner. The 25% represents a reduction from the 33-1/3% fee agreement signed by the Petitioner. Thus, the total amount requested for attorney's fees and costs is $3,853.77. See the Contingent Fee Agreement, attached hereto, made a part hereof, and marked "Exhibit C," as well as a true copy of the billing summary, attached hereto, made a part hereof, and marked "Exhibit D." Also attached hereto, made a part hereof, and marked "Exhibit E," is a copy of the proposed settlement release. 19. Petitioner requests this Honorable Court order a payment of said balance of $11,146.23 to be placed in an account investing only in securities guaranteed bythe United States government or a Federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until minor reaches the age of 18 or without the Order of a Court of Competent jurisdiction." 4 WHEREFORE, Petitioner requests this Honorable Court to: a. Approve the Compromise above-stated; b. Authorize the payment of fees above-stated from funds due the minor; and c. Directpayment of the netfunds due, in accordance with the Compromise above-stated. Date: 206 Respectfully submitted, HANDLER, HENNING & ROSENBERG, LLP By: a ew S. sby, Esq. ,-r ? ???,?? ? . _ ?° _} .?_ ? ? .., ,. Y .? y •? F 4 F F ? Y Ifr'r ?????+ ? L1?? JORDAN NICHOLSON, a minor : IN THE COURT OF COMMON PLEAS OF by and through his natural parent : CUMBERLAND COUNTY, PENNSYLVANIA and guardian, LEELA SMITH, Petitioner NO. 2005 - 3QS CIVIL V.. CIVIL ACTION - LAW JENNA M. BUSBY, Respondent MINOR'S COMPROMISE r? ORDER AND NOW, this /th day of Q1JU 2005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursem nt of funds, including counsel fees and expenses, is approved as set forth in said Petition and the funds shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $12,994.31 to Matthew S. Crosby, Esq., representing reasonable attorneys' fees of $12,500.00 and $494.31 for reimbursement of costs; B. Direct the remaining $37,005.69 to be placed in an account investing in securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. BY THE C URT: J. vt , lids.. 2.y+'13? ?^laYa i?%1.e.;kS.!1 Ill TdSt fil0^.ti lnrft r- ?,? _ „^,0 ?2, ,,,y IQAdd a. the searl ?of s-id "o.'.. a' ?<:rlisle, roihonot?ry EXHIBIT / ?I i ??` ?? Y? CONTINGENT FEE AGREEMENT I, LEELA SMITH, natural parent and guardian of Jordan Nicholson, a minor, do hereby retain HANDLER, HENNING & ROSENBERG, LLP., of Harrisburg, Pennsylvania, as my attorneys in this matter to represent me and to process, negotiate, arbitrate a settlement or to institute in my name, any legal proceedings or actions that, in theirjudgment are necessary, against AN AS-YET UNIDENTIFIED PARTY OR PARTIES as a result of injuries and damages my son sustained in an incident that occurred on July 20, 2003. I agree not to settle, negotiate or adjust the above claim or any proceedings based thereon without the written consent of my said attorneys. In consideration of the services so to be rendered by Handler, Henning & Rosenberg, LLP, I hereby covenant, promise and agree to pay them for their professional services rendered, THIRTY-THREE AND ONE-THIRD PERCENT (33 1/39/c) of whatever sum is recovered as a result of settlement without lawsuit; or FORTY PERCENT (40%) of whatever sum is recovered after lawsuit is filed or in the event of arbitration or mediation. I will reimburse Handler, Henning & Rosenberg, LLP. for any necessary expenses advanced on my behalf in pursuing my claim. Examples of typical expenses include Court filing fees, investigation, auto mileage, photocopies, court reporters, medical records, expert witness fees, etc. If no money is obtained, client will not owe a legal fee or expenses. I also agree to take possession of my medical files at the conclusion of this case. My failure to take possession of these files within 60 days after the conclusion of the case will authorize my lawyers to destroy said files. I agree that HANDLER, HENNING & ROSENBERG, LLP. may associate additional lawyers to assist with this case and I agree to the sharing of fees between lawyers. 1 understand the terms herein apply to other lawyers associated on this case. I understand that the association of other lawyers does not increase the amount of the attorney fees at the conclusion of the case. Counsel reserves the right to withdraw if they desire to do so, for any reason(s) they deem proper. I acknowledge that I have read, approved and understood the above Contingent Fee Agreement and I acknowledge having received a copy of the same. The terms set forth herein are accepted. IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of 2003. i -FOI (SEAL) LEELA SMITH, natural parent and guardian of JORDAN NICHOLSON ?? ???? ti andler , Client No: 208556 enningfi Matter: 00000 0senberg,LLP Attorney: MSC ATTORNEYS AT LAW My 1300 Linglestown Road, Harrisburg, PA 17110 Pre-Bill No: 15580 Bill Date: August 29, 2005 Jordan Nicholson c/o Leela Smith 2310 BerryHill Street Harrisburg, PA 17104 INVOICE PAYMENT DUE UPON RECEIPT Balance forward as of invoice dated March 2, 2005 $0.00 EXPENSES 08/31/2005 Fax Charges 37.50 FAX 0$/3112005 $37,50': 08/31/2005 Document Reproduction 51.40 IS I 08/31124195 08/31/2005 Postage Costs 5.55 POS 08/31121)95 $6,55: 08/31/2005 Postage Costs 8.97 POST 08/31/2005 $8.97 08/31/2005 Long Distance Telephone Charges 0.35 TELE 08/31/2iY05 $0.35 TOTAL EXPENSES $103.77 Total due this invoice $103.77 TOTAL BALANCE DUE $103.77 I E xl? ? ? t+ [E RELEASE AND TRUST AGREEMENT (UNDERINSURED) POLICYHOLDER: JESSICA L. MEYERS CLAIM NO.:102840-UIMBI-03 Received of Safe Auto Insurance Comnanv (hereinafter called the Company) the sum of Fifteen Thousand and 00/100 Dollars 515,000.00) in full settlement and final discharge of all claims under the underinsured motorist protection coverage of any policy of insurance which was issued to you, your spouse or any other resident of your household, or any other policy which may be applicable to this loss because of bodily injuries known and unknown and which have resulted or may in the future develop, sustained by Jordan Nicholson by reason of an accident or occurrence arising out of the ownership or operation of an underinsured motor vehicle which occurred on or about the 20"'day of July, 2003. For the consideration stated above, the undersigned agrees to hold in trust for the benef_n of the Company all rights of recovery which he/she shall have against any person or organization legally liable for such bodily injuries, to the extent such consideration exceeds the amount of damages recovered from the bodily injury liability insurance on said underinsured motor vehicle(s) and assigns to the Company the proceeds of any settlement with or judgment against such person(s) or crganizacions(s) to That extent. The Comuanv is herebv authorized to take a - actor: w-.'_o_ may be __e7__sa4_ either in law or in equity in zhe name the undersigned against any such person or organization, and the undersigned covenants and agrees to cooperate fully with the Company in the presentation of such claims and to furnish all papers and documents necessary in such proceedings and to attend court and testify if the Company deems such to be necessary. The undersigned further warrants that he/she has given no release, except as authorized in writing by the Company, to any person or organization legally liable for such bodily injuries, and that no such release will be given without the written consent of the company. This Agreement does not apply to any Underinsured Motorist claims with Donegal Insurance Co. and/or Atlantic States Insurance Co. ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE OR DEFRAUD ANY INSURER FILES AN APPLICATION OR CLAIM CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION SHALL,, UPON CONVICTION. BE SUBJECT TO IMPRISONMENT FOR UP TO SEVEN YEARS AND PAYMENT OF A FINE OF UP TO $15,000. IN WITNESS WHEREOF, !/we have hereunto set my/our hand(s) this day of 2005. SIGNED: Witness SIGNED: Name: parent or natural guardian or representative of Jordan Nicholson Address: Address: EXHBIT VERIFICATION I, LEELA SMITH, natural parent and guardian of JORDAN NICHOLSON, minor, hereby verify that the statements made in the foregoing pleading are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A., Section 4904 relating to unsworn falsification to authorities. L LASE SMITH, natural parent and guardian of JORDAN NICHOLSON, minor DATE: k\? ?1 I Zoe C) {-7 < -'Ti :? ._? -ri ti:t n? C`J -? it C7 `' JORDAN NICHOLSON, a minor by and through his natural parent and guardian, LEELA SMITH, Petitioner V. JENNA M. BUSBY, Respondent .:..:..::..: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2005 - 305 CIVIL CIVIL ACTION - LAW MINOR'S COMPROMISE ORDER AND NOW, this z8 ` day of Ok-?, 2005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursement of funds, including counsel fees and expenses, is approved as set forth in said Petition and the funds shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $3,853.77 to Matthew S. Crosby, Esq., representing reasonable attorneys' fees of $3,750.00 and $103.77 for reimbursement of costs; B. Direct the remaining $11,146.23 to be placed in an account investing in securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. 6e BY THE COURT: / JORDAN NICHOLSON, by and through his natural parent and guardian, LEELA SMITH, Petitioner V. JENNA M. BUSBY, Respondent IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 2005-305 CIVIL CIVIL ACTION - LAW MINOR'S COMPROMISE PROOF OF DEPOSIT AND NOW, comes the Petitioner, by and through her attorneys, HANDLER, HENNING and ROSENBERG, LLP by Matthew S. Crosby, Esq., and attaches the Proof of Deposit of the minor's settlement proceeds that were deposited for the minor on March 16, 2006, into the Fulton Bank, as evidenced by Fulton Bank's Certificate of Deposit Terms and Conditions - Summary, and pursuant to the November 28, 2005, Court Order signed by The Honorable Kevin A. Hess, Judge, both made a part hereof and marked, "Exhibit A." Respectfully submitted, HANDLE EN IN & ROSENBERG, LLP BY: Matthew S. Crosby, Esq. Atty. ID No. 69367 1300 Linglestown Rd. Harrisburg, PA 17108 717-238-2000 Attorneys for Petitioner DATE: lzmp ??;??? ? ndler, ¢nningEj tosenberg ATTORNEYS AT LAW Leslie B. Handler, Retired W. Scott Henning David H Rosenberg IPA, FL) Carolyn M. Anner (PA, NY, RNI Matthew S. Crosby IPA, NJ) Gregory M. Feather IPA, NJ) Stephen G. Held Jason C. Imler Robin 5trauser Fulton Bank Third and Locust Streets Harrisburg PA 17101 Dear Robin: February 7, 2006 HARRISBURG OFFICE 1300 Linglestown Road Harrisburg, PA 17110 717-238-2000 1-800-422-2224 717-233-3029 Ifax) LANCASTER OFFICE 140A E King Street Lancaster, PA 17602 717-431-4000 DIRECT MAIL TO: P.O. Box 60337 Harrisburg, PA 17106 www.HHRLaw,com LorieS@HHRLaw.com Enclosed you will find a completed Retail Account Agreement to open a new account in the name of: Jordan Nicholson Tax Identification # 169-74-0192 This deposit in the amount of $11,146.25 shall be placed in a College Savings Plan Account marked not to be withdrawn without a court order until Jordan reaches the age of 15. His date of birth is July 15,1992 which means these funds may not be released until July 15, 2010. Thank you for your immediate attention to this matter. Sincerely, ?lbtj . Lorie A. Snyder Assistant Administrator BANK CERTIFICATION:: Term of CD: 50 N1ornkvt C.I) Type of Account Opened C er c ct { e, ., F Interest Rate Zi .X10 Dt'-s; t Account# 61a?a?a U?r? 3 Withdrawal Restrictions A)c w.?11?fcJwl Su? ?o 15 y 1 10 Amount of Deposit O I I. Itl G • >Z 3 Court Order Received _ 'S I 1 G 1 C6 Account Opened By 15e_Y Cc. P. i 't ?clcif Date 31 «?C? n EXHIBIT A FultonBwA 000-0220253 Downtown Harrisburg CERTIFICATE OF DEPOSIT TERMS AND CONDITIONS - SUMMARY Certificate of. Deposit Type: ro M., to CO Renewed CD #: ;. Account No.: 012-0Z'afil SS Issue Date: 511C?a?- Maturity Date: 5l1612wo Principal Amount: JII 11, Ir-1(n, 13 Interest Rata: 4."100 Annual Percentage Yield: L7. So Registered Holder Name(s) and Address: Interest Distribution Method: JORDAN NICHOLSON COURT ORDERED Deposit to Account LEELA SMITH GUARDIAN Savings Checking NO WD TILL MAJ 7/15/2010 AAdd to Principal CASE NO 2005-305 CIVIL Issue Check 2310 BERRYHILL STREET HARRISBURG, PA 17104 Frequency of Payment: Tax ID Number(s): JORDAN 169-74-0192 LEELA 207-54 -4107 Individuals) Sole Proprietor Partnership Corporation Lodge/Similar Org. Bus. Trust Ltd. Liability Co. `,..] Combined Statement-Transaction Account Number I- ullon Bank acknowledges receipt of the above-described deposit, subject to collection of any portion thereof made in other than cash, in accordance with the Rules and Regulations for Certificates of Deposit. Fulton Bank k. . Aut? S?nalure ?E?=?CIa _ ?: ?C E 1 e ?Ne have received a copy of the Rules and Regulations For Certificates of Deposit and agree, on behalf of all Registered Holders, to the terms and conditions of the certificate of deposit. diyiduas and -ole Plnprietorships: Non-Individuals: ?.1 ]?j J ;?11f? r ?Or or,mary` Mme .,au sewn ary gna um .1,der penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, of (b) I have not been notified by the Internal Revenue Service that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding. ou must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because of ';nder. oporling interest or dividends on your tax return. Alt d O 1/ C[ _ f/1ndividual) / Mfg lure (Pr,miItlivitlual) Title tit Nm-Individual) Dale ect.ryl 0:312005 nuPbu,bn [Iflpcausnrv Pape t of3 w ?r I li NOV 1 3 flti5 I JORDAN NICHOLSON, a minor IN THE COURT OF COMMON PLEAS by and through his natural parent : CUMBERLAND COUNTY, PENNSYLVANIA and guardian, LEELA SMITH, Petitioner NO. 2005 - 305 CIVIL V. CIVIL ACTION - LAW JENNA M. BUSBY, Respondent MINOR'S COMPROMISE f6 ORDER AND NOW, this day of 2005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursement of funds, including counsel fees and expenses, is approved as set forth in said Petition and the funds shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $3,853.77 to Matthew S. Crosby, Esq., representing reasonable attorneys' fees of $3,750.00 and $103.77 for reimbursement of costs; B. Direct the remaining $11,146.23 to be placed in an account investing in securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. , ;y hand fn rx)lI, r 3. rn-A n 41 /.%l.L?.....f 7 jQ V J. } ?1 l ? ,n ?. .? T: ?;1 1 (. I S Y1 n.. 'L i F:\WP DirectoriesUMMinor's Comp\nicho1son3.wpd Matthew S. Crosby, Esq. I . D.#69367 HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road Harrisburg, PA 17110 Telephone: (717) 238-2000 Attorneys for Petitioner Fax: (717) 233-3029 E-mail: Crosby@hhrlaw.com JORDAN NICHOLSON, a minor : IN THE COURT OF COMMON PLEAS OF by and through his natural parent : CUMBERLAND COUNTY, PENNSYLVANIA and guardian, LEELA SMITH, Petitioner : NO. 2005 - 305 CIVIL V. JENNA M. BUSBY, Respondent CIVIL ACTION -LAW : MINOR'S COMPROMISE PETITION FOR LEAVE TO COMPROMISE MINOR'S ACTIONS Pursuant to Pennsylvania Rule of Civil Procedure No. 2039, Leela Smith, the natural parent and legal guardian of minor, Jordan Nicholson, by her attorneys, HANDLER, HENNING & ROSENBERG, LLP, by Matthew S. Crosby, Esq., petitions this Honorable Court to enter an Order permitting settlement and compromise of this action, and in support thereof, avers: 1. Jordan Nicholson was born on July 15, 1992, and is, therefore, 14 years old and a minor. He currently resides at 2310 Berryhill Street, Harrisburg, Dauphin County, PA 17104. 2. Petitioner, Leela Smith, is an adult individual and said minor's natural mother and legal guardian; she currently resides with Jordan at 2310 Berryhill Street, Harrisburg, Dauphin County, PA 17104. 3. Respondent, Jenna M. Busby, is an adult individual currently residing at 702 East Simpson Street, Mechanicsburg, Cumberland County, PA 17055. 4. At all times material hereto, the minor, Jordan Nicholson, was a passenger in a 1993 Chevrolet Cavalier owned and being operated by Michael L. Myers bearing Pennsylvania registration number FCX 5298 (hereinafter "minor's vehicle"). 5. At all times material hereto, Respondent, Jenna M. Busby, was the operator of a 1993 Mercury Sable, owned by Peter Busby, bearing Pennsylvania registration number EJT 7535 (hereinafter "Respondent's vehicle"). 6. On or about July 20, 2003, at approximately 5:30 a.m., minor's vehicle was traveling southbound on Stevens Road in Newberry Township, York County, Pennsylvania. 7. On or about July 20, 2003, at approximately 5:30 a.m., Respondent's vehicle was traveling westbound on Sheep Bridge Road in Newberry Township, York County, Pennsylvania, approaching the intersection with Stevens Road. 8. At approximately the same time and place, Respondent, Jenna Busby, failed to stop at the properly posted Stop sign controlling westbound Sheep Bridge Road traffic and, as a result, Respondent's vehicle violently struck minor's vehicle in the intersection. 9. As a result of the crash, Respondent, Jenna M. Busby, was cited for, inter alia, Aggravated Assault While Driving Under the Influence of Alcohol, Reckless Driving, Reckless Endangerment, and Driving at an Unsafe Speed. 10. As a direct and proximate result of the negligence of the Respondent, the minor, Jordan Nicholson, suffered multiple injuries including, but not limited to, a laceration to his face beneath his left eyebrow and across his forehead requiring approximately 18 2 stitches, two black eyes, and frequent headaches. Said scarring is permanent and is in a prominent location on Jordan's face. (See pictures of Jordan's facial scarring taken on April 19, 2004, attached hereto, made a part hereof, and marked "Exhibit A.") 11. At the time of this collision, the minor, Jordan Nicholson, was insured under Petitioner's automobile insurance policy with Donegal Mutual Insurance Company. To date, all of said minor's collision-related medical bills have been paid by Donegal Mutual Insurance Company. 12. Also, at the time of this collision, Respondent's vehicle was insured under a policy of motor vehicle insurance issued by Allstate Insurance Company. 13. After protracted negotiations, Allstate Insurance Company settled the minor's claim against its insured, Jenna M. Busby, for $50,000 (Although there was a $300,000 single-limit policy limit, the monies were divided among a total of six (6) claimants.) Attached hereto, made a part hereof, and marked, "Exhibit B," is a copy of this Honorable Court's Order approving said settlement on January 27, 2005. 14. After protracted negotiations, Safe Auto Insurance Company, the insurer of the vehicle in which minor was an occupant, settled the minor's Underinsured Motorist claim for $15,000 which represened its single-person Underinsured Motorist policy limit. Attached hereto, made a part hereof, and marked, "Exhibit C," is a copy of this Honorable Court's Order approving said settlement on November 28, 2005. 15. Petitioner, Leela Smith, through her counsel, Matthew S. Crosby, Esq., has pursued additional settlement monies via Underinsured Motorist benefits available through Donegal Mutual Insurance Company, the insurer of the minor's mother, Leela Smith, and the secondary UIM carrier in this matter. 3 16. After protracted negotiations, the parties have agreed to a preliminary, UIM settlement pending the outcome of Generette v. Donegal Mutual Insurance Co., 884 A.2d 266 (Pa. Super. 2005), currently on appeal before the Pennsylvania Supreme Court. In reviewing Generette, the Supreme Court will address the issue of what effect a stacking waiver has on inter-policy Underinsured Motorist policy limits. A copy of the proposed partial-settlement release is attached hereto, made a part thereof, and marked "Exhibit D." 17. Pursuant to the preliminary settlement agreement, Donegal Mutual, has offered $10,000, which represents its single-person Underinsured Motorist policy limit of $25,000, less the $15,000 previously tendered from the primary UIM carrier, Safe Auto Insurance Co. 18. The $10,000 UIM settlement with Donegal Mutual is not a complete and final settlement. If the outcome of the Generette case is favorable to the minor, Petitioner, Leela Smith, through her counsel, Matthew S. Crosby, Esq., will pursue additional settlement proceeds via Underinsured Motorist benefits available under the Donegal Mutual Insurance Co. policy in question. 19. Petitioner believes said settlement is in the best interests of her minor son and proposes to accept the preliminary settlement offer of $10,000, but does not release Donegal Mutual Insurance Company from additional Underinsured Motorist benefits to which minor may be entitled in the future. 4 20. Matthew S. Crosby, Esquire, of HANDLER, HENNING & ROSENBERG, LLP, has been the attorney for the minor in this action and he requests reasonable counsel fees of $2,500 for services rendered plus costs and expenses of $103.77, pursuant to a Contingent Fee Agreement signed by Petitioner. The 25% represents a reduction from the 33-1/3% fee agreement signed by the Petitioner. Thus, the total amount requested for attorney's fees and costs is $2,603.77. See the Contingent Fee Agreement, attached hereto, made a part hereof, and marked "Exhibit E," as well as a true copy of the billing summary, attached hereto, made a part hereof, and marked "Exhibit F." 21. Petitioner requests this Honorable Court order a payment of said balance of $7,396.23 to be placed in an account investing only in securities guaranteed by the United States government or a Federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until minor reaches the age of 18 or without the Order of a Court of Competent jurisdiction." WHEREFORE, Petitioner requests this Honorable Court to: a. Approve the Compromise above-stated; b. Authorize the payment of fees above-stated from funds due the minor; and 5 C. Direct payment of the net funds due, in accordance with the Compromise above-stated. Date: to i lu'nA Respectfully submi , HANDLER ENNING OS G, LLP By: Matthew S. Crosby, Esq. I.D. No. 69367 1300 Linglestown Road Harrisburg, PA 17110 (717) 238-2000 Attorneys for Petitioner Exhibit A j r. ?:.. ? F: ?'?=: ?„, j ?i •a!• ? ` ?. ! ,•?4?. ?.h l_I? #. „ ? .r"?: ?- ?. ;a ?? ? ?? _. _ ? ?? ?Y:?. ' ?. . ???'?? i` t Via; . t ;h?- 4 ni i ?? ?}, ) `,^ '' . T;l, ,? ` `? ?.i ??? ?? '+ 1?. 1'i t a. h'? F ?, J, 5?: ??.j }, e `?,? 4 ? I ? TX ,?, ? ., ta, , ??bZ Y i? 1, ? . R 1 y Exhlbii 5 JORDAN NICHOLSON, a minor by and through his natural parent and guardian, LEELA SMITH, Petitioner V., JENNA M. BUSBY, Respondent : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 2005 - 3Q5 CIVIL : CIVIL ACTION -LAW : MINOR'S COMPROMISE r? ORDER AND NOW, this (th day of U , 2005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursem nt of funds, including counsel fees and expenses, is approved as set forth in said Petition and the funds shat{ be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $12,994.31 to Matthew S. Crosby, Esq., representing reasonable attorneys' fees of $12,500.00 and $494.31 for reimbursement of costs; B. Direct the remaining $37,005.69 to be placed in an account investing in ,71 securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. BY THE C URT: J. TRUE y ')?y 2 r qo ?, In Testimor l?Jil f; s y rr; h d unto set t my a, the seal of ?id roar. a'- (:ar'lisle, a. T ..L. .: af?o1... d,I `??? ?-? t t JORDAN NICHOLSON, a minor by and through his natural parent and guardian, LEELA SMITH, Petitioner V. JENNA M. BUSBY, Respondent : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA NO. 2005 - 305 CIVIL CIVIL ACTION -LAW MINOR'S COMPROMISE OR R AND NOW, this n-01- day of 2005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursement of funds, including counsel fees and expenses, is approved as set forth in said Petition and the funds shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $3,853.77 to Matthew S. Crosby, Esq., representing reasonable attorneys' fees of $3,750.00 and $103.77 for reimbursement of costs; B. Direct the remaining $11,146.23 to be placed in an account investing in securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. BY THE OURT: J. M. r f,,, ?Yhi bi+b CONTINGENT FEE AGREEMENT 1, LEELA SMITH, natural parent and guardian of Jordan Nicholson, a minor, do hereby retain HANDLER, HENNING & ROSENBERG, LLP., of Harrisburg, Pennsylvania, as my attorneys in this matter to represent me and to process, negotiate, arbitrate a settlement or to institute in my name, any legal proceedings or actions that, in their judgment are necessary, against AN AS-YET UNIDENTIFIED PARTY OR PARTIES as a result of injuries and damages my son sustained in an incident that occurred on July 20, 2003. I agree not to settle, negotiate or adjust the above claim or any proceedings based thereon without the written consent of my said attorneys. In consideration of the services so to be rendered by Handler, Henning & Rosenberg, LLP, 1 hereby covenant, promise and agree to pay them for their professional services rendered, THIRTY-THREE AND ONE-THIRD PERCENT (33 1/3%) of whatever sum is recovered as a result of settlement without lawsuit; or FORTY PERCENT (40%) of whatever sum is recovered after lawsuit is filed or in the event of arbitration or mediation. I will reimburse Handler, Henning & Rosenberg, LLP. for any necessary expenses advanced on my behalf in pursuing my claim. Examples of typical expenses include Court filing fees, investigation, auto mileage, photocopies, court reporters, medical records, expert witness fees, etc. if no money is obtained, client will not owe a legal fee or expenses. 1 also agree to take possession of my medical files at the conclusion of this case. My failure to take possession of these files within 60 days after the conclusion of the case will authorize my lawyers to destroy said files. I agree that HANDLER, HENNING & ROSENBERG, LLP. may associate additional lawyers to assist with this case and I agree to the sharing of fees between lawyers. I understand the terms herein apply to other lawyers associated on this case. I understand that the association of other lawyers does not increase the amount of the attorney fees at the conclusion of the case. Counsel reserves the right to withdraw if they desire to do so, for any reason(s) they deem proper. I acknowledge that I have read, approved and understood the above Contingent Fee Agreement and I acknowledge having received a copy of the same. The terms set forth herein are accepted. WITNESS WHEREOF, I have hereunto set my hand and seal this „? L/ day of )2003. (SEAL) LEELA SMITH, natural parent and guardian of JORDAN NICHOLSON E)<hibit E Wier, ginning fi sanberg «P ATTORNEYS AT LAW 1300 Linglestown Road, Harrisburg, PA 17110 Jordan Nicholson c/o Leela Smith 2310 BerryHill Street Harrisburg, PA 17104 INVOICE Client No: 208556 Matter: 00000 Attorney: MSC My Pre-Bill No: 15580 Bill Date: August 29, 2005 PAYMENT DUE UPON RECEIPT Balance forward as of invoice dated March 2, 2005 $0.00 EXPENSES 08/31/2005 Fax 37.50 08/31/2005 Document Reproduction 51.40 08/31/2005 .. Postage Costs 5.55 08/31/2005 Postage Costs 8.97 7 08/3112005 Long Distance Telephone Charges 0.35 x ?,S} ",....m.....:.M..N. t.. -y 4H :. t ij h 1 ..............s :.4...f` ... ....._?.a.Y?. 009V TOTAL EXPENSES $103.77 Total due this invoice $103.77 TOTAL BALANCE DUE $103.77 VERIFICATION I, LEELA SMITH, natural parent and guardian of JORDAN NICHOLSON, a minor, hereby verify that the statements made in the foregoing pleading are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A., Section 4904 relating to unsworn falsification to authorities. LEE SMITH, natural parent and guardian of JORDAN NICHOLSON DATE: 0((G(06 t-,y4 :? aD OC71 9 200E?kr JORDAN NICHOLSON, a minor : IN THE COURT OF COMMON PLEAS OF by and through his natural parent : CUMBERLAND COUNTY, PENNSYLVANIA and guardian, LEELA SMITH, Petitioner NO. 2005 - 305 CIVIL V. CIVIL ACTION - LAW JENNA M. BUSBY, Respondent MINOR'S COMPROMISE ORDER AND NOW, this 7-0 ` day of Ocn%, - , 2006, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursement of funds, including counsel fees and expenses, is approved as set forth in said Petition and the funds shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $2,603.77 to Matthew S. Crosby, Esq., representing reasonable attorneys' fees of $2,500 and $103.77 for reimbursement of costs; B. Direct the remaining $7,396.23 to be placed in an account investing in securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. ADO ?D? BY THE COURT: I ,UIN r" 9 l : E! WIV 4Z 130 90QZ AuviONG11,1 OL40, MjHi 30 3"'IMIw 0-03113 Matthew S. Crosby, Esq. I . D.#69367 HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road Harrisburg, PA 17110 Telephone: (717) 238-2000 Fax: (717) 233-3029 E-mail: Crosby@hhrlaw.com Attorneys for Petitioner JORDAN NICHOLSON, a minor : IN THE COURT OF COMMON PLEAS OF by and through his natural parent : CUMBERLAND COUNTY, PENNSYLVANIA and guardian, LEELA SMITH, Petitioner : NO. 2005 - 305 CIVIL V. JENNA M. BUSBY, Respondent : CIVIL ACTION -LAW : MINOR'S COMPROMISE PROOF OF DEPOSIT AND NOW, comes the Petitioner, LEELA SMITH, natural parent and guardian of, JORDAN NICHOLSON, a minor, by and through her attorneys, HANDLER, HENNING & ROSENBERG, LLP, and avers that a restricted account was opened for the said minor, with regard to a $10,000 settlement with Donegal Mutual Insurance Co.,in a Federally insured Certificate of Deposit, in accordance with the October 20, 2006, Order of Court, signed by The Honorable Kevin A. Hess, Judge. Attached hereto, made a part hereof, and marked, "Exhibit A," is documentation evidencing the opening of the said restricted account for the said minor. DATE: 2? Z HAND , HENNI ERG, LLP 1066 B Matthew S. Crosby, Esq. Attorneys for Petitioner • undler, enning? osenberg ATTORNEYS AT LAW Leslie B. Handler, Retired W. Scott Henning David H Rosenberg (PA, FL) Carolyn M. Anner (PA, NY, RN) Matthew S. Crosby (PA, NJ) Gregory M. Feather (PA, NJ) Stephen G. Held Jason C.Imler Fulton 13ank Third and Locust Streets Harrisburg PA 17101 Qe?? Dearli&W": HARRISBURG OFFICE 1300 Unglestown Road Harrisburg, PA 17110 717-238-2000 1-800-422-2224 717-233-3029 (fax) LANCASTER OFFICE 140A E King Street Lancaster, PA 17602 717-431-4000 DIRECT MAIL TO: P.O. Box 60337 Harrisburg, PA 17106 www.HHRLaw.com LorieS@HHRLaw.com Enclosed you will find a completed Ketail Account Agreement to open a new account in the name of: Jordan Nicholson Tax Identification # 169-74-0192 This deposit in the amount of $7,396.23 shall be placed in a College Savings Plan Account marked not to be withdrawn without a court order until Jordan reaches the age of 18. His date of birth i5 July 15,1992 which 'means these funds may not be released until July 15, 2010. Thank you for your immediate attention to this matter. Sincerely, t ' i 't!(l ? Lorie A. Snyder Assistant Administrator BANK CERTIFICATION:: Term of CD: ?v Type of Account Opened Interest Rate Sp ?(o Account # GI2.- D2S-5'3q I Withdrawal Restrictions Nr, W? -riL MAY 71IS"/2clb Amount of Deposit ?1 3?1 Court Order Received I l 1 ?C7? November 17, 2006 Account Opened by Dp6 rucC.'- ?! M, "CA Date f ?TZ?U?r .V FultonBank eee=0255891 Cnrrm, DlvlsioN • L 1NGsuvlClleswx DIVISION D-,uts u.\Nx Dnl,I (lN • C-1 WO.1..I DIl'IxIDN Downtown Harrisburg CERTIFICATE OF DEPOSIT TERMS AND CONDITIONS - SUMMARY Certificate of Deposit Type: 3 `[e.clr Gd Renewed CD #: IpIH - Account No.: o) Z - GZ5 5139 ( Issue Date: it 17-yIZwG Maturity Date: tl ZZ ?2 t i i Principal Amount: ? 13Ci?, Z3 Interest Rate: Annual Percentage Yield: U .6Dr(G Registered Holder Name(s) and Address: Interest Distribution Method: JORDAN NICHOLSON, COURT ORDERED Deposit to Account No 'WD T/1- M 4 S :71IS )au i U Savings Checking a,W- #k apUS - Sc-' C:.:: I c 7F D r do r X Add to Principal Z 3io% Rw.; (J k, lj S6 rca Issue Check J Frequency of Payment: Av%e%Vc,115 riar.n 'SSS?t ?xk Tax ID Number(s): JORDAN # 169-74-019a LEELA # 207-54-4107 Individual(s) Sole Proprietor Partnership Corporation Lodge/Similar Org. Bus. Trust Ltd. Liability Co. .0 Combined Statement - Transaction Account Number O12 - ua'A 0'a 53 Fulton Bank acknowledges receipt of the above-described deposit, subject to collection of any portion thereof made in other than cash, in accordance with the Rules and Regulation for Certificates of Deposit. u n nk , ; Authorized Slgnalure Re III 6accct, :!We have received a copy of the Rules and Regulations For Certificates of Deposit and agree, on behalf of all Registered Holders, to the terms and conditions of the certificate of deposit. 4,,1duard,s and Propriatorships: Non-individuals: L-peed, 51n,Eh Prentpm F3rne I e signature T'r Title Signature la ure se n ry Name FUn r (secondary) Name Title i n ure .Irder penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or i am waiting for a number to be issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, of (b) I have not been notified by the Internal Revenue Service that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding. ou must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because of ,ndereportirg interest or dividends on your tax retum. n L?e•jCl S 1'?(rCl1>C?????h?uard:cl_/t=. i ure (Prima ndividual) Title (if bate :.drec1.rp1 0312005 Dial( lim: CIF(Deposxm Page 1 of 3 1 CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of the foregoing document was served on the Allan C. Molotsky, Esq., POST & SCHELL, Four Penn Center, 1600 John F. Kennedy Blvd. Philadelphia, PA 19103, counsel for Petitioner's insurance carrier, Donegal Mutual Insurance Co., with a courtesy copy served on The Honorable Kevin A. Hess, CUMBERLAND COUNTY COURTHOUSE, 1 Courthouse Square, Carlisle, PA 17013-3387, by United States Mail, regular service, in Harrisburg, Pennsylvania on NovemberV, 2006. HANDLE ING & ROSENBERG, LLP By Matthew S. Crosby, Esq. Attorney I.D. 69367 1300 Linglestown Rd. Harrisburg, PA 17110 (717) 238-2000 Attorneys for Petitioner DATE: ! ? Z7 (? 3' {11 .. W t??? RUP DirectorieMAGR\Minor's Comp\Nicholson, Jordan - pet to wdraw funds.wpd Matthew S. Crosby, Esq. I. D.#69367 HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road Harrisburg, PA 17110 Telephone: (717) 238-2000 Fax: (717) 233-3029 E-mail: Crosby@hhrlaw.com Attorneys for Petitioner JORDAN NICHOLSON, a minor by and through his natural parent and guardian, LEELA SMITH, Petitioner V. JENNA M. BUSBY, Respondent : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA NO. 2005-305 CIVIL CIVIL ACTION -LAW PETITION TO WITHDRAW FUNDS FROM MINOR'S RESTRICTED SETTLEMENT ACCOUNT AND NOW, comes Leela Smith, the natural parent and legal guardian of minor, Jordan Nicholson, by and through her attorneys, HANDLER, HENNING & ROSENBERG, LLP, by Matthew S. Crosby, Esq., and hereby petitions this Honorable Court to enter an Order permitting a withdraw of funds from the minor's restricted settlement account: 1. Jordan Nicholson was born on July 15, 1992, and is, therefore, 14 years old and a minor. He currently resides at 2310 Berryhill Street, Harrisburg, Dauphin County, PA 17104. 2. Petitioner, Leela Smith, is an adult individual and said minor's natural mother and legal guardian; she currently resides with Jordan at 2310 Berryhill Street, Harrisburg, Dauphin County, PA 17104. 3. On or about January 27, 2005, this Honorable Court granted the first of Petitioner's settlement requests, authorizing the minor to accept a gross settlement of $50,000.00, and placing the money in a restricted account with Fulton Bank. 4. On or about November 28, 2005, this Honorable Court granted the second of Petitioner's settlement requests, authorizing the minor to accept a gross settlement of $15,000.00, and placing the money in a restricted account with Fulton Bank. 5. On or about October 20, 2006, this Honorable Court granted the third of Petitioner's settlement requests, authorizing the minor to accept a gross settlement of $10,000.00, and placing the money in a restricted account with Fulton Bank. 6. As set forth in Petitioner's previous requests for approval of settlements, the minor, Jordan Nicholson, suffered injuries in an automobile accident, including a prominent scar on his forehead. 7. Recently, one of Jordan's treating physicians, Dr. Wolf, recommended a plastic surgery procedure to lessen the appearance of the scar on his forehead. 8. The minor, Jordan Nicholson, and his mother, both wish to proceed with the procedure proposed by Dr. Wolf. 9. However, the first-party automobile insurance medical coverage available to the minor, Jordan Nicholson, under his mother's auto insurance policy, only has $1,560.00 remaining in available coverage. 2 10. In addition, Jordan's health-insurance carrier, Capitol Blue Cross, has denied payment of these bills, on the basis that the medical treatment is cosmetic. 11. The costs of the procedure, for which the medical personnel require pre- payment, are as follows: a. Dr. Wolf: $2,525.00 b. Riverside Anesthesia: $495.00, and c. Susquehanna Valley Surgery Center: $1,373.60. 12. Consequently, the minor, Jordan Nicholson, does not have enough PIP medical coverage available to cover the up-front costs of the desired procedure. 13. Petitioner, Leela Smith, therefore, requests this Honorable Court allow the withdrawal of $3,000.00 from the minor, Jordan Nicholson's, settlement account with Fulton Bank to cover the excess costs of the scar-revision surgery. 14. This matter is of a somewhat urgent nature, as the minor's procedure is scheduled to take place December 19, 2006, and as previously stated, the medical personnel involved have required ere-payment. 15. Consequently, Petitioner respectfully requests this Honorable Court act with some urgency in granting the withdrawal of $3,000.00 from the minor's settlement account with Fulton Bank so that he may have the desired scar revision procedure. 3 WHEREFORE, Petitioner requests this Honorable Court approve a withdrawal of $3,000.00 from the minor, Jordan Nicholson's, settlement account with Fulton Bank, so that he may go through with a desired scar revision procedure. Respectfully submitted, HANDLER, HENNII04k-ROSENBERG, LLP Date: I 2(?Z-0 0? By. atthew S. Crosby, Esq. 4 VERIFICATION PURSUANT TO Pa. R.C.P. No. 1024(c) MATTHEW S. CROSBY, ESQ. states that he is the attorney for the party(ies) filing the foregoing document; that he makes this Complaint as an attorney and verifies that it is correct and accurate to the best of his knowledge, information and belief and that this statement is made subject to the penalties of 18 Pa. C.S.A., Section 4904 relating to unsworn falsification to authorities. MATTHEW S. CROSBY, ESQ. DATE: I 8 bb r-a Co rv C JORDAN NICHOLSON, a minor by and through his natural parent and guardian, LEELA SMITH, Petitioner V. JENNA M. BUSBY, Respondent : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA NO. 2005 - 305 CIVIL CIVIL ACTION - LAW ORDER AND NOW, this P day of 26,cw , 2006, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the Petitioner may withdraw $3,000.00 from the minor, Jordan Nicholson's, restricted settlement account with Fulton Bank, for the purpose of paying for his collision-related scar-revision surgery. ifs BY THE COURT: 90 :°i Wd S-- 330 9902 F:\WP Directories\AMC\Minor's comp\Nicholson, Jordan-UIM.wpd Matthew S. Crosby, Esq. I.D. No. 69367 HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road Harrisburg, PA 17110 Telephone: (717) 238-2000 Attorneys for Petitioner Fax: (717) 233-3029 E-mail: Crosby@hhrlaw.com IN THE MATTER OF JORDAN IN THE COURT OF COMMON PLEAS OF NICHOLSON, by and through his CUMBERLAND COUNTY, PENNSYLVANIA natural parent and legal guardian, LEELA SMITH, Petitioner : NO. 2005 - 305 CIVIL V. : CIVIL ACTION -LAW JENNA M. BUSBY, Respondent MINOR'S COMPROMISE PETITION FOR LEAVE TO COMPROMISE MINOR'S ACTIONS Pursuant to Pennsylvania Rule of Civil Procedure No. 2039, Leela Smith, the natural parent and legal guardian of minor, Jordan Nicholson, through her attorneys, HANDLER, HENNING & ROSENBERG, LLP, by Matthew S. Crosby, Esquire, petitions this Honorable Court to enter an Order permitting settlement and compromise of this action, and in support thereof, avers: 1. Jordan Nicholson was born on July 15, 1992, and is therefore, 16 years old and a minor. He currently resides at 2310 Berry Hill Street, Harrisburg, Dauphin County, PA 17104. 2. Petitioner, Leela Smith, is an adult individual and said minor's natural parent and legal guardian and she resides with her child at 2310 Berry Hill Street, Harrisburg, Dauphin County, PA 17104. 3. Respondent, Jenna M. Busby, is an adult individual currently residing at 702 East Simpson Street, Mechanicsburg, Cumberland County, PA 17055. 4. At all times material hereto, the minor, Jordan Nicholson, was a passenger in a 1993 Chevrolet Cavalier owned and operated by Michael L. Myers, bearing Pennsylvania registration number FCX 5298 (hereinafter "minor's vehicle"). 5. At all times material hereto, Respondent, Jenna M. Busby, was the operator of a 1993 Mercury Sable, owned by Peter Busby, bearing Pennsylvania registration number EJT 7535 (hereinafter "Respondent's vehicle"). 6. On or about July 20, 2003, at approximately 05:30 a.m., minor's vehicle was traveling southbound on Steven Road in Newberry Township, York County, Pennsylvania. 7. On or about July 20, 2003, at approximately 05:30 a.m., Respondent's vehicle was traveling westbound on Sheep Bridge Road in Newberry Township, York County, Pennsylvania, approaching the intersection with Stevens Road. 8. At approximately the same time and place, Respondent, Jenna Busby, failed to stop at the properly posted Stop sign controlling westbound Sheep Bridge Road traffic and, as a result, Respondent's vehicle violently struck minor's vehicle in the intersection. 9. As a result of the crash, Respondent, Jenna M. Busby, was cited for, inter alia, Aggravated Assault While Driving Under the Influence of Alcohol, Reckless Driving, Reckless Endangerment, and Driving at an Unsafe Speed. 2 10. As a direct and proximate result of the negligence of the Respondent, the minor, Jordan Nicholson, suffered multiple injuries including, but not limited to, a laceration to his face beneath his left eyebrow and across his forehead, requiring approximately 18 stitches; two black eyes; and frequent headaches. Said scarring is permanent and is in a prominent location on Jordan's face. 11. At the time of this collision, Respondent's vehicle was insured under a policy of motor vehicle insurance issued by Allstate Insurance Company. 12. Petitioner, Leela Smith, by and through her counsel, Matthew S. Crosby, Esq., settled her son's claim against Allstate Insurance Company and Jenna M. Busby, for $50,000.00. [Although there was a $300,000.00 policy limit, the monies were divided among a total of six claimants.] Attached hereto, made a part hereof, and marked, "Exhibit A," is a copy of this Honorable Court's Order approving said settlement on January 27, 2005. 13. At the time of the collision, the minor's vehicle was insured with Safe Auto Insurance Company, and carried a single-person Underinsured Motorist (UIM) policy limit of $15,000.00. 14. Petitioner, Leela Smith, by and through her counsel, Matthew S. Crosby, Esq., pursued additional settlement monies for her minor son with Safe Auto Insurance Company. Because he was an occupant in Petitioner's vehicle, the minor, Jordan Nicholson's, primary Underinsured Motorist (UIM) carrier was Safe Auto. 3 15. After protracted negotiations, Safe Auto agreed to tender its UIM policy limit of $15,000.00 per person to minor, Jordan Nicholson. Attached hereto, made a part hereof and marked "Exhibit B," is a copy of this Honorable Court's Order approving said settlement on November 28, 2005. 16. Petitioner, Leela Smith, by and through her counsel, Matthew S. Crosby, Esq., then pursued additional settlement monies for her son via UIM benefits available through Petitioner's automobile policy with Donegal Mutual Insurance Company, the secondary UIM carrier in this matter. 17. At the time of the collision, Petitioner's policy with Donegal Mutual carried a UIM per-person limit of $25,000.00. 18. In the course of settlement negotiations with Donegal Mutual, said carrier cited the case of Generette v. Donegal Mutual Ins. Co., 884 A.2d 266 (Pa.Super. 2005), for the proposition that it was entitled to a "set-off' in the amount of $15,000.00, the settlement proceeds with the primary UIM carrier, Safe Auto. 19. In fall, 2006, Petitioner and Donegal Mutual agreed to a preliminary settlement in the amount of $10,000.00 (representing its single-person UIM policy limit of $25,000.00, less the $15,000.00 previously tendered from the primary UIM carrier, Safe Auto), pending the ultimate outcome of the Generette case, which had been appealed to the Pennsylvania Supreme Court. Attached hereto, made a part hereof and marked "Exhibit C", is a copy of this Honorable Court's Order approving said preliminary settlement. 20. On October 23, 2008, in Generette v. Donegal Mutual Ins Co., 957 A2d 1180 (Pa. 2008), the Pennsylvania Supreme Court reversed the Superior Court's opinion, and held, inferalia, that Donegal's "other insurance" clause was not enforceable and conflicted 4 with the public policy behind the Motor Vehicle Financial Responsibility Law (MVFRL) to provide "express" rather than "gap" UIM coverage. 21. Shortly thereafter, after contact by Petitioner's counsel, Donegal Mutual offered to tender its remaining UIM per-person policy limit of $15,000.00. 22. Petitioner, Leela Smith, believes said settlement is in the best interests of her minor son, Jordan Nicholson, and she proposes to accept said settlement offer of $15,000.00 which represents the remaining policy limits. 23. Matthew S. Crosby, Esq., of HANDLER, HENNING & ROSENBERG, LLP, has been the attorney for the minor in this action and requests reasonable counsel fees of $3,750.00 for services rendered, plus costs and expenses of $27.36 pursuant to a Contingent Fee Agreement signed by Petitioner. The 25% fee represents a reduction from the 33-1/3% fee agreement signed by the Petitioner on behalf of her minor son. Thus, the total amount requested for attorney's fees and costs is $3,777.36. Attached hereto, made a part hereof, and marked "Exhibit D," is a true copy of the Contingent Fee Agreement and "Exhibit E," is a true copy of the billing summary. 24. Petitioner further requests this Honorable Court to order a payment of the balance, $11,222.64, to be placed into a restricted account in the name of the minor, Jordan Nicholson, marked not to be withdrawn until he reaches the age of 18 on July 15, 2010, totaling at least $11,222.64. 5 WHEREFORE, Petitioner requests this Honorable Court to: a. Approve the above-stated Compromise; b. Authorize the payment of fees above-stated from funds due the minor; C. Direct payment of the net funds due, in accordance with the above- stated Compromise. Respectfully submitted, Date: " 3 af? HANDLER, HENNING & ROSENBERG, LLP By: atthew S. Cros , Esq. Attorneys for Petitioner VERIFICATION I, LEELA SMITH, natural parent and guardian of JORDAN NICHOLSON, minor, hereby verify that the statements made in the foregoing pleading are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A., Section 4904 relating to unsworn falsification to authorities. LEE LA SMITH, natural parent and guardian of JORDAN NICHOLSON DATE: ALLSTATE LEGAL 9C022205?0 Kati i s zoov? JORDAN NICHOLSON, a minor by and through his natural parent and guardian, LEELA SMITH, Petitioner : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA NO. 2005 - . CIVIL V. . CIVIL ACTION -LAW JENNA M. BUSBY, Respondent MINOR'S COMPROMISE I_ ORDER AND NOW, this r fr1 day of U (ntof 005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursem funds, including counsel fees and expenses, is approved as set forth in said Petition and the funds shall be disbursed k in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $12,994.31 to Matthew S. Crosby, Esq., representing` reasonable attorneys' fees of $12,500.00 and $494.31 for reimbursement of costs; B. Direct the remaining $37,005.69 to be placed in an account investing in securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. BY THE C URT: TRUE COPY FROM RECORD In Testimony whereof, ( here unto set my laud; jtehe seal7of id Court Carlisle, Pa. / i nrnn r JORDAN NICHOLSON, a minor by and through his natural parent and guardian, LEELA SMITH, Petitioner V. JENNA M. BUSBY, Respondent : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA NO. 2005 - 305 CIVIL : CIVIL ACTION -LAW : MINOR'S COMPROMISE OR R AND NOW, this day of 2005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursement of funds, including counsel fees and expenses, is approved as set forth in said Petition and the funds shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $3,853.77 to Matthew S. Crosby, Esq., representing reasonable attorneys' fees of $3,750.00 and $103.77 for reimbursement of costs; B. Direct the remaining $11,146.23 to be placed in an account investing in securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. BY THE OURT: J. f f., JORDAN NICHOLSON, a minor by and through his natural parent and guardian, LEELA SMITH, Petitioner V. JENNA M. BUSBY, Respondent OCT 19 20Db nn : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA NO. 2005 - 305 CIVIL CIVIL ACTION -LAW •: MINOR'S COMPROMISE ORDER AND NOW, this day of , 2005, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursement of funds, including counsel fees and expenses, is approved as set forth in said Petition and-the funds shail be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of .$2,603.77 to Matthew S. Crosby, Esq., representing reasonable attomeys' fees of $2,500 and $103.77 for reimbursement of costs; B. Direct the remaining $7,386.23 to be placed in an account investing in securities guaranteed by the United States government or a federal governmental agency managed by responsible financial institutions, bearing the name of the minor, Jordan Nicholson, that is marked "Not to be withdrawn until the minor reaches the age of 18 or without the Order of a Court of competent jurisdiction." C. Proof of deposit is to be filed with the Court. BY THE OURT: S J. TRADE COPY In Testimony whucrif rm he seal of FROM RECORD A i-,?:xe unio set my hand lisle, Pa. r. lt^ f'?. 7y m.. '. t:. CONTINGENT FEE AGREEMENT I, LEELA SMITH, natural parent and guardian of Jordan Nicholson, a minor, do hereby retain HANDLER, HENNING & ROSENBERG, LLP., of Harrisburg, Pennsylvania, as my attorneys in this matter to represent me and to process, negotiate, arbitrate a settlement or to institute in my name, any legal proceedings or actions that, in their judgment are necessary, against AN AS-YET UNIDENTIFIED PARTY OR PARTIES as a result of injuries and damages my son sustained in an incident that occurred on July 20, 2003. I agree not to settle, negotiate or adjust the above claim or any proceedings based thereon without the written consent of my said attorneys. In consideration of the services so to be rendered by Handler, Henning & Rosenberg, LLP, I hereby covenant, promise and agree to pay them for their professional services rendered, THIRTY-THREE AND ONE-THIRD PERCENT (33 1/s%) of whatever sum is recovered as a result of settlement without lawsuit; or FORTY PERCENT (40%) of whatever sum is recovered after lawsuit is filed or in the event of arbitration or mediation. I will reimburse Handler, Henning & Rosenberg, LLP. for any necessary expenses advanced on my behalf in pursuing my claim. Examples of typical expenses include Court filing fees, investigation, auto mileage, photocopies, court reporters, medical records, expert witness fees, etc. If no money is obtained, client will not owe a legal fee or expenses. i also agree to take possession of my medical files at the conclusion of this case. My failure to take possession of these files within 60 days after the conclusion of the case will authorize my lawyers to destroy said files. I agree that HANDLER, HENNING & ROSENBERG, LLP. may associate additional lawyers to assist with this case and I agree to the sharing of fees between lawyers. understand the terms herein apply to other lawyers associated on this case. I understand that the association of other lawyers does not increase the amount of the attorney fees at the conclusion of the case. Counsel reserves the right to withdraw if they desire to do so, for any reason(s) they deem proper. I acknowledge that I have read, approved and understood the above Contingent Fee Agreement and I acknowledge having received a copy of the same. The terms set forth herein are accepted. IN WITNESS WHEREOF, I have hereunto set my hand and seal this, day of 2003. 90 (SEAL) L ELA S ITH, natural parent and guardian of JORDAN NICHOLSON andlar, anning& I osanbarg.u,n ATTORNEYS AT LAW 1300 Linglestown Road, Harrisburg, PA 17110 Jordan Nicholson c/o Leela Smith 2310 BerryHill Street Harrisburg, PA 17104 INVOICE PAYMENT DUE UPON RECEIPT Balance forward as of invoice dated November 28, 2006 EXPENSES Client No: 208556 Matter: 00000 Attorney: MSC MV Pre-Bill No: 28045 Bill Date: December 30, 2008 $0.00 12/08/2006 Parking Costs 0.25 i AMMINSM 1111 1 ling :,v 8 12/04/2008 Vendor PROTH OF CUMBERLAND CO; CASE EXPENSE 78.50 12/30/200 8 Vendor PROTH OF CUMBERLAND CO; CASE EXPENSE -78.50 . 12/31/2008 Fax Charges 5.00 F 12!31/2008 Document Reproduction 1.60 12131/2008 Mileage 18.69 12/31 /2008 /20 08 . Postage Costs 0.42 . IIy} 12/31/2008 Long Distance Telephone Charges 1.40 TOW TOTAL EXPENSES $27.36 Total due this invoice $27.36 TOTAL BALANCE DUE $27.36 Matthew S. Crosby, Esq. I.D. No. 69367 HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road Harrisburg, PA 17110 Telephone: (717) 238-2000 Attorneys for Petitioner Fax: (717) 233-3029 E-mail: Crosby@hhrlaw.com IN THE MATTER OF JORDAN IN THE COURT OF COMMON PLEAS OF NICHOLSON, by and through his CUMBERLAND COUNTY, PENNSYLVANIA natural parent and legal guardian, LEELA SMITH, Petitioner V. JENNA M. BUSBY, : NO. 2005 - 305 CIVIL : CIVIL ACTION -LAW Respondent : MINOR'S COMPROMISE CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of the foregoing document was served on the following: Allan C. Molotsky, Esq. POST & SCHELL Four Penn Center 1600 John F. Kennedy Blvd. Philadelphia, PA 19103 by United States Mail, regular service, in Harrisburg, Pennsylvania on VACQVIec, 30, 2009/ DATE: IZ 36 d HANDLER, NING & ROSENBERG, LLP M S. C sby, Esq. Attorneys for Petitioner + ..y ?' ? _, r-, _,..g °' 1 y _. QA N 0 It 2009?v z Matthew S. Crosby, Esq. I.D. No. 69367 HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road Harrisburg, PA 17110 Telephone: (717) 238-2000 Fax: (717) 233-3029 E-mail: Crosby hhrlaw.com IN THE MATTER OF JORDAN NICHOLSON, by and through his natural parent and legal guardian, LEELA SMITH, Petitioner V. JENNA M. BUSBY, Respondent : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, P15NNSYLVANIA NO. 2005 - 305 CIVIL CIVIL ACTION - LAW : MINOR'S COMPROMISE ORDER AND NOW, this 7* day of Qa,,,.-, 2009, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursement of funds, as well as counsel fees and expenses, are approved as set forth in said Petition and shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $3,777.36 to Matthew S. Crosby, representing reasonable attorney's fees of $3,750.00 and $27.36 for reimbursement of costs; B. Direct payment of the balance of $11,222.64, placed into a restricted account in the name of the minor, Jordan Nicholson, marked not to be withdrawn until the age of 18, on July 15, 2010; C. Proof of deposit is to be filed with the Court. BY TH COURT J. Attorneys for Petitioner RLE e Or, THE h. ,t ?r ?? 2009 AN -7 P,1 12: 4 L trey) a . 07, ?s r4l? /?1 • t,:2as?? 16. Matthew S. Crosby, Esq. I. D.#69367 HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road Harrisburg, PA 17110 Telephone: (717) 238-2000 Fax : (717) 233-3029 E-mail: Crosby@HHRLaw.com Attorneys for Petitioner IN THE MATTER OF JORDAN NICHOLSON, by and through his natural parent and guardian, LEELA SMITH, Petitioner V. JENNA M. BUSBY, Respondent : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 2005-305 CIVIL CIVIL ACTION - LAW MINOR'S COMPROMISE PROOF OF DEPOSIT AND NOW, comes the Petitioner, by and through his attorneys, HANDLER, HENNING and ROSENBERG, LLP by Matthew S. Crosby, Esq., and attaches the Proof of Deposit of the minor's settlement proceeds that were deposited for the minor on February 6, 2009, into the Fulton Bank, as evidenced by Fulton Bank Certification, and pursuant to the January 7, 2009, Court Order signed by The Honorable Kevin A. Hess, Judge, both made a part hereof and marked, "Exhibit A." Respectfully bmi , HANDLE ING & ROSEN _ C,LLP BY: DATE: 4 (Z-(0 7 Matthew S. Crosby, Esq. Attorneys for Petitioner ndier, enning& 1 osenber9,«P ATTORNEYS AT LAW Leslie B. Handler, Retired W. Scott Henning David H Rosenberg (PA, FL) Carolyn M. Anner (PA, NY, RN) Matthew S. Crosby (PA, NJ) Gregory M. Feather (PA, NJ) Stephen G. Held Jason C.Imler Laurie J. DeBarr Megan Ellis Fulton Bank -third and Locust Streets Harrisburg PA 17101 Dear Megan: MAIN OFFICE 1300 Linglestown Road Harrisburg, PA 171 10 Office: 717-238-2000 Fax: 717-233-3029 Toll Free: 1-800-422-2224 www.HHRLaw.com LorieS@HHRLaw.com February 4, 2009 Enclosed you will find a completed Retail Account Agreement to open a new account in the name of: Jordan Nicholson Tax Identification #169-74-0192 This deposit in the amount of $11,222,64 ehall be, placed in a College 5aving5 flan Account marked not to be withdrawn without a court order until Jordan reaches the age of 18. His date of birth i5 July 15,1992 which means these funds may not be released until July 15, 2010 . Thank you for your immediate attention to this matter. Sincerely, 11 )(j_ Lorie A. Snyder A55i5tant Administrator BANK CERTIFICATION:: Term of CD: 15 Type of Account Opened CZU4 Oceotlu;A ? Interest Rate,22•y7?L 17k .2507 PY Account # G1Q- 031 2Q3,;3" Withdrawal Reotriction" ? J I ?7f l5f /(? Amount of Deposit Ia , Court Order Received Account Opened B Date CQ log EXHIBIT A Lancaster Office 717-431-4000 * Carlisle Office 717-241-2244 * York Office 717-845-7800 * Hanover Office 717-630-8200 Fultat Mmk LISTENING. CERTIFICATE OF DEPOSIT TERMS AND CONDITIONS - SUMMARY Certificate of Deposit Type: Renewed CD #: I I Account No. Principal Amount: S Registgred Holder Name(s) and Address: Tax ID Number(s): Issue Date: Interest Rate: Individual(s) Sole Proprietor Partnership Corporation Maturity Date: % Annual Percentage Yield: Interest Distribution Method: Deposit to Account Savings Checking Add to Principal Issue Check Minimum Balance: .00 Frequency of Payment: o? Lodge/Similar Org. Bus. Trust Ltd. Liability Co. ? Combined Statement - Transaction Account Number The Issuing Bank (the "Bank") acknowledges receipt, as of the Issue Date set forth above, of the above-described deposit (subject to collection of any funds not paid in cash), in accordance with the above Summary, the accompanying Important Information About Your Certificate of Deposit (the "Important Information"), and (except for a Certificate of Deposit that is an Individual Retirement Account) the attached Rules, including the Arbitration Agreement. Issuing Bank: Fulton Bank Branch Name: Downtown Harrisburo Office By: Authorized Signature I/We have received a copy of the above Summary, the accompanying Important Information, and (except for a Certificate of Deposit that is an Individual Retirement Account) the attached Rules, including the Arbitration Agreement, and I/We agree, on behalf of all Registered Holders, to the terms and conditions thereof. Individuals & Sole roprietorshi/ps: ` Y s?] )_ Sign re (prima 6) Signature (secondary) Non-Individuals: Name / Title Name / Title Signature Signature Signature (secondary) Name / Title Signature Under penalties of perjury, I certify that: I . The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup witlilrolding because of underreporting interest or dividends on your tax return. ,Sirg a re (Primar,,y- ndividual) Title (if Non-Individual) Date FecoSumspt 0312008 Distribution: CIF/Depositor 1'a11e I of 2 ?AN 02, 1L Matthew S. Crosby, Esq. I.D. No. 69367 HANDLER, HENNING 8, ROSENBERG, LLP 1300 Linglestown Road Harrisburg, PA 17110 Telephone: (717) 238-2000 Attorneys for Petitioner Fax: (717) 233-3029 E-mail: CrosbV@hlirlaw.com IN THE MATTER OF JORDAN IN THE COURT OF COMMON PLEAS OF NICHOLSON, by and through his CUMBERLAND COUNTY, PENNSYLVANIA natural parent and legal guardian , LEELA SMITH, , Petitioner . ° NO. 2005 - 305 CIVIL V. : CIVIL ACTION - LAW JENNA M. BUSBY , Respondent ; MINOR'S COMPROMISE ORDER . '.,.. AND NOW, this day of 2009, upon i'. consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursement of funds, as well as counsel fees,,/- . and expenses, are approved as set forth in said Petition and shall be disbursed in accordance with the terms and conditions of the settlement agreement as follows: A. Direct payment of $3,777.36 to Matthew S. Crosby, representing reasonable attorney's fees of $3,750,00 and $27.36 for reimbursement of costs; Q. Direct payment of the balance of $ j 1,222.64, placed into a restricted account in the name of the minor, Jordan Nicholson, marked not to be withdrawn until the age of 18, on July 15, 20'10; C. Proof of deposit is to be filed with the Court. 3,. 9l Y ( fly. ?An;• .(1VaS! +?iVi?' tr. .i44 Z,OZfE71f e 4N? ?e1l J]t3b?W, a ?. BY THE COURT: J. C`> ? ?. ?i ? ? ?? cxz ? f --- ?: - ? _ ? ;.- ? _ ; ?r,-s ?. .. .. - ? :? ? x.