HomeMy WebLinkAbout05-0515
Ira H. Weinstock, Esquire
Pa.l.D. No. 01602
IRA H. WEINSTOCK, P.C.
800 North Second Street
Harrisburg, P A 17102
Phone: 717-238-1657
Fax: 717-238-6691
Attorney for Petitioner
INRE:
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNA.
ESTATE OF LARRY E.
JOHNSON
NO. oS- .i' I{ {l~..j J;....
PETITION TO APPROVE SETTLEMENT AND DISTRIBUTION
OF FUNDS IN THE WRONGFUL DEATH OF LARRY E. JOHNSON
TO THE HONORABLE, THE JUDGES OF SAID COURT:
The Petition of Margaret A. Johnson, Administratrix of the Estate of Larry E. Johnson,
deceased, by and through her attorneys, Ira H. Weinstock, P.C., respectfully requests:
I. Petitioner is Margaret A. Johnson who was appointed Administratrix of the Estate
of Larry E. Johnson, deceased, on May 5, 2004 by the Register of Wills in and for the County of
Cumberland. A copy of the Short Certificate granting Lette.Ts of Administration is attached
hereto as Exhibit "A".
2. The decedent died on June 26, 2003 as a result of injuries sustained from a motor
vehicle accident that occurred on June 26, 2003.
3. The decedent was 58 years old at the time of his death and had a date of birth of
May 23,1945 and a Social Security Number of241-78-8116. Decedent did not have a Will.
4. Decedent was married and had two children at lLhe time of his death.
5. Pursuant to Pa. R.C.P. 2206, Petitioner served a copy of this Petition on the
intestate heirs of decedent who are as follows:
David L. Johnson
Paul E. Johnson
Son 41670 Lawson Circle, Temecula, CA 92592
Son 315 South 3'd Avenue, Lebanon, PA 17042
6. The Department of Public Welfare does not have a claim or lien against the
Petition, the Estate or any wrongful death beneficiary.
7. At all times relevant hereto, the decedent was insured by Allstate Insurance
Company. The applicable policy limits for the policy covering the decedent, issued by Allstate
Insurance Company, is Five Hundred Thousand ($500,000.00) Dollars.
8. The Petitioner has negotiated a settlement directly with Allstate Insurance
Company and has agreed to settle, upon Court approval, all und,:rinsured motorist claims arising
out of this motor vehicle accident for the total sum of Five Hundred Thousand ($500,000.00)
Dollars, in exchange for a Release to be executed in favor of Allstate Insurance Company.
9. A copy of the proposed Release is attached hereto and marked as Exhibit "B".
10. Counsel is of the professional opinion that the proposed settlement is reasonable
given that it represents the full policy limits due under the aforestated policy of insurance.
11. Petitioner is of the opinion that the proposed settlement is reasonable. See
attached Verifications of Petitioner, Margaret A. Johnson, and intestate heirs.
12. In procuring said settlement with Allstate Insurance Company's undcrinsured
motorist liability coverage, Petitioner engaged Ira H. Weinstock, Esquire, and entered into a
contingency fee agree (see Exhibit "COO, attached hereto), and has agreed that:
2
(a) Ira H. Weinstock, Esquire, should be paid the sum of One Hundred Fifty
Thousand ($150,000.00) Dollars of the aforesaid settlement regarding the Estate of Larry E.
Johnson, which represents a reduced fee of the contingent fee of thirty-three and one-third (33
1/3%) percent of the payment of Five Hundred Thousand ($500,000.00) Dollars. If approved by
Your Honorable Court, the sum of Five Hundred Thousand ($500,000.00) Dollars shall be
apportioned and distributed as follows:
Ira H. Weinstock, P.C.
Margaret A. Johnson
TOTAL
$ 150,000.00
$ 350,000.00
$ 500,000.00
13. The reason for the requested allocation is as follows:
The pecuniary loss suffered by the Petitiom~r far exceed the policy limits
available.
14. Pursuant to the Wrongful Death Statute (42 Pa. C.S. S 8301), the beneficiary of
the Wrongful Death Claim, and the portion of her interest, is as follows:
Margaret A. Johnson $ 500,000..00
15. The pecuniary loss suffered by the beneficiary listed in Paragraph 13 is as
follows: Petitioner relied upon the decedent for maintenance, services and gifts and intended to
rely upon the decedent for same in her elder years. Decedent also provided the Petitioner with
companionship and comfort which she looked forward to in her elder years as well. The loss of
the decedent's maintenance, services, gift, companionship and comfort is immeasurable.
3
WHEREFORE, Petitioner requests that she be permitted to enter into the settlement
recited above, and that the Court enter an Order of Distribution as :follows:
Ira H. Weinstock, P.C.
$ 150,000.00
Margaret A. Johnson
$ 350,000.00
Respectfully Submitted
IRA H. WEINSTOCK, P.C.
800 North Second Street
Harrisburg, PA 17102
Phone: 717-238-1657
By:
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IRA H. WEINSTOCK
Attorney LD. No. 01602
4
VERIFICATION
I, Paul E. Johnson, hereby verifY that I am an intestate heir ofthe decedent in this action.
1 have received a copy of the Petition for Approval of Settlement and Distribution of Funds. I
have no objection to the proposed settlement or distribution.
/7,
/At/ I C. J:;~S-0'7-7
PAUL E. JOHNSON
DATED: c>/ ~ 3' ~.s---
VERIFICATION
I, David L Johnson, hereby verify that I am an intestate heir of the decedent in this
action. I have received a copy of the Petition for Approval of Settlement and Distribution of
Funds. I have no objection to the proposed settlement or distribution.
DATED: }- (q- 2oo~
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SHORT CERTIFICATE
I,
GLENDA FARNER STRASBAUGH
estate of JOHNSON LARRY E
Register for the Probate of Wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 5th day of May, Two Thousand and Four,
Letters of ADMINlSTRA TfON
in common form were granted by the Register of
said County, on the
, la te of HAMPDEN TOWNSHIP
(Last, First, Middle)
in said county, deceased, to JOHNSON MARGARET A
(Last, First, MicJdJeJ
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 5th day of May
Two Thousand and Four.
File No. 2004-00440
PA File No. 21-04-0440
Da te of Dea th 6/26/2003
S.S. # 241-78-8116
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
EXHIBIT
"A"
NOV. 4.2004' lO:2~"""ALLSTATE INS. H~g. Pa. 17112
l!?J ALLSTATE INSUAANCE COMPANY (hereinafter referred to H A1lslute)
o ALLStATe INDeMNITY COMPANY (hereinafter referred to.. Allstate)
o ALLSTATE NEW JERSEY INSURANCe COMPANY (hereinafter reffllTed to as Allstate)
RECEIPT AND RELEASE UNDER
o UNINSURED MOTORIST INSURANCe - Coverage SS
C!SI UNPERINSURED MOTORIST INSURANCE - Coverage SU
SUBROGAnON AGREEMENT
NO, '761
ClAIM. 1S5477041~27
1. In conslderallon of the payment of Five Hundred Thousand Dollare I'Y Allstate. the receipt of
whloh Is hereby acknowledged, the undersigned hereby for~er rele,ases and discharges
Allstate from any and allllab~ity and from any and all contrac\ual obligations whlllSoever under
the OllVeragl! designated above of Policy No. 008138320 issued to Lanv E. Johnson by
Allstate and arising out of 181 bodily Injuries, 0 properly d..mages sustained by Estate of Lany
E. Johnson due to an acoIdent on or about the MIll day of.!WJt,~.
2. The undersigned hereby asslgns. transfers and 5el3 over to Allstate any and all claims or
ceuses of adton fOr bodily Injury and/or properly damage which thll under5igned now has, or
may herelilt!er have, to recover against any person or persons as thll result of said BCCident
and loss abOve staled to the extent of the payment above made; i/le undersigned agl'ee$ lhet
Allstate may enforce the same In such manner as shall be neces!;ary.or appropriate for the
use ;md benllllil of A1\$tate, either In Its own name or In the name of the undersigned; that the
undersigned will furnish such papers, Information or evidence as shall be within the
undersigned's pllSSM$ion or control for the purpose of enforcing 9UCh claim, demand or
cause of action; that the undersigned wm do whatever else is necessary to seoure such righ18
of rect:rl/ery on behalf of Allstate and do nothing Il1ler loss to prejudice them; and
3. The undersigned covenants that no release or selllement of any such claim, demand or
cause of action ha$ been made.
IN WITNESS WHEREOF I have hereunto set my hand this
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Wl\nesses:
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C58O-a, SS-SU RocoIp\ & P.oIeaso-Subro Agreement Pllpe 1 Of 1
day of
(Seal)
rev.06/21l100
P. 2/2
EXHIBIT
liB II
POWER OF ATTORNEY AND CONTINGENT FEE AGREEMENT
KNOW ALL MEN BY THESE PRESENTS:
that I, Margaret A. Johnson, 3924 Brookridge Dr., Mechanicsbmg, PA 17050, do hereby make,
constitute and appoint IRA H. WEINSTOCK, P .C., of Harrisburg, Dauphin County, Pennsylvania, my
true, lawful, sole and exclusive attorneys, in law and in fact, to institute and maintain for me and in my
name, an action against ABF Trucking and to conduct said action and! award in as speedy manner as the
said attorneys reasonably can; AND in their sole judgment and discretion, to compromise and settle said
claim without suit; AND to conduct the prosecution of said action or suit so to be brought and to use all
effectual ways and means in my name therein, in as full and effectual a manner as I could do if personally
present; HEREBY ratifying and confirming whatsoever my said attorney, in the said claim, whether by
litigation or compromise touching the prosecution thereof, may do according to law in the premises.
It is understood that no costs or expenses shall be advanced by the said attorneys, and that I(we) shall be
responsible for advancing all costs including, but not limited to filing fees, sheriff's fees, medical record
reproduction fees and expert fees. I understand that said Attorneys shall be entitled to receive, based upon
and from the gross sum of such recovery secured 33 % thereof in th(: event that such recovery is obtained
with or without the institution of suit, but prior to trial, or compulsory or policy-mandated arbitration, and
40% thereof in the event that such recovery is received after comm.encement of trial, or compulsory or
policy -mandated arbitration; and further said attorneys shall be entitled to payout from the residue before
turning over the balance any witness fees, and any other expenses which may have been incurred incident
to the preparation for or conduct of litigation. In addition, it is expressly understood that if an appeal
results after a decision of the lower Court, the fee arrangement will be subject to further negotiation.
In consideration ofthe foregoing, said attorneys agree to act diligently and in the best interests of the said
claimant in the assertion, negotiation and, if necessary, litigation in hislher behalf of any claims which
may exist. I understand that if said attorneys are unwilling to act as my legal representative at any time
during the course ofthis matter, that they are hereby authorized to withdraw from this case upon ten (10)
days written notice.
Executed and delivered in duplicate this q~ day of I u.t , 2003, the undersigned hereby
acknowledging receipt of one copy hereof. ~
~ fa tt; I
c. (,L _- 'JJ-..tv\..)
Itness
'~~J{) ~ (Seal)
MA GARET .. JOHNSON
IRA H. WEINSTOCK, P.C.
By:
(Seal)
IRA H. WEINSTOCK
EXHIBIT
"CII
CERTIFICATE OF SERVICE
".1;-/1, / \
AND NOW, this :::L-- day of ~iLfLLLLL'-'J"52005, I, Ira H. Weinstock,
Esquire, attorney for Petitioner, Margaret A. Johnson, hereby c(:rtity that I served the within
PETITION FOR APPROVAL OF SETTLEMENT AND DISTRIBUTION OF FUNDS this
day by depositing the same in the United States mail, postage prepaid, in the post office at
Harrisburg, Pennsylvania, addressed to:
By First Class Mail:
David L. Johnson
41670 Lawson Circle
Temecula, CA 92592
Paul E. Johnson
315 South Third Avenue
Lebanon, PA 17042
By: t~~ ;-(. C~{\L rieL
IRA H. WEINSTOCK -
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IN RE: ESTATE OF
LARRY E. JOHNSON
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION -. LAW
NO. 05-515 CIVIL TERM
ORDER OF COURT
AND NOW, this 2nd day of February, 2005, upon consideration of the Petition To
Approve Settlement and Distribution of Funds in the Wrongful Death of Larry E.
Johnson, a hearing is scheduled for Monday, April 4, 2005, at 9:30 a.m., in Courtroom
No. I, Cumberland County Courthouse, Carlisle, Pennsylvania.
IT IS FURTHER ordered and directed that Petitioner shall give notice of the
above hearing to all intestate heirs and to the Pennsylvania Department of Revenue.
BY THE COURT,
.;r(H. Weinstock, Esq.
800 North Second Street
Harrisburg, PA 17102
Attorney for Petitioner
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Ira H. Weinstock, Esquire
Pa. J.D. No. 01602
IRA H. WEINSTOCK, P.c.
800 North Second Street
Harrisburg, PA 17102
Phone: 717-238-1657
Fax: 717-238-6691
Attorney for Petitioner
INRE:
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNA.
ESTATE OF LARRY E.
JOHNSON
NO. 0 s: ')15 {1;,.,J -c....
PETITION TO APPROVE SETTLEMENT AND DISTRIBUTION
OF FUNDS IN THE WRONGFUL DEATH OF LARRY E. JOHNSON
TO THE HONORABLE, THE JUDGES OF SAID COURT:
The Petition of Margaret A. Johnson, Administratrix of the Estate of Larry E. Johnson,
deceased, by and through her attorneys, Ira H. Weinstock, P.C., respectfully requests:
I. Petitioner is Margaret A. Johnson who was appointed Administratrix of the Estate
of Larry E. Johnson, deceased, on May 5, 2004 by the Register of Wills in and for the County of
Cumberland. A copy of the Short Certificate granting Letters of Administration is attached
hereto as Exhibit "A".
2. The decedent died on June 26, 2003 as a result of injuries sustained from a motor
vehicle accident that occurred on June 26, 2003.
3. The decedent was 58 years old at the time of his death and had a date of birth of
May 23,1945 and a Social Security Number of241-78-8116. Decedent did not have a Will.
4. Decedent was married and had two children at thf: time of his death.
5. Pursuant to Pa. R.C.P. 2206, Petitioner served: a copy of this Petition on the
intestate heirs of decedent who are as follows:
David L. Johnson
Paul E. Johnson
Son 41670 Lawson Cirde, Temecula, CA 92592
Son 315 South 3'd Avenue, Lebanon, P A 17042
6. The Department of Public Welfare does not have a claim or lien against the
Petition, the Estate or any wrongful death beneficiary.
7. At all times relevant hereto, the decedent was insured by Allstate Insurance
Company. The applicable policy limits for the policy covering the decedent, issued by Allstate
Insurance Company, is Five Hundred Thousand ($500,000.00) Dollars.
8. The Petitioner has negotiated a settlement directly with Allstate Insurance
Company and has agreed to settle, upon Court approval, all undt:rinsured motorist claims arising
out of this motor vehicle accident for the total sum of Five Hlmdred Thousand ($500,000.00)
Dollars, in exchange for a Release to be executed in favor of Allstate Insurance Company.
9. A copy of the proposed Release is attached hereto and marked as Exhibit "B".
I o. Counsel is of the professional opinion that the proposed settlement is reasonable
given that it represents the full policy limits due under the aforestated policy of insurance.
II. Petitioner is of the opinion that the proposed settlement is reasonable. See
attached Verifications of Petitioner, Margaret A. Johnson, and intestate heirs.
12. In procuring said settlement with Allstate Insurance Company's underinsured
motorist liability coverage, Petitioner engaged Ira H. Weinstock, Esquire, and entered into a
contingency fee agree (see Exhibit "C", attached hereto), and has agreed that:
2
(a) Ira H. Weinstock, Esquire, should be paid the sum of One Hundred Fifty
Thousand ($150,000.00) Dollars of the aforesaid settlement regarding the Estate of Larry E.
Johnson, which represents a reduced fee of the contingent fee of thirty-three and one-third (33
1/3%) percent of the payment of Five Hundred Thousand ($500,000.00) Dollars. If approved by
Your Honorable Court, the sum of Five Hundred Thousand ($500,000.00) Dollars shall be
apportioned and distributed as follows:
Ira H. Weinstock, P.C.
Margaret A. Johnson
TOTAL
$ 150,000.00
$ 350,000.00
$ 500,000.00
13. The reason for the requested allocation is as follows:
The pecuniary loss suffered by the Petitioner far exceed the policy limits
available.
14. Pursuant to the Wrongful Death Statute (42 Pa. C.S. S 8301), the beneficiary of
the Wrongful Death Claim, and the portion of her interest, is as follows:
Margaret A. Johnson $ 500,000.00
15. The pecuniary loss suffered by the beneficiary listed in Paragraph 13 is as
follows: Petitioner relied upon the decedent for maintenance, services and gifts and intended to
rely upon the decedent for same in her elder years. Decedent also provided the Petitioner with
companionship and comfort which she looked forward to in her <elder years as well. The loss of
the decedent's maintenance, services, gift, companionship and comfort is immeasurable.
3
WHEREFORE, Petitioner requests that she be permitted to enter into the settlement
recited above, and that the Court enter an Order of Distribution as follows:
Ira H. Weinstock, P.C.
$ 150,000.00
$ 350,000.00
Margaret A. Johnson
Respectfully Submitted
IRA H. WEINSTOCK, P.C.
800 North Second Street
Harrisburg, P A 171102
Phone: 717-238-1657
By:
~ 1 IX fl. el)(J i >~dc-y..{)__
IRA H. WEINSTOCK
Attorney J.D. No. 01602
4
VERIFICATION
I, Paul E. Johnson, hereby verify that I am an intestate heir of the decedent in this action.
I have received a copy of the Petition for Approval of Settlemllnt and Distribution of Funds. I
have no objection to the proposed settlement or distribution.
~/' c-. :J: ~ S"<77?
PAUL E. JOHNSON
DATED: ~//3'~~
VERIFICATION
I, David 1. Johnson, hereby verify that I am an intestate heir of the decedent in this
action. I have received a copy of the Petition for Approval of Settlement and Distribution of
Funds. I have no objection to the proposed settlement or distribution.
~
10 L. JOHNSON
--
DATED: J- f q- ;20DS--
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SHORT CERTIFICATE
I,
GLENDA FARNER STRASBAUGH
estate of JOHNSON LARRY E
Register for the PrQbate of wills and Granting
Letters of Administration in and for
CUMBERLAND County, do hereby certify that on
the 5th day of May, Two Thousand and Four,
Letters of ADMINISTRA TlON
in common form were ~Jranted by the Register of
said County, on the
, la te of HAMPDEN TOWNSHIP
(Last, First, Middle)
in said county, deceased, to JOHNSON MARGARET A
(Last, First, Middle)
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the
seal of said office at CARLISLE, PENNSYLVANIA, this 5th day of May
Two Thousand and Four.
File No. 2004-00440
FA File No. 21-04-0440
Date of Death 6/26/2003
S. S. # 241-78-8116
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
EXHIBIT
"A"
.,",_.,-.""",.~
NOV. 4,2004 10:29AM ALLSTATE INS, Hbg, Pa, 17112
181 ALLSTATE INSURANCE COMPANY (hereinafter referred to lI$lUlstate)
o AlLSTATE INDEMNIlY COMPANY (hereinllfl<< referred to lIS Allstate)
o ALLSTATE NEW JERSEY INSURANCE COMPANY (hereinafter referred to lIS Allstate)
RECEIPf AND RELEASE UNDEFt
o UNINSURED MOTORIST INSURANCE - COy.....g.. ss
181 UNDERlNSURED MOTORIST INSURANCE - Coverage SU
SUBROGAnON AGREEMENT
NO, '761
CLAIM' 155477041Nl27
1. In consideration of the payment of Five Hundred Thousand Dollars by Allstate. the receipt of
which Is hereby acknowledged, the undeflligned hereby forever r,eleases and discharges
Allstate from any and allliabili\y' and from any and all contnlelual obligations whatsoever under
the ooverage designated above of Policy No. 008138320 issuad IXI L8ITV E. Johnson by
Allstate and arising out of 181 bodily Injuries, 0 property damage'; sustained by Estate of L.arrv
E. Johnson due to en accldenl on or about the ~ day of~,~.
2. The undersigned hereby assigns, transfers and sets over to Allstate any and all claims or
ceuses of adlon for bodily Injury and/or property damage which the undersigned now has, or
may hereafter have, to recover against any parson or parsons a's the result of said accident
and Io!ls above stated to the extent of the payment above made; the undersigned agrees that
Allstate may enforce the same In such manner as shall be nece!lsary.or appropriate for the
use .and benlll'it of Allstate, either In Its own name or In the namEI of the undersigned; that the
undersigned will furnish such papers, Infonnallon or evidence al: shall be within the
undersigned's possession or conlrQI for the purpose of enforot"l;1 such claim, demand or
cause of acllon; that the undersigned wHI do whatever else is necessllry to seoure such rights
of recovery on behalf of Allstate and do nothing after loss to prejudice them; and
3. The llndersigned covenants that no release or sl!Jltlement of any such olalm. demand or
cause of acIIon hilS been made.
IN WITNESS WH~R~OF I have hereunto set my hand this
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Witnesses:
;,
C~. SS-SU Receipt & Reloaso-8ub<o Agreement Page 1 of 1
day of
(Seal)
rev.06I28100
P, 2/2
EXHIBIT
liB"
POWER OF ATTORNEY AND CONTINGENT FEE AGREEMENT
KNOW ALL MEN BY THESE PRESENTS:
that I, Margaret A. Johnson, 3924 Brookridge Dr., Mechanicsburg, PA 17050, do hereby make,
constitute and appoint IRA H. WEINSTOCK, P.C., of Harrisburg, Dauphin County, Pennsylvania, my
true, lawful, sole and exclusive attorneys, in law and in fact, to institute and maintain for me and in my
name, an action against ABF Trucking and to conduct said action and award in as speedy manner as the
said attorneys reasonably can; AND in their sole judgment and discretion, to compromise and settle said
claim without suit; AND to conduct the prosecution of said action or suit so to be brought and to use all
effectual ways and means in my name therein, in as full and effectual a manner as I could do if personally
present; HEREBY ratifying and confirming whatsoever my said attorney, in the said claim, whether by
litigation or compromise touching the prosecution thereof, may do according to law in the premises.
It is understood that no costs or expenses shall be advanced by the said attorneys, and that I(we) shall be
responsible for advancing all costs including, but not limited to filing fees, sheriffs fees, medical record
reproduction fees and expert fees. I understand that said Attorneys shall be entitled to receive, based upon
and from the gross sum of such recovery secured 33 % thereof in the event that such recovery is obtained
with or without the institution of suit, but prior to trial, or compulsory or policy-mandated arbitration, and
40 % thereof in the event that such recovery is received after commencement of trial, or compulsory or
policy-mandated arbitration; and further said attorneys shall be entitled to payout from the residue before
turning over the balance any witness fees, and any other expenses which may have been incurred incident
to the preparation for or conduct of litigation. In addition, it is expressly understood that if an appeal
results after a decision of the lower Court, the fee arrangement will be subject to further negotiation.
In consideration of the foregoing, said attorneys agree to act diligently and in the best interests of the said
claimant in the assertion, negotiation and, if necessary, litigation in hislher behalf of any claims which
may exist. I understand that if said attorneys are unwilling to act as my legal representative at any time
during the course of this matter, that they are hereby authorized to withdraw from this case upon ten (10)
days written notice.
Executed and delivered in duplicate this 1'1-1\. day of I" 0 _,2003, the undersigned hereby
acknowledging receipt of one copy hereof. ~
~At1;d'r, J
ltness
'~1ii{) ~ (Seal)
MA CARET . JOHNSON
IRA H. WEINSTOCK, P.C.
By:
(Seal)
IRA H. WEINSTOCK
EXHIBIT
lie"
CERTIFICATE OF SERVIC:~
AND NOW, this :::n-lh day of /-fcIUL<L"L~y2005, I, Ira H. Weinstock,
Esquire, attorney for Petitioner, Margaret A. Johnson, hereby certifY that I served the within
PETITION FOR APPROVAL OF SETTLEMENT AND DISTRIBUTION OF FUNDS this
day by depositing the same in the United States mail, postage prepaid, in the post office at
Harrisburg, Pennsylvania, addressed to:
By First Class Mail:
David L. Johnson
41670 Lawson Circle
Temecula, CA 92592
Paul E. Johnson
315 South Third Avenue
Lebanon, P A 17042
By: \:~Lc- H. (tltU: L,l rick
IRA H. WEINSTOCK -
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Ira H. Weinstock, Esquire
Pa. J.D. No. 01602
IRA H. WEINSTOCK, P.C.
800 North Second Street
Harrisburg, PA 17102
Phone: 717-238-1657
Fax: 717-238-6691
Attorney for Petitioner
INRE:
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNA.
ESTATE OF LARRY E.
JOHNSON
NO. 05 - 515 Civil Term
AFFIDAVIT OF SERVICE
Ira H. Weinstock, Esquire, being duly sworn according to law, deposes and says
that he mailed a true and correct copy of the Order of Court dated February 2, 2005 signed by the
Honorable J. Welsey Oler, Jr. upon the intestate heirs and the Pennsylvania Department of
Revenue on February 7, 2005, by depositing it in the United States mail, regular first class
delivery, addressed as follows:
~s.~argaretJohnson
3924 Brookridge Drive
Mechanicsburg, PA 17050
~r. David L. Johnson
41670 Lawson Circle
Temecula, CA 92595
Mr. Paul E. Johnson
315 South Third Avenue
Lebanon, PA 17042
Department of Revenue
Bureau ofIndividual Taxes
Inheritance Tax Division
Department 280601
Harrisburg, PA 17128-0601
Attention: J. Paul Dibert
I verify that the statements made in this Affidavit are true and correct. I
understand that false statements herein are made subject to the penalties of I 8 Pa.C.S. ~4904
relating to unsworn falsification to authorities.
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IRA H. WEINSTOCK
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Ira H. Weinstock, Esquire
fa. J.D. No. 01602
IRA H. WEINSTOCK, P.c.
800 North Second Street
Harrisburg, PA 17102
Phone: 717-238-1657
Fax: 717-238-6691
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JAN 2 B ZDD5
Attorne~ for Petitioner
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INRE:
IN THE COURT OF OMMON PLEAS
CUMBERLAND COU TY, PENNA.
ESTATE OF LARRY E.
JOHNSON
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NO. uj -/ ,50
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ORDER
AND NOW, this ~day Of~, 2005, upon considera ion of the foregoing
Petition to Approve Settlement and Distribution of Funds in the wrong I death of Larry E.
I. The settlement of the claim of Petitioner, Margaret A. Johns n, Administratrix of
Johnson, it is hereby ORDERED and DECREED as follows:
the Estate of Larry E. Johnson, for the sum of Five Hundred Thousand ($5 0,000.00) from the
underinsured motorist claim with Allstate Insurance Company is approved.
2. Margaret A. Johnson, as Administratrix of the Estate of
hereby authorized to effect such settlement from the underinsured motorist claim with Allstate
Insurance Company and accept the sum of Five Hundred Thousand ($500,0 0.00) Dollars as set
forth in the foregoing Petition in full payment and settlement of the afo esaid claim, which
amount shall be distributed as follows:
Ira H. Weinstock, P.C.
$ 150,00 .00
Margaret A. Johnson
$ 350,00 .00
4. The maximum amount of recovery IS Five Hundred Tho and ($500,000.00)
Dollars from the underinsured motorist benefits with Allstate Insurance Com any.
5. Margaret A. Johnson, as Administratrix of the Estate of ljarry E. Johnson, is
authorized to execute and deliver a good and sufficient release of the u4derinsured motorist
claim.
6. The payment of the underinsured motorist claim shall con~titute evidence and
complete satisfaction of all underinsured motorists claims and demands of hatsoever kind and
nature arising out of the motor vehicle accident that occurred on June 26, 20 3.
BY THE COURT:
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