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Home My WebLink About05-0786 Johnson, Duffie, Stewart & Weidner By: John R, Ninosky, Esquire LD, No, 78000 301 Market Street p, 0, Box 109 Lemoyne, Pennsylvania 17043-0109 (717) 761-4540 Attorneys for Defendants KAREN L. DWORCHAK. as parent and : IN THE COURT OF COMMON PLEAS OF natural guardian of TYLER R. DWORCHAK: CUMBERLAND COUNTY, PENNSYLVANIA and HALEY DWORCHAK, minors, 113 York Street Enola, PA 17025 : CIVIL ACTION - LAW Plaintiffs v, KAREN L. DWORCHAK 113 York Street Enola, PA 17025 Defendant TO THE PROTHONOTARY: : NO, DS - 'Iff, C i <-> ~ L <---y- EfZ.YYl : AMICABLE ACTION IN TRESPASS PRAECIPE PLEASE issue a Writ of Summons in the above-captioned matter, advising the Defendant the an action in trespass has been filed against her, DATE: ","/;0/0 <: 244668 JOHNSON, DUFFIE, STEWART & WEIDNER B'(/;i~ t AI'-w~ / Jo n R. Ninosky, Esq 'e 1.0,#:78000 301 Market Street Lemoyne, PA 17043-0109 e-mail: jjs@jdsw.com Commonwealth of Pennsylvania County of Cumberland WRIT OF SUMMONS KAREN L. DWORCHAK AS PARENT AND NATURAL GUARDIAN OF TYLER R. DWORCHAK AND HALEY DWORCHAK, MINORS 113 YORK STREET ENOLA, PA 17025 Plaintiff Court of Common Pleas Vs, No, 05-786 CIVIL TERM In CivilAction-Law KAREN L. DWORCHAK 113 YORK STREET ENOLA, PA 17025 Defendant To KAREN L. DWORCHAK You are hereby notified that KAREN L. DWORCHAK, AS PARENT AND NATURAL GUARDIAN OF TYLER R. DWORCHAK AND HALEY DWORCHAK, MINORS, the Plaintiff has / have commenced an action in Civil Action-Law against you which you are required to defend or a default judgment may be entered against you, (SEAL) CURTIS R. LONG Prothonotary Date FEBRUARY 11, 2005 ~y ~ n-,. t> P ,7J;MLLJ Deputy Attorney: Name: JOHN R. NINOSKY, ESQUIRE Address: JOHNSON, DUFFIE, STEWART & WEIDNER 301 MARKET STREET LEMOYNE, PA 17043-0109 Attorney for: Plaintiff t;:;)\-)-{4 .~ ~ 0 ....... U1 \r. ~ C>\ ~ f P:: ~ 1- .." -- - , (""c) ~ Johnson, Duffie, Stewart & Weidner By: John R. Ninosky, Esquire LD, No, 78000 301 Market Street p, 0, Box 109 Lemoyne, Pennsylvania 17043-0109 (717)761-4540 KAREN L. DWORCHAK, as parent and natural guardian of TYLER R. DWORCHAK : and HALEY DWORCHAK, minors, 113 York Street Enola, PA 17025 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW Plaintiffs v, NO, 05-786 Civil Tenn KAREN L. DWORCHAK 113 York Street Enola, PA 17025 Defendant : AMICABLE ACTION IN TRESPASS PETITION FOR APPROVAL OF MINORS' SETTLEMENT AGREEMENT AND NOW, comes Karen L. Dworchak, as parent and natural guardian of Tyler and Haley Dworchak, who files this Petition for Court Approval of Minors' Settlement Agreement, by respectfully stating the following: 1, Karen L. Dworchak is the parent and natural guardian of Tyler R. Dworchak and Haley D, Dworchak, who all reside at 113 York Street, Enola, Cumberland County, Pennsylvania, 17025, 2, Haley Dworchak was born on October 7, 1993 and is currently 12 years old, 3, Tyler Dworchak was born on March 19, 1992 and he is currently 12 years old, 4, On April 9, 2004, Karen L. Dworchak was operating a vehicle on Route 850 in Marysville, Perry County, Pennsylvania. when she lost control rounding a curve, thereby causing her vehicle to flip and hit a guardrail. 5, As a result of this automobile accident, Tyler Dworchak and Haley Dworchak suffered injuries, 6, Haley D, Dworchak was taken to the Holy Spirit Hospital where she was diagnosed with a laceration over her forehead which required suturing, She also suffered a laceration over her right knee which needed suturing, She further had lacerations over her ankle which required suturing, A copy of the Emergency Room Report is attached hereto as Exhibit "A", 7, Haley Dworchak has recovered well from her injuries and is not suffering any permanent injury, 8, Tyler R. Dworchak was taken to the Milton S, Hershey Medical Center after the accident. He suffered a lacerated tongue as well as loss of tooth #10, A copy of the Discharge Summary from the Milton S, Hershey Medical Center is attached hereto as Exhibit "8", 9, Tyler Dworchak also received treatment from Minium & Kearns Orthodontists, A copy of a report from Dr. Minium is attached hereto as Exhibit "C", 10, Tyler Dworchak is recovering well from the injuries as stated above, 11, Karen Dworchak has negotiated a settlement of her children's claims with the Erie Insurance Group, her automobile insurance carrier, 12, It has been agreed that Haley Dworchak will receive a payment of $10,000, which will be placed into a structure with a guaranteed yield of $14,830, A copy of the structure document is attached hereto as exhibit "D", 13, Payment of $26,000 will be paid into a structured settlement on behalf of Tyler Dworchak, The guaranteed yield would be $36,520, A copy of the structured settlement document is attached hereto as Exhibit "E", 14, There are no out-of-pocket medical expenses, 15, It is believed that the proposed settlement is in the best interest of the children, WHEREFORE, it is respectfully requested that this Honorable Court approve the settlement stated in this Petition, Respectfully submitted, JOHNSON, DUFFIE. STEWART & WEIDNER DATE: 244685 3/11~ BY~~~e I.D, #: 78000 301 Market Street Lemoyne, PA 17043-0109 e-mail: jjs@jdsw.com 01/26/2005 11:42 FAX 717 795 2315 ERIE HBG BRANCH ADM, DATE: 04/0912004 PCP: Blu8 Mountain family "..coIle8, CHIEF OOMPLAINT: Th. pal~nt _ brow;Jht In by aqu.d follOWing. molar vehicle .""Id.nl. complaining 0' ho.d Injury and ocrap.. and cu~ ovorth. kn.... end handa, HISTORY OF PRESENT I~LNESS: Th. pllllont" a 10 )9....,ld girl who w.. tha front 1,,1\ pu.ongorwlth tn. ..at~1t on, Tho car that h.r mothar..lIS driving whll.gOIn" .round the cuN., flipped over and w.nl onto . ,the aida, Tlw P4IIlent_ .blo to II"" ouf 0' thl ClIr wl1h lIle IIf1p of hI' mother at 1M ....n., Sh. walkld Iround lmora. She haa hlld . out .nd ble.dlng from the cut 0"" tII. r111111alde of the forehead.. w," .. brul.Jnll oVllrthe fac. 1I'0mthe al'bag, IIhe "'0 hoe complolnla 01 cvla OV8r the boo... or h.r hond.. end rlllht kn.. ond rtg/llonkle erea, She had aome ""p.ndo.. In tho mOUlh, which ono stili In pi 0"", According to Il1Om, .he Is up to dall on Immunl%atlona. ALLERGII:S: No known dru" allorgloa. MEDICATIONS: Sholl not on any moalCllUona, She waigh. 85 pouncU. PHYSICAL EXAMINATION: Villll Signs reviewed on nurse's nolAS T.mperlltUre 99.9 orally, pul..i0e, ...gul.r. Raaplratlon. 20 unl.bonld, Blood p"..ure1141S2, Pul.. Ole 98V. on room .Ir, CONS'TI'TUTIONAL: 10 ,..ar""d girl brought In by .quad with C"PIn" Immobilized on a b..kbosr(\, alert and Orlen~d, Vary calm, H~: There I. acme lac&ratlon about' 'It ...nllm.ter oVer th" rtghlnon,.,...... .bov" tile halrllna from which there waa bl841dlng and malting of lha hair. Tho.. w.. no torelQn body f.l1. no bony abnorm.llty. Sha ha. .ome sup.rl1clal abraalon. OVer tM forah_d ju.t below .nd .bov. th" hairline, e;NT: Earl: TYmpsnlc m.mbl1lna look. normal. Mouth/No..: Sho h.. .onto "ontu.lon .net .Oll tillue aw.llIlllI CMlr 1M uppor and low.r lips.. well .. on tn. noa. bUI thare I. no tencllm... t)V4Ir th. n...1 bones or tho facial bon.., No lend..rna.. over tho upper and lowo,jaw, Sha h..lhe oxpand.rs In tho mouth, both upparand 10"'.' 1-, Tn_I' no avldanea of any Injury to !tIa teath, NloCK: N.Ck II .uppl.. No tan<leme.. ovorth" C-oplne. 'Trach I. cantralln poalllon, CHEST: No tenderne.. over the rlb.,ltarnum. both rig'" .nd 'ett. No tendernes. OVer thll clavicles. GIIA8DOMEN: Soft, non-Ulna.., With aCIJVI bowol .ounda. No vl.lble bruising or eontuslon th..., EXTREMITIES: .upp.r .lctromltl... aha I. moving both ""lremltl.. In tho .houloo" elbow ono wmot ara., She has dwp .br..lon. ,>0 tho Mep lolnto on tha dOI'Hlupect of the rlghl hand as walt as a couple of abra.lon. over th" dorso! e.~ Of1hel"ft hand acrOlllh. MCP jolnl. She h.. abrQlon. ovar 111. PIP Joint of the 3" and 4th flng.r of the rlgh.t t\an<l but raange of motion of tho right hand, 11 ng&rs normal. Sensation II normal. Capillary raflllll normal. Bllat.ral...dlal pul68 equal, norm.l. I.alllowor .x~mlty. no InJurl.. not.d olhor lh.n .uperficlal obraolon over lhe I"g bUl on the rlllhlsld. ah.. h.. an Irregular laearollon with .bre,'on avo' the kn.. In the Infrlpat.nar I'ftgJon about 2: Vt centlmet..rs wfth aor1')lo In .ground diM In It but there I. no other do.p 'or.lon body fall, Rang. <>1 mollon In Ihe rlghl knoo normal, RIllhl ankl. sh. ha. 31leorotlona, ono 2 centlmetera. The other OM. I' 1.5 c.ntlmmer and the other one t. haff 0 eent\metor, all oyer tno anterolateral as~"t 01 the onkl8 Joint. No acrtlv8 bleeding, No fore/lln body noted, Rang. 0' motion In Ih' right anklo normal. Fadel pu...... normal. SACK Th. p8t'.nt wa. _turned over and ..mlned on the b'Ck and thin WN no tlJnam... over the- thor.ell; Iopl"e, IUmOar splnG. 1'10 bruising or CQnt~.ton Of _kIn InJurl.. noted O'Ier the back at all. Paga' of2 ~ ---... N : Dwo'Gh.k. Haley I;> ') M 48783~ ROO R1 .-/ OR,; PUSH ~ /liD ORIGINAL HOLY SPIRIT HOSPITA~ Camp Hili, PA 17011 ~ ~ {t? ~ -if EMERGENCY ROOM REPORT 141008 ~ ~ ,~ ~....,' U.L/.i::ts/.i::UUtl .Ll.: 4.i:: t'A.A "'.L"' .'\oJ1) Z31D }:;IU}:; llll\; llKANl;ll ll!J 009 NAME: Dwol'tlh'lk. Haloy 0 MRI/: 487839 'NEUROLOGICAL: She '0 _kG, ol.rt onel o,t.m.d, O...nlol neMlo lnloet 5on.ory ond motor funedon 'normal. R.n",.. .ymlMtrlc:al. 'C.ph.. x....y. x.,oy of tI1. right kn..,.nII tho right anl<lo wo,. oil _ by I'" Radlologlll" normal, Cheat x. roy normal, 8....ln OT nOl'tl'lol. Sho did havo Juot 0 foreign body l!l1lt __ on tho nrfaco ollno chelt. Thllt.. ;,ollho... bullho,. I. nothing In.ldo u~dom,"lh lho .kln. V>.BOAATORY DATA: Her labOl'ltory work .how.d a whllo count of 15,3. h.m"Vlobln and h..".tOCl'lI nonnol , a112.7 ond 35~5, DIffe_11l11 ohowlng 19% Iymphoeyteo, glue_159. MT 58. Her e"ol"'l~ I. .8. lIOdIum 140, p_lum 5,3, <lhlorltle 105. C0224, Hood CT 'old by tho f'todlologlot o. normal. Urln.. dip will be dono, CLINICAL. IMPRESSION: MVA rollov..r, front.....I p.....nger with tho .o1ltbolt On, with 111. lollowlng InJurl..: 1) CIoted h.lId Injury, No 10.. of con.c1ou.n..., 2) Abraolono and "'"ration. of scalp, right frontal """0, 31 Contuoloo upp..' an" lowar lip and no.., 4) ........."'Ion and llb_lon rlllhl kn.., 5) ~aceratlcms right ...klo. 6) Abraolon.. back of tho n....d ond flngo,. right ond loll hond .M contu.lon right log and laft leg. \q;~ ~+ COURSE IN THE EMERGENCY DEPARTMENT: Tho plltlanl1olUolly hod all hor wound. cle.nood WIth o"'rlla 'tOllne ,mI then the had an IV ..t'bll'hed, glvon An.., SOO mllllg...ms IntrIVGnoutly, She tolel'lltKtho cl.anlng an" the IV .e.... very woll. Al.o: The 18""",11"" over In.. forehe.d WM outured u.lng Inlerrupted 4.0 Prolon.. totally 4 tuture. put In. Leooratlon ove. tha rlllnt kMa 'II" d6brlaad, Irrlgatad and Ihon .uturod uOlng 5 InlarTllpled 4~ Prol.n. OUlu'.' totally 5 .ulu...' put In, 3) laceration. ovor tha ankl. were .uturad u.lng one 4.0 Prolen. for a h./I-centl"",tor la..ratlon and lhan lh....o Interrupted 4.0 Prolene .utu.... {or the 2 contlmoWT I,coretlon and th.n 2,5 eon1lm.l.r I....-atlonw.. .utunad wllh lour Interrupted <HI ProIon. .utur.., Sterll. d~lng. appllod an over, Th. pOllont ha' romalnlld alart and orIented and .tablo, Sho I. going to be dlooharged homo with he. mother'. friend who I. ot n.. bod,ld.. Her brolhar, wilD 'II" In Iho ...... .ccltlon\. '11M a baCk Hel pu..nga.. H. heo e C1aap 10oa...llon of th.. tongue.. IQII a. mld.faclal fractu,.. He wu ..01 over to Horahey Medlca' OVnte' for traum. evaJu8tJon and car$. Signed PUSHPA R MUDAN, MD 04113/2004 06:26 PUSHPA R MUDAN, MD ~M/ct DOC #: 444252 D: 04/10/2004 T: 04/12/2004 6:04 P 000661259 ce: THE BLUE MOUNTAIN FP P 820 HOI. Y SP FlIT HOSPITAl. Camp Hili. PA 17011 EMERGENCY ROOM REPORT AMES: oworeh.., Holoy D ~: o467e39 OM: ER1 DR.: R . D ORIGINAL ff II ~ ~ t:::)~ .if' ~ ~ "is' VJ..I.i::O! ~VUI:> 11: 44 lOA..:\. /1.1 HJI:> ~Jltl "1<1" t1t\1,; I:H<AN~II l{iJ U~U PENNSTATE m Milton s. Hershey Medical omer . CoUege ofMedidne Patient Nam.: DWORCHAK, TYLER R PSUHMCMRN: 0367280 o scharge Summary Document , Final prSCBlIJ\GE S1JMMlIJty 1?A'rJ:EMT NAME. llWORCHAK, TYLER R PA'rI:JDl'r mnmml: 0367280 LO~J:Ollh 5240 SEX; M DATE OF ADMISSION, March 10. 2004 CONSULTING PHYSICIAN, Donald R. Mackay, M.P., Plastic Surgeon. PATE ADMITTED. 04/10/2004 PATH PJ:SCftARGED. 04/11/2004 PA'rS OF BIRTH. 03/19/1992 PRIMARY PHYSICIAN: Bruce S, Cohick, ~.D., 2151 LinglestowcL Road, Suite #100, Harrisburg, PA 17110 ADMITTING DIAGNOSIS: Status post motor vehicle acciden~, closed head injury, tongue laceration, and maxillary fracture. PROCEDURES PERFORMED, Closure of tongue laceration, In~ernal tixation of maxillary fracture, H'OS'I'PITAL accident.. maxillary COURSE; at which alveolar This is a 12-year-old male who was ~nvolved in a motor vehicle time he sus~ained a closed head injury, tongue laceration, as well ridge fraeturG. w:i.th some loose and rn1ssi:ng t.eeth. as a He was brought to Hershey Medical Center and underwent seandard T"auma Life Support Protocol. At that time, he was found to have the aforementioned ~njuries. he underwent debridement and suture of his tongue laceration by Pla8tic Surgery, The patient was subsequently admitted to the hospital. placed on t:he pediatric surgery service and observed. The patient was taken to the operating room by plastic surgery th" next day for fixation of his maxilla, He tolerated this well, He was maint~ined on IV c.indamycin postoperatively. He diet was advanced to soft diet, which he is tolerating well, The pain was well controlled. He is stable for discharge. vital signs were afebrile and he will go home today, PISCahRGE MEDICATIONS: He will be discharged with prescription for Tylenol No,3 Elixir to ta~e lS cc ev~ry 4-6 nours as.needea for pain. He is okay eo use over-the-counter Motrin for pain and was sl?ecificaUy inst;ructed not to Tylenol while taking Tylenol No, 3, He is to take clindamycin 7S mg/5 mL at 15 cc 3 times a day for the next 7 days, DISCHARGE I~STRUCTIONS; He is to be maintained on di~t to be soft and pureed, He is to have standard closed head injury precaution. Incision to be kept clean, ary, ana intact. He will follow up wi,t;h plastiC surgery as instructed, He is to call tor appointment, 403875 Data Primed.' 7/1612004 Tillie prllill).//; hJ2 FM ~ ~ ~ f:? ~ ~ ~ ~ '" ~ "it' DICTATING MD, 01/26/2005 11:43 FAX 717 795 2315 ERIE HBG BRANCH l4!012 .--- Minium and .J<iarns Orthodontist6 \ Specialists in Orthodontics and DenwfClcial Orthopedics 1412 Bridge Street New Cumberland' PA 17070 (717) 774.1200 4509 Union Deposit Road Harrisburg' PA 17111 ~ (717) 558.9808 ~ Mc......."AmeriCDn Auodation gf OnhodontiJt; Mark M, Minium, D,D,S, Diplomate America.n Board of Orthodontics Mark), Kearns. D,D,S,. M,S Lawrence E. DiPietro, D,D,S. J1ll1e 17, 2004 Lori Renaldi- Wagar Erie Insurance Group P,O. Box 2013 Mechanicsburg, Pa 17055-9917 Re; Tyler Dworchak Olaim #010170743116 Dear Lori, As you are aware, Tyler was involved in a motor vehicle accident on April 9, 2004 Which caused trauma to his teeth and face. This trauma resulted In tooth loss of # 1 0 and tooth movement of the anterior teeth, On May 12, 2004, impressions were taken and on May 30, 2004 upper and lower retainers were placed to help realign and stabilize the anterior teeth. A temporary replacement tooth was also added to Tyler's upper retainer for missing #10. At this time, Tyler will be monitored for possible nerve damage to his anterior teeth, which could result in the need of endodontic therapy, Until 6-12 months goes by, it is difficult to ascertain ifany permanent damage has occurred to the adjacent teeth, Obviously, a more permanent replacement for the #10 will need to be done in Tyler's future (implant/crown or bridge). Until these teeth have been monitored for 6-12 months, I would have to say their prognosis is guarded regarding future possible endodontic needs. Sincerely, -#t/~:-nt~ . "t),J.J Mark ~, Minium, DDS MMM/gjj Enclosures: Records as per requested, ~ :::5 ~ ~ ~ ~~ -$ ~ -<' ~ 'S ----9~(Ort~. I, iVV? li:?!r1Vi7 728KIN~LtK ~~~lJlJ~lt~ H ASSOCIATES 00 0, BENEFIT RDlGLE~ ASsoClAlES .1t1hn K'. CImert1fI !asml'!J'Of1@lin"lerusocIBteS.com (717) n8-1500 (BOO) Sl~ (717) 728-1502 (FAX) January 27, 2005 Individually Designed Setf:lement Haley Dworchek 0/0/8 1017/93 COST Guaranteed Lump Sums Tax..free payments: $ 2,000 on '10107111 (age 18) $ 4,000 on 10/07/14 (age 21) $ 8,830 on 10107118 (age 25) 1,594 2,875 5,531 $10,000 4902 CAR!lSLE I'IKE;, PMB 395, MECt-fANOS!lURGi, I'A 17050-3079 www.rlnglerm~.c.om ~ .PIlTSBUIVV, / ~ L / ., LI j GUARANTEED YIELD 2,000 4,000 8,830 $14,830 OZlOrtb. I, LUU~ IL:~UWI7 72'K1IV~LtK M~~UvlMICv 1< "~'''''l^H''O 00 '0 RINGLIR ASSOaAl'S JDbn Iv. CII/mN'IIII prneronerlnal@r~ssodates.com (717) 728-1500 (800) 515-5033 (717) 728-1502 (FAX) Jan\lll1)' 27, 2005 Individually Designed Settlement Tyler Dwordlak 0/0/8 3119/92 BENEFIT COST Guaranteed Lump Sums Tax.free payments: $ 5,000 on 03/19110 (age 18) $ 10,000 on 03l1Sf13 (age 21) $ 21,5?-O on 03/19/17 (age 25) 4,202 7,581 14,217 $26,000 49(12 CAAUSL.E l'IKE, ?MB 395, MKHANc:ISllURG, PA 17050-3079 lNW1/II.ring/Arml<!llm.CXlI1\ -r r"'J..L~.L.,ll..'I~V, I"1L I I. J/.J GUARANTEED YIELD 5,000 10,000 2.1,520 $36,520 VERI FICA TION I, KAREN L. DWORCHAK. have read the foregoing Petition for Approval of Minors' Settlement Agreement and hereby affirm that it is true and correct to the best of my personal knowledge. or information and belief, This Verification and statement is made subject to the penalties of 18 Pa, C,S, ~4904 relating to unsworn falsification to authorities; I verify that all the statements made in the foregoing are true and correct and that false statements may subject me to the penalties of 18 Pa, C,S, ~4804, k~~ brU Karen L. Dworc k DATE: 244693 (') ,.., ('C? ("J (~~ <'~:.;) --n o.;..,'t ::::t: :1! :0" ...,., :;{} PI F;:' I -0 ('"n '() (11 r'" (~ C~) -'0 ~-\~ ~2" t -'''' (~") ;, i-n , <.,.) " .~ '~,:>O- \"'-.) '" ,< - KAREN L. DWORCHAK, as parent and : IN THE COURT OF COMMON PLEAS F natural guardian ofTYLER R. DWORCHAK: CUMBERLAND COUNTY. PENNSYLV NIA and HALEY DWORCHAK. minors, 113 York Street Enola, PA 17025 : CIVIL ACTION - LAW Plaintiffs v, NO, 05-786 Civil Term KAREN L. DWORCHAK 113 York Street Enola, PA 17025 Defendant : AMICABLE ACTION IN TRESPASS ORDER AND NOW, this )., Jt.., day of March, 2005, Anthony T, Lucido, Esquire. oft e law firm Martson Deardorff Williams and Otto, is hereby appointed Guardian Ad Litem for Ie minors Tyler R. Dworchak, and Haley Dworchak in the above captioned proceeding, Edward E. Guido, J, .~ \~.~~~ If\r;-00 o_/d-' C I :I\!/;'->".' I\U'" {',.' <"in:) "7, :01 :,1\:1 0' J ,," 82 ~vt'l saUl Ab\I:L(},<J(,i.~l)dd 3Hl ;dO :18):':~[O-{J:nlj KAREN L. DWORCHAK, as parent and natural guardian of TYLER R. DWORCHAK : and HALEY DWORCHAK, minors, 113 York Street Enola, PA 17025 IN THE COURT OF COMMON PLEA OF CUMBERLAND COUNTY, PENNSYL ANIA CIVIL ACTION - LAW Plaintiffs v, NO, 05-786 Civil Term KAREN L, DWORCHAK 113 York Street Enola, PA 17025 Defendant : AMICABLE ACTION IN TRESPASS ~ ORDER AND NOW, this ~ day of March, 2005, upon considerationof.thePetiti n to Approve the Minors' Settlement Agreement, it is hereby ordered that a hearing is sch duled for Thursday, April 14, 2005, at 1 :00 p,m,. in Courtroom Number 5 to consider the Petitio BY THE COURT: ~ Edward E, Guido, J, ~~ ~)~ (. ~,O ~J OJ \ t'} ~.., ,\)\'"'' ':;,C> " ,r , ", ,_..j:,,\~C'\- ';;;.' . \:w \ \), .\....; \ J\A\';; ,\~ 1".,) .>" ~.('\,.'~ ',...... '. ?,f-' , \ 1>\:,.\,,1 '( ""~\.,I ....\:>IVlt ()\ ~ ~.~ .;. U 1\-" - ---- KAREN L, DWORCHAK, as parent and : IN THE COURT OF COMMON PLEAS OF natural guardian of TYLER R. DWORCHAK: CUMBERLAND COUNTY, PENNSYLVANIA and HALEY DWORCHAK, minors, 113 York Street Enola, PA 17025 CIVIL ACTION - LAW Plaintiffs v, NO,: 05-786 CIVIL TERM KAREN L, DWORCHAK 113 York Street Enola, PA 17025 Defendant : AMICABLE ACTION IN TRESPASS ORDER AND NOW. this 14th day of April, 2005, upon consideration of the Petition to Approve the Minors' Settlement Agreement, and after conducting a hearing on this date, and in finding that the proposed settlement is in the best interest of the minor children, it is hereby ordered that the Petition is GRANTED. A sum of $10,000 will be paid to purchase an annuity contract through the Erie Family life Insurance Company on behalf of Haley Dworchak, The annuity contract will have a guaranteed yield of $14,830 to Haley Dworchak, A sum of $26,000 will be paid to purchase an annuity contract through the Erie Family life Insurance Company on behalf of Tyler Dworchak, The annuity contract will have a guaranteed yield of $36,520 to Tyler Dworchak, Edward E, Guido, J, ~ ~ 6~. J.1~/( ~~ --R~r.. ~ If ;(Ut~) ~ , - .~ / @t'\ 7/ Nlp.J' -;" - ---' I) ...' c_~~ .-....} z-. (~ -n ~~ .......~ - .:;.:-' -0 =;.~: u? KAREN L DWORCHAK, as parent and : IN THE COURT OF COMMON PLEAS OF natural guardian of TYLER R. DWORCHAK: CUMBERLAND COUNTY. PENNSYLVANIA and HALEY DWORCHAK, minors, 113 York Street Enola, PA 17025 : CIVIL ACTION - LAW Plaintiffs v, NO, 05-786 CIVIL TERM KAREN L DWORCHAK 113 York Street Enola, PA 17025 Defendant : AMICABLE ACTION IN TRESPASS PRAECIPE TO THE PROTHONOTARY: PLEASE mark the docket in the above-captioned matter settled and discontinued with prejudice, JOHNSON, DUFFIE, STEWART & WEIDNER DATE: V / /~ lor 248890 B~R.~~~~ 1.0, #: 78000 301 Market Street Lemoyne, PA 17043-0109 e-mail: jjs@jdsw.com ~. \..i ~~; ~-;~,~~ :'<) '-,.. ~>? :-~) f' ., (- '''''n :j~ -'.',