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HomeMy WebLinkAbout14-1952David H Rosenberg (PA 20569) HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road, Suite 2 Harrisburg, PA 17110 Ph. 717.238.2000 Fax 717.233.3029 rosenberg@hhrlaw.com :LL • !-- in r■,./ (1,0}1i,j11J I Tt'd\ i I's PR —2 PH 1:26 CLVi.3ERLAND COUNTY 'ENNSYLVANIA Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN THE MATTER OF BRITNEY JOY, a minor, by and through her natural parent and guardian, KELLY WITTEN, Petitioner. NO.: MINOR'S COMPROMISE PETITION FOR LEAVE TO SETTLE A MINOR'S CLAIM To the Honorable Judges of the Court: Pursuant to Pennsylvania Rule of Civil Procedure No. 2039, Britney Joy ("Miss Joy"), a minor, by and through her parent and natural guardian, Kelly Witten ("Petitioner"), by and through her attorneys, HANDLER, HENNING & ROSENBERG, LLP, petitions this Honorable Court to enter an Order permitting settlement and compromise of this claim and in support thereof avers as follows: 1 Miss Joy was born on February 15, 2006, and is therefore, seven years old and a minor. She currently resides at 18 Meadow Brook Court, New Cumberland, Cumberland County, Pennsylvania. W.-7S pcJ tim ex+t S°?LS iZt- 20g2 2. Petitioner is an adult individual and Miss Joy's natural mother and legal guardian. She currently resides with Miss Joy at 18 Meadow Brook Court, New Cumberland, Cumberland County, Pennsylvania. 3. Raymundo Ortiz Andrade ( "Tortfeasor ") is an adult individual with a last known address of 19 Meadow Brook Court, New Cumberland, Cumberland County, Pennsylvania. 4. At all times material hereto, Miss Joy was riding her bike on Meadow Brook Court, New Cumberland, Cumberland County, Pennsylvania. 5. At all times material hereto, Tortfeasor was the operator of a motor vehicle ( "Tortfeasor's Vehicle "). 6. At approximately 8:00 p.m. on June 8, 2012, Tortfeasor's Vehicle struck Miss Joy, causing her injuries. 7. As a direct and proximate result of Tortfeasor's negligence, Miss Bryson suffered injuries including, but not limited to, facial lacerations, abrasions on one of her legs, and fractures of her fibula and tibia of that leg, which caused a valgus alignment of that knee. 8. Miss Joy has recovered from most of her collision - related physical injuries. (See, attached hereto, made a part hereof, and marked Exhibit "A," Miss Joy's last medical record from Osteopathic Institute of Pennsylvania, which indicates her current medical status). 9. At the time of this collision, Miss Joy was not covered under any automobile insurance policy and did not reside with a relative who maintained an insurance policy. 10. There are no unpaid or outstanding claims or liens against this settlement. 11. Tortfeasor's insurance has paid medical benefits for Miss Joy. There remains $2,260.17 in coverage to pay for future medical expenses if needed. A copy of the medical payments log is attached hereto and marked "Exhibit B ". 2 12. Tortfeasor's insurer has offered to settle Miss Joy's claim against Tortfeasor for $15,000.00, which represents Tortfeasor's policy limits. A copy of the Release is attached hereto as Exhibit "C" 13. Petitioner believes said settlement is in the best interests of Miss Joy since it represents the policy limits and proposes to accept the settlement offer of $15,000.00, thereby releasing Tortfeasor from any and all claims, suits, and/or actions in the future. A copy of the Declaration Page and the Affidavit of No Other Insurance Coverage is attached hereto and marked Exhibit "D". 14. David H Rosenberg, Esq., of HANDLER, HENNING & ROSENBERG, LLP, has been the attorney for Miss Joy in this action and he requests reasonable counsel fees of 25%, amounting to $3,750.00, for services rendered, plus costs and expenses of $326.88, pursuant to a Contingent Fee Agreement signed by Petitioner for Miss Joy. The 25% represents a reduction from the 33-1/3% fee agreement signed by Petitioner for Miss Joy. Thus, the total amount requested for attorney's fees and costs is $4,076.88. (See the Contingent Fee Agreement and expense summary, attached hereto, made a part hereof, and marked Exhibits "E" and "F" respectively). 15. Petitioner's counsel is of the professional opinion that this Compromise is reasonable and in the best interest of Miss Joy. WHEREFORE, Petitioner requests this Honorable Court to: a. Approve the Compromise above-stated; b. Direct payment of $4,076.88 to David H Rosenberg, Esq., representing reasonable attorney's fees of $3,750.00 and $326.88, for reimbursement of costs; c. Direct payment of the balance, $10,923.12, be placed into a restricted account in the name of the minor, Britney Joy, marked not to be withdrawn until the age of majority on February 15, 2024. DATE: 11- '020/Y Respectfully submitted, HANDLER, HENNING & ROSENBERG, LLP BY: 4 David H R enberg (PA 20569) Attorneys for Petitioner Orthopedic Institute of Pennsylvania (717)761-5530 Chart No.: 439121 -S Patient: Britney N Joy Physician: HIMMELWRIGHT, BRETT A, D.O. Office: 3399 Trindle Road Account No.: 279305 DOB: 02/1 5/2006 Date: 05/17/13 CHIEF COMPLAINT: Britney is a pleasant 7- year -old young lady who presents to the office today with her mother for evaluation of her right leg. HISTORY OF PRESENT ILLNESS: We had seen her previously for a proximal tibia fracture back about a year ago. Her mother and folks at school have noticed that her knee is going in, and she is rubbing the inside of her left knee with the right. She has no significant pain to speak of. REVIEW OF SYSTEMS: The patient's past medical history, social history, family history and detailed review of systems were reviewed and recorded. PHYSICAL EXAMINATION: The patient ambulates to the office today without any assistive devices or immobilization. There is an obvious valgus alignment of her knee. There is no gross instability of the knee, There is good range of motion in flexion and extension. There is no thigh pain, or calf pain, and distally the left lower extremity is neurovascularly intact. DIAGNOSTIC TESTS: Two view x -rays of the right tib-fib and knee were obtained in the office today. Those studies demonstrate healing of the proximal tibia fracture. There does appear to be a valgus alignment of the fracture in the AP projection. ASSESSMENT: Valgus alignment of right proximal tibia, status post proximal tibia fracture. PLAN: I reviewed Britney's findings with her and her mother at today's visit. We compared her films today to her previous films a year ago. Previously she had excellent alignment. i think she has overgrowth of the medial side of her knee now because of her proximal tibial fracture. I will discuss this with one of the pediatric orthopedists and see if this is something that we just need to watch, and see if it corrects on its own, or whether or not a stapling of the medial physis is necessary to help swing her leg back into a more neutral alignment. We will contact her mother to discuss further treatment. BAH /DS -red #5221 /sjk cc: Cynthia T. Demuth, M.D. , Brett A. Himmelwright, DO 05/23/2013 1:33 pm Britney N Joy Chart# 439121-S DOB 02/15/2006 DD 05/17/2013 Page #2 Orthopedic Institute of Pennsylvania (717)761-5530 Chart No.: 439121-S Patient: Britney N Joy Physician: HIMMELWRIGHT, BRETT A, 3.0. Office: 3399 Trindle Road Account No.: 279305 DOB: 02/15/2006 Date: 05/17/13 RIGHT LEG: Two view x-rays of the right fib-fib and knee were obtained in the office today. Those studies demonstrate healing of the proximal tibia fracture. There does appear to be a valgus alignment of the fracture in the AP projection. IMPRESSION: See Above Study. BAH/DS-red Brett A. Himmelwright, DO 05/23/2013 1:33 pm PIP / Medical Payments Log Current Date: 02/20/2014 Policy Limits Claim Number: 92A345485 PIP Limit: 5,000.00 Claimant: B) BRITNEY JOY Med Pay Limit: 0.00 Process Amount Allowable Applied to Applied to Amount PIP PIP PIP PIP Medical Date Service From - To Billed Amount Deductible Co-pay Paid Med Wage Econ NO Payments 07/08/2013 06/11/2012 - 05/17/2013 745.00 466.83 0.00 0.00 466.83 466.83 0.00 0.00 0.00 0.00 Provider / Service: ORTHOPEDIC INSTITUTE OF PA / Orthopedic Surgery Comments: Bill Nbr: 922577 07/18/2013 06/08/2012 - 08/27/2012 9,778.20 1,264.70 0.00 0.00 1,264.70 1,264.70 0.00 0.00 0.00 0.00 Provider / Service: HOLY SPIRIT HOSPITAL! Hospital Comments: Bill Nbr: 924929 10/01/2013 06/11 /2012. 07/30/2012 243.00 145.92 0.00 0.00 145.92 145.92 0.00 0.00 0.00 0.00 Provider / Service: ORTHOPEDIC INSTITUTE OF PA / Orthopedic Surgery Comments: Bill Nbr: 941656 10/01 /2013 08/27/2012 - 08/27/2012 63.00 29.08 0.00 0.00 29.08 29.08 Provider! Service: ORTHOPEDIC INSTITUTE OF PA FORGE ROAD SUITE 50 CARLISLE / Diagnostic Radiology Comments: Bill Nbr: 941417 0.00 0.00 0.00 0.00 12/09/2013 11/06/2013 - 11/06/2013 166.00 106.25 0.00 0.00 106.25 106.25 0.00 0.00 0.00 0.00 Provider / Service: ORTHOPEDIC INSTITUTE OF PA / Orthopedic Surgery Comments: Bill Nbr: 959372 02/13/2014 06/08/2012 - 06/08/2012 1,044.00 237.98 0.00 0.00 237.98 237.98 Provider / Service: QUANTUM IMAGING THERAPUTIC ASSOC- NORTH ST, CAMP H / Diagnostic Radiology Comments: Bill Nbr: 972723 0.00 0.00 0.00 0.00 02/13/2014 06/08/2012 - 06/08/2012 4,902.00 489.07 0.00 0.00 489.07 489.07 0.00 0.00 0.00 0.00 Provider / Service: CAMP HILL EMERGENCY PHYSICIANS! Emergency Medicine Comments: Bill Nbr: 972938 02/20/2014 06/09/2012 - 06/09/2012 0.00 Provider / Service: RITE AID CORPORATION I Comments: BRITTNEY JOY DOS 6/9/12 0.00 0.00 0.00 22.98 22.98 0.00 0.00 0.00 0.00 Page 1 of 2 Service From - To PIP / Medical Payments Log Amount Allowable Applied to Applied to Amount PIP PIP Billed Amount Deductible Co-pay Paid Med Wage PIP Econ PIP Medical NO Payments Totals: 16,941.20 2,739.83 0.00 0.00 2,762.81 2,762.81 0.00 0.00 0.00 0.00 Page 2 of 2 PARENTS RELEASE AND INDEMNITY AGREEMENT FOR AND IN CONSIDERATION of payment to me at this time of the sum of fifteen thousand and 00 /100 dollars ($15,000.00), the receipt of which is hereby acknowledged, I, Kelly Witten, the undersigned parent or guardian of BRITNEY JOY, a minor, age 8, do forever release, acquit, discharge and covenant to hold harmless Viking Insurance Company of Wisconsin and RAYMUNDO ORTIZ, their stockholders, officers, directors, employees, agents, insurers, attorneys, predecessors, heirs, successors, and assigns, of and from any and all actions, causes of action, claims, demands, damages, costs, loss of services, expenses and compensation, on account of, or in any way growing out of, any and all known and unknown bodily injuries and property damage which I may now or hereafter have as the parent or guardian of the said minor and also all claims or rights of action for damages which the said minor has or may hereafter have, either before or after he or she has reached his or her majority, resulting or to result from a certain accident which occurred on or about June 8, 2012 at or near Meadowbrook Ct., New Cumberind, PA. In further consideration for the payment recited above, I, Kelly Witten, promise and bind myself, (severally) my heirs, administrators and executors to repay to Viking Insurance Company of Wisconsin and RAYMUNDO ORTIZ, their stockholders, officers, directors, employees, agents, insurers, attorneys, predecessors, heirs, successors, and assigns, any sum of money, except the money above mentioned, that he or she or they may hereafter be compelled to pay because of injuries and damages sustained by said minor in or as a result of the described accident. It is understood and agreed that this settlement is a compromise of a doubtful and disputed claim and that this payment is not to be construed as an admission of liability. It is further understood and agreed that this release and payment pursuant thereto is not to be construed as waiver by or estoppel of any party released to prosecute a claim or action for any damages sustained. I, Kelly Witten, further state that I, having carefully read the foregoing release and knowing the contents thereof, do sign the same as my own free act. BRITNEY JOY agrees that they will repay any Medicare Conditional Payments to Medicare before the settlement funds are dispersed for other purposes. 2 140401100752.0055 0030090868400000000017110283899 EXHIBIT G CAUTION: READ BEFORE SIGNING! I HAVE READ AND UNDERSTAND THIS RELEASE. Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. X Signature Date STATE OF ) ( ss: COUNTY OF ) Personally appeared before me the person(s) whose signature appears above on this day of 20 , and executed this instrument in my presence. (signature of Notary) (NOTARY SEAL) Notary Public, State of My commission expires: I. 1111111 11111 1111111111 11111 11111 Ern 1111111111 11111 1111111111 1 1111111 DOCCLMS 92A345485 Viking Insurance Company of Wisconsin PO BOX 8042 11111111111111111111111 REL Stevens Point WI 54481-9836 IIIIIIIIIIIIPeillyle I I 111111111iiiiiiiiiillilli'llill'Iliellni Please fold for return envelope window. 420 1111111111111111111111111 LEG 10/01/2013 10:27 FAX 563 459 5252 SENTRY CLAIMS a 002 AffipAVIT,9*F.:.N9/93: lytifIty!ANcE 'My name min -de; Raysv 040 ()Ali and I reside ,at..19tagPoYu. firricik: court. New u.rnb.erlancl:.0tA 17 On ti8/212, 1.7,110i thg-tOlverofan .autOrnObdi which waSinv011yed- MotOr -vehicle; aco ent nvolVin,g injuries 4)-86646y: I Und'et$tant "that' :clairns mOd'e-A0einstIti.1, Britni?y Joy in an *amount trt.pitesi;of• $04:140,0:, the liability .:polity limits of riv:iop.thOlitie I HEREBY cir - other irisutAhe'poill WuId Oroyi0e;c6N:14 ,:e polidy with Viking Corndani:Of WitDi,sfh, !FY ; that, On:the:date Ofthe•tPlii.i.b•m,,,'0100i1-,-1-WatllY0t•:cOvked.k!iy ant whether It:bean excess po I iCy or an urnbefla , pofity.or, otherwise, that ge;f e.danilagesitOBritriey,py,:asialestilt;ottftts•ccilliSitlo, . I F1:11400. CERTIF. .that, at-the •11rhe of theftollIgOn., I *as riot Itetlhig, on ehal f.'m,' • employer Ih any mlner. I uNDERtr.i4 ;tri t I am .giving.:this Affidavit tqAhdwee; Brit.nly•tciy..to,accept policy 'limits of•rny abOVe: named insOrante•POlky,. in fiiH tettlemefft of Oatm 'against the. t • further understand that Brltney Joy. is.:reIyhigri thiS infdernatiOn In making a :detisiora tolaccept such settlement. VERIFY that t,he• Statements In. thi,Affidayit.a.re true 'end, core. t u.ndefstand that false statements hemein are Made ttibje(i.-to. the,..0en Oki es Of c.A..: 4490; :rootril Et. to false swearing., Sw.Orn to and'Subscri4d :I, tler before, nne.this „day Andrade ilaymundo.Pittlx oM of , • ..NOTARIAL.SUIL • ..t.:,•44sIlLlic.goOggligz,NOttelf)i! * "rogiNSiolf Ex 1 IG •ttlY PERSON 4410. dwiwiit'Arsll.i..*1.*INT fit tOitiC;gt: c41..tYt , . „ .AtirINgittpt.'010,Ar:c. •0114.10,110N 491; CONTAINING ANY FAL5E, tNCOMPLm OR imst-F-ApiNp* INFORMATION. SHALL, AJPiiktONVIOION. BE RAM EtITIO .IMPRISONMENT FOR UP TO :YE AND WAYMENY Of A FINE:UP-Tet 150004' Claim Number: 92A345485 Policy Number: 385544876 Coverage Verification Date: 6/8/2012 Policy Snapshot Created: 6/12/2012 9:53:05 AM Insured Information Date of Loss: 6/8/2012 Insured Name: ORTIZ ANDRADE, RAYMUNDO Address: 19 MEADOWBROOK CT NEW CUMBERLAND, PA 17070 Phone Number: Phone (Work): Underwriting Company: 011 - Viking Insurance Company of Wisconsin Policy Type: YAP - Viking Auto Policy (717) 695-7421 Policy State: Pennsylvania Policy Term: Semi-Annual Effective Date: 2/8/2012 Expiration Date: 8/8/2012 Inception Date: 2/8/2012 Cancellation Date: Carry Date: 7/8/2012 Vehicle Coverage Information Vehicle Year Make / Model 11111111111111111111111 Coverage UNINSURED MOTORIST STACKED BODILY INJURY UNDERINSURED MOTORIST NON-STACKED BODILY INJURY MEDICAL PAYMENTS UNDERINSURED MOTORIST STACKED BODILY INJURY UNINSURED MOTORIST NON-STACKED BODILY INJURY PROPERTY DAMAGE LIABILITY BODILY INJURY LIABILITY IlLienholder Driver Information Driver Name ORTIZ ANDRADE, RAYMUNDO Endorsements Form Number PIP2-PA PA1101 PPA-PA PAPI Policy Coding ['Producer Coding Deductible Birth Date License # 3/15/1984 N04853044 7 Limits REJECTED REJECTED 5,000 REJECTED REJECTED 5,000 15,000/30,000 State SR Filing F Vehicle Type Excluded Named Non- Driver Insured Driver Description Edition Date FIRST PARTY BENEFITS ENDORSEMENT-PA 02/10 PA-AUTOMOBILE INSURANCE APPLICATION 06/11 CAR POLICY AMENDATORY ENDORSEMENT - PA 01/11 PERSONAL AUTO POLICY 03/08 Distribution Code: S- Special Markets Agent Producer Code: 3800390 Center Code: M- Viking Nonstandard Producer State: Pennsylvania Division Code: 11- Viking NSA or Cycle or Illinois DIC Branch Profit Center /Sales Code: 073800390 Policy Coding, Policy Source System: N- OASIS IMPS Line of Business: 09- Private Auto Summit Plan Code: VN -NON SELECTED VIKING PLAN CODES Policy System Code: 07- OASIS - MADISON Foreign Policy Number: ]VIIPS /OASIS Underwriting Company: Viking Insurance Company Facility Information Facility: No Contract Number: ee Handler Henning & Rosenberg LIP Attorneys at Law CONTINGENT FEE AGREEMENT I, Kelly Witten, natural parent and legal guardian of Britney Joy, do hereby retain HANDLER HENNING & ROSENBERG LIP, 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 Raymond Andrade Ortiz, or against anyone else as a result of injuries and damages I sustained in an incident that occurred on 6/18/2012. 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 (33'3 %) 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 LIP 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. I further understand that my attorney(s) may have to resolve Medicare, Medicaid, and /or private health insurance reimbursement claims or liens for past and /or future medical care. My attorney(s) may associate separate experts /case workers who will assist with the reimbursement of claims or liens. The expense of any such service will be treated as a case expense. 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 f i day of April, 2013. d y�- dt k W - (SEAL) Kelly Witj, , natural parent and legal guardian of Britney 1300 LINGLESTOWN ROAD, SUITE 2 I HARRISBURG PA 17110 717 238 2000 I f 717 233 3029 I toll free 800 422 2224 I www.hhrlaw.com H Handler Henning & Rosenberg LP Attorneys at Law 1300 LINGLESTOWN ROAD, SUITE 21 HARRISBURG, PA 17110 717 238 2000 1 f 717 233 3029 1 toll free 800 422 2224 1 www.hhrlaw.com Miss Britney Joy 18 Meadow Brook Court New Cumberland, PA 17070 USA Motor Vehicle Incident EXPENSES 06/04/2013 CAS E -` 06/04/2013 CASE 06/24/2013 • CASE- - 07/08/20.13 CASE -- 07/09/2013 CASE - 09/05/2013 CASE • • 04/01 /2014 CASE. 04/30/2014 COPY 04/30/2014 FAX 04/30/2014 POS 04/30/2014 POST 04/30/2.0.14 TELE - INVOICE PAYMENT DUE UPON RECEIPT CC- SDS - HOLY SPIRIT HOSPITAL 706704/2013" CC -SDS- ORTHOPEDIC INSTITUTE OF PA 06/04/2013 • - --$51.-11 HOLY SPIRIT HOSPITAL 06/24/2013 '$ 20.00 HOLY SPIRIT HOSPITAL •07/08/2013 HOLY SPIRIT HOSPITAL .07/09/2013 CC- HEALTHPORT - 0115 .09/0.5/2013 PROTH OF YORK COUNTY 04/01/2014 . • - -- _. _ Document R eproduction _ 04/30/2014 Fax Charges 04/30/2014 Postage Costs -$2•0.00-- - $20.00 $0.80 $7.50 - . 04/30/2014 $8.74 • Postage Costs 04/30/2014..... 777-$4.26 Long Distance Telephone Charges 04/30/2014 $0.08- - EXHIBIT t -F Client No: 218601 Attorney: DHR MV Pre -Bill No: 48213 Bill Date: April 01, 2014 TOTAL EXPENSES Total due this invoice OTAL BALANCE DUE 94.58 51.11 20.00 20.00 -20.00 36.06 103.75 0.80 7.50 8.74 4.26 0.08 $326.88 $326.88 $326.88 VERIFICATION The undersigned hereby verifies that the statements in the foregoing document are based upon information which has been furnished to counsel by me and information which has been gathered by counsel in the preparation of this lawsuit. The language of the document is of counsel and not my own. I have read the document and to the extent that it is based upon information which I have given to counsel, it is true and correct to the best of my knowledge, information and belief. To the extent that the contents of the document are that of counsel, I have relied upon my counsel in making this Verification. The undersigned also understands that the statements made therein are made subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. Date: Olf/u elly itten „ t. APR 10 AH 9: /7 CI.MBERL i' {��i! CO•r I P NNSy , NIA A:�,`i . IN THE ORPHANS COURT OF CUMBERLAND COUNTY, PENNSYLVANIA IN THE MATTER OF BRITNEY JOY, a minor, by and through her natural parent and guardian, KELLY WITTEN, Petitioner. /1/1950q MINOR'S COMPROMISE ORDER A� ` AND NOW, this I day of r i\ , 2014, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that the disbursement of funds is 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 $4,076.88 to David H Rosenberg, Esq., representing reasonable attorney's fees of $3,750.00 and $326.88 for reimbursement of costs; B. Direct payment of the balance, $10,923.12, to be placed into a restricted account in the name of the minor, Britney Joy, marked not to be withdrawn until the age of majority on February 15, 2024. C. Proof of deposit of the funds to be filed with the Court. BY THE COURT ecri \\\‘\ 144,I_y 9. .syop David H Rosenberg (PA 20569) HANDLER, HENNING & ROSENBERG, LLP 2 i ,i r3 2' P`t 19 1300 Linglestown Road, Suite 2 __rr ,.UC'l3Ef�L.rii' D COL/"Is Harrisburg, PA 17110 �'EP���S Y ' '� ' Ph. 717.238.2000 LYAN/,:; Attorneys for Plaintiff Fax 717.233.3029 rosenberg@hhrlaw.com IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN THE MATTER OF BRITNEY JOY, a minor, by and through her natural parent and guardian, KELLY WITTEN, NO.: 14-1952 Civil Petitioner. MINOR'S COMPROMISE PROOF OF DEPOSIT AND NOW, comes the Petitioner, by and through her attorneys, HANDLER, HENNING & ROSENBERG, LLP, by David H Rosenberg, Esquire, pursuant to the April 9, 2014, Court Order, attaches the Proof of Deposit of the minor's settlement proceeds hereto, to wit, the bank certification from Integrity Bank, which is made a part hereof and is marked, "Exhibit A." Respectfully submitted, HANDLER, HENNING & ROSENBERG, LLP By: d David Rosenberg, Esquire Supreme Court I.D. #20569 1300 Linglestown Road Harrisburg, PA 17110 (717) 238-2000 • & ?// y Rosenberg(ujhhrlaw.com DATED: f , , '..-•"1,1 41-1 4.. ', . r:a ai-r- --..2.>•Ct.07-0-:10 0 I aarg-Cge Ta W.3.-a(Z-* Integrity 4.4 BANK IL9;1 INTEGRITY BANK t/ COLONIAL ROAD, 301 Colonial Rd, Hamsbu .,PA 17109 5 TIME CERTIFICATE OF DEPOSIT A NONTRANSFERABLE AND NONNEGOTIABLE Account Title Account Type Taxpayer ID Number BRITNEY JOY 60 MONTH CD 205-82-6650 i V tZ BY KELLY M WITTEN,GUARDIAN V.4 Account Number Amount Date of Issue Maturity Date Term a. 't.14 0000000604002360 $ 10,923.12 June 18,2014 June 18,2019 60 Months/Automatic Renewal ( :V1 1.193 %with an annual percentage yield Interestof1R2a0tePer Annum Interest%. Payment Frequency Monthly ....4 I. . Interest Payment Disposition .' VP / Interest will be capitalized to this certificate. ..c. TIME CERTIFICATE OF DEPOSIT O Agreement. This Time Certificate of Deposit is a part of, and governed-by, our Time Deposit Agreement. Among other things, this means that all terms defined in that agreement have the same meanings here, "You have received a copy of that agreement, the Truth in Savings (' disclosures(if applicable),and the fee schedule. You have read them and agree to them. Early Withdrawal Penalty. We do not have to permit early withdrawals from the account. On each one we do permit, we can charge a 2, penalty calculated as follows: If the term is between 30 days and under one year a penalty of one month interest will be assessed. If the term 1„.1 vp,t is between one year and under three years a penalty of three months of interest will be assessed.If the term is three years and over,a penalty ' `:/ .4, of six months of interest will be assessed. If'there is enough accrued interest to cover the penalty, we deduct the penalty from it. If not, we w, g deduct the remainder of the penalty from principal. If the-account is a variable rate account, we will calculate the penalty using the interest LA rate being applied at the time of withdrawal. If the account is an Individual Retirement Account,the early withdrawal penalty will be in addition " to any penalty imposed under the Individual Retirement Account(IRA)Disclosure Statement. The minimum early withdrawal penalty is seven 0' dayssimple interest on any amount withdrawn (a)within the first six days after the account is opened, or(b)within six days after a previous - . early withdrawal. L Nontransferable. This Time Certificate of Deposit is nonnegotiable and nontransferable. All purported holders or assignees of it agree that k ;17:4 our right of setoff will have priori over any of their claims. .1P4' INTEGRITY BANK _ • - • t, Date 1 ;sow 17 4 t l. 17 •4 . CI EX A $HIBIT 4-1, • • . . I v. . 11 L... . tA, 3 m. TIME CERTIFICATE OF DEPOSIT 00001100/20121110 Printed 6/18/2014 10:57:00 AM V lUg NONTRANSFERABLE AND NONNEGOTIABLE I. ' ©2012 Fidelity National Information Services,Inc.and its subsidiaries. ,21... Ali BRITNEY JOY/0000000604002360 ,.1'730E10 r....._.‹ i''.,1.'. \ .C C....Si .i.0,CG).... CZ)gsle r.& \....S.C..Dc-• ._f:i..z)--0-:G.9:0 TO TO:CSI:j--.. .....5_.5.0.""...g 8/ ~_ . ° ' . . `I . / / . TDDEPS 0004 402 16 0618/14 11 :07 AM Deposit fort , Time Deposit �****2360 for $10,923.12 � | ' . . ' • David H Rosenberg (PA 20569) HANDLER, HENNING & ROSENBERG, LLP 1300 Linglestown Road, Suite 2 Harrisburg, PA 17110 Ph. 717.238.2000 Attorneys for Plaintiff Fax 717.233.3029 rosenberg@hhrlaw.com IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN THE MATTER OF BRITNEY JOY, a minor, by and through her natural parent and guardian, KELLY WITTEN, NO.: 14-1952 Civil Petitioner. MINOR'S COMPROMISE CERTIFICATE OF SERVICE On the 19th day of June, 2014, I hereby certify that a true and correct copy of Plaintiff's Proof of Deposit was served upon the following by depositing in U.S. Mail: Honorable Merle L. Ebert,Jr. Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Respectfully submitted, HANDLER, HENNING & ROSENBERG, LLP By: David Rosenberg, Esquire Supr me Court I.D. # 20569