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HomeMy WebLinkAbout14-4399 r Supreme Court of Pennsylvania Court of Common Pleas For Prothonota)v Use only: Civil Cover Sheet Docket No: CUMBERLAND County y+ J l' The information collected on this form is used solely for court administration purposes. This form does not supplement or replace the filing and service ofpleadings or other papers as required by law or rules of court. Commencement of Action: S ❑ Complaint ❑x Writ of Summons ❑ Petition ❑ Transfer from Another Jurisdiction ❑ Declaration of Taking E C Lead Plaintiff's Name: Lead Defendant's Name: BRITTANY ROTANZ TYLER BAKER T I Are money damages requested? El Yes ❑ No Dollar Amount Requested: ❑within arbitration limits (check one) [@ outside arbitration limits O N Is this a Class Action Suit? ❑Yes 0 No Is this an MDJAppeal? 0 Yes El No A Name of Plaintiff/Appellant's Attorney: FREDRIC S. KARPF, ESQUIRE(#76294) ❑ Check here if you have no attorney(are a Self-Represented [Pro Sel Litigant) Nature of the Case: Place an"X"to the left of the ONE case category that most accurately describes your PRIMARY CASE. If you are making more than one type of claim,check the one that you consider most important. TORT(do not include Mass Tort) CONTRACT(do not include Judgments) CIVIL APPEALS ❑ Intentional ❑ Buyer Plaintiff Administrative Agencies ❑ Malicious Prosecution ❑ Debt Collection:Credit Card ❑ Board of Assessment Motor Vehicle ❑ Debt Collection:Other © Board of Elections Nuisance ❑ Dept.of Transportation ❑ Premises Liability ❑ Statutory Appeal:Other S ❑ Product Liability(does not include E mass tort) ❑ Employment Dispute: ❑ Slander/Libel/Defamation Discrimination C ❑ Other: ❑ Employment Dispute:Other [3 Zoning Board T ❑ Other: I ❑ Other: O MASS TORT ❑ Asbestos N ❑ Tobacco ❑ Toxic Tort-DES ❑ Toxic Tort-Implant REAL PROPERTY MISCELLANEOUS ❑ Toxic Waste ❑ Other: ❑ Ejectment [I Common Law/Statutory Arbitration B ❑ Eminent Domain/Condemnation ❑ Declaratory Judgment ❑ Ground Rent ❑ Mandamus ❑ Landlord/Tenant Dispute ® Non-Domestic Relations ❑ Mortgage Foreclosure:Residential Restraining Order PROFESSIONAL LIABLITY ❑ Mortgage Foreclosure:Commercial ❑Quo Warranto ❑ Dental ❑ Partition ®Replevin ❑ Legal ❑ Quiet Title ❑Other: ❑ Medical ❑ Other: 0 Other Professional: Updated 1/1/2011 a"w IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,PENNSYLVANIA CIVIL DIVISION Plaintiff(s)&Address(es) BRITTANY ROTANZ 351 WALTER ROAD CHALFONT, PA 18914 u �i Case No. � —I I Civil Term VS. Civil Action Defendant(s)&Address(es) TYLER BAKER 12 FAIRFIELD STREET rpt NEWVILLE, PA 17241 cW See attached for complete caption r°rn c -G> co b PRAECIPE FOR WRIT OF SUMMONS r—CD -7 CD DQ X" C7 t-? TO THE PROTHONOTARY/CLERK OF SAID COURT: T, Issue summons in the above case Writ of Summons shall be issued and forwarded to ttorne SWAM. Please Circle choice Date: i Attor y Print Name: FRMgIC S. KARqf, ESQUIRE Address: 737 SECOND Sf REET PIKE SOUTHAMPTON, PA 18966 Telephone#:215-953-8955 Supreme Court ID Number: 76294 . . . . . WRIT OF SUMMONS TO: TYLER BAKER and CAROLYN BAKER YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFF(S)HAS/HAVE COMMENCED AN ACTION AGAINST YOU. Prothonotary/Clerk,Civil Division Date: Deputy COMPLETE CAPTION: BRITTANY ROTANZ 351 WALTER ROAD CHALFONT, PA 18914 vs. TYLER BAKER 12 FAIRFIELD STREET NEWVILLE, PA 17241 and CAROLYN BAKER 12 FAIRFIELD STREET NEWVILLE. PA 17241 FREDRIC S. KARPF, ESQUIRE HOFFMAN, MICHELS & STERNBERG, LLC 737 SECOND STREET PIKE SOUTHAMPTON, PA 18966 (215) 953-8955 IDENTIFICATION NO. 76294 BRITTANY ROTANZ vs. TYLER BAKER and CAROLYN BAKER Fit_ ED- OFF/CL O THON,S TA;; 2014 AUG -7 FH 1: 3� CUMBERLAND COUNTY PENNSYLVANIA ATTORNEY FOR PLAINTIFF COURT OF COMMON PLEAS CUMBERLAND COUNTY LAW DIVISION NO: 14-4399 ACCEPTANCE OF SERVICE I, LISA M. DIBERNARDO, ESQUIRE, hereby agree to accept Service of Process of Plaintiff's Writ of Summons in the above -referenced matter on behalf of the Defendants, TYLER BAKER and CAROLYN BAKER, and certify that I am authorized to do so. (.(Dated: q.31.1 By: Lisa M. DiBernardo, Esquire Attorney for Defendants, Tyler Baker and Carolyn Baker Flanagan and DiBernardo, LLP 150 E Chestnut Street Lancaster, PA 17602-2741 (717) 553-0522 (717) 397-2397 (1) Attorney ID # 0` IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Brittany Rotanz No. 14-4399 Plaintiff VS Tyler Baker and Carolyn Baker Defendant NOTICE TO DEFEND U r .71 -- -+� rn Co C7 CA) aC7 --n ry tz'rt YOU HAVE BEEN SUED IN COURT. IF YOU WISH TO DEFEND AGAINST THE CLAIMS SET FORTH IN THE FOLLOWING PAGES, YOU MUST TAKE ACTION WITHIN TWENTY (20) DAYS AFTER THIS COMPLAINT AND NOTICE ARE SERVED, BY ENTERING A WRITTEN APPEARANCE PERSONALLY OR BY AN ATTORNEY AND FILING IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. YOU ARE WARNED THAT IF YOU FAIL TO DO SO THE CASE MAY PROCEED WITHOUT YOU AND A JUDGMENT MAY BE ENTERED AGAINST YOU BY THE COURT WITHOUT FURTHER NOTICE FOR ANY MONEY CLAIMED IN THE COMPLAINT OR FOR ANY OTHER CLAIM OR RELIEF REQUESTED BY THE PLAINTIFF. YOU MAY LOSE MONEY OR PROPERTY OR OTHER RIGHTS IMPORTANT TO YOU. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUECED FEE OR NO FEE. CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 1-800-990-9108 717-249-3166 FREDRIC S. KARPF, ESQUIRE HOFFMAN, MICHELS & STERNBERG, LLC 737 SECOND STREET PIKE SOUTHAMPTON, PA 18966 (215) 953-8955 IDENTIFICATION NO. 76294 BRITTANY ROTANZ vs. TYLER BAKER and CAROLYN BAKER CIVIL ACTION MAJOR CASE JURY TRIAL DEMANDED ATTORNEY FOR PLAINTIFF CUMBERLAND COUNTY COURT OF COMMON PLEAS LAW DIVISION NO: 14-4399 1. Plaintiff, BRITTANY ROTANZ, is an individual who currently resides at 351 Walter Road, Chalfont, Pennsylvania 18914. 2. Defendant, TYLER BAKER, is an individual who resides at 12 Fairfield Street, Newville, Pennsylvania 17241. 3. At all times material to this Civil Action, Defendant, TYLER BAKER, acted or failed to act as an agent, servant, workman and/or employee of Defendant, CAROLYN BAKER, who was then and there acting within the course and scope of his employment with said Defendant and in furtherance of the business of said Defendant. 4. In the alternative, at all times material to this Civil Action, Defendant, TYLER BAKER, acted or failed to act individually or through his agents, servants, workmen and/or employees who were then and there acting within the course and scope of their employment with said Defendant and in furtherance of the business of said Defendant. 5. Defendant, CAROLYN BAKER, is an individual who resides at 12 Fairfield Street, Newville, Pennsylvania 17241. 6. At all times material to this Civil Action, Defendant, CAROLYN BAKER, acted or failed to act as an agent, servant, workman and/or employee of Defendant, TYLER BAKER, who was then and there acting within the course and scope of her employment with said Defendant and in furtherance of the business of said Defendant. 7. In the alternative, at all times material to this Civil Action, Defendant, CAROLYN BAKER, acted or failed to act individually or through her agents, servants, workmen and/or employees who were then and there acting within the course and scope of their employment with said Defendant and in furtherance of the business of said Defendant. 8. Defendants, TYLER BAKER and CAROLYN BAKER, shall be collectively referred to, hereinafter, as the "DEFENDANTS". 9. On or about December 3, 2012 at approximately 9:00 pm, Plaintiff, BRITTANY ROTANZ, possessed, operated, owned and controlled a certain motor vehicle that was involved in the accident hereinafter more fully set forth. 10. On the aforesaid date and time, Defendant, TYLER BAKER, acting as aforesaid, possessed, operated and controlled a certain motor vehicle owned by Defendant, CAROLYN BAKER, which motor vehicle was involved in the accident hereinafter more fully set forth. 11. On the aforesaid date and time, the motor vehicle operated by Plaintiff, BRITTANY ROTANZ, was traveling eastbound on Walnut Bottom Road, at or near its intersection with the Shippensburg Shopping Center, a public highway located within the County of Cumberland, Commonwealth of Pennsylvania. 12. On the aforesaid date and time, the motor vehicle owned by Defendant, CAROLYN BAKER, and operated by Defendant, TYLER BAKER, acting as aforesaid, was traveling westbound on Walnut Bottom Road, when the DEFENDANTS were so careless, reckless and negligent that said DEFENDANTS, suddenly and without warning, caused their vehicle to swerve to the left, cross the solid center line, travel westbound in the eastbound lane of travel and then strike Plaintiff, BRITTANY ROTANZ's vehicle in the front. 13. Pursuant to a police report issued by the Pennsylvania State Police in this matter (Incident Number H02 -2168769)(a copy of which is attached as Exhibit "A"), Defendant, TYLER BAKER, admitted to Trooper Alex Grote that, at the time of the aforesaid accident, he was "messing with a cd and a cigarette." 14. Pursuant to a police report issued by the Pennsylvania State Police in this matter (Incident Number H02-2168769), on the aforesaid date and time and at all times relevant hereto, Defendant, TYLER BAKER, was under the influence of "illegal drugs" and was subsequently charged with a number of criminal violations, including but not limited to driving under the influence at the time of the December 3, 2012 motor vehicle accident. 15. Pursuant to the Criminal Docket of the Court of Common Please of Cumberland County (a copy of which is attached as Exhibit "B"), as a result of the December 3, 2012 motor vehicle accident and the injuries he caused Plaintiff, BRITTANY ROTANZ, to sustain, Defendant, TYLER BAKER, plead guilty to a felony offense of Aggravated Assault by Vehicle While Driving Under the Influence (75 Pa.C.S.A. §3735.1(a)) and a misdemeanor offense Driving Under the Influence of a Controlled Substance (75 Pa.C.S.A. §3802(d)(2)). 16. Moreover, the aforesaid December 3, 2012 motor vehicle accident was the second time that Defendant, TYLER BAKER, had been charged with Driving Under the Influence of a Controlled Substance (75 Pa.C.S.A. §3802(d)(2)). 17. As a direct result of the aforesaid accident, Plaintiff, BRITTANY ROTANZ, sustained serious personal injuries hereinafter more specifically set forth. 18. At the time and place aforesaid, the carelessness, recklessness and negligence of the DEFENDANTS, acting as aforesaid consisted of the following: (a) Operating their said vehicle at a high and excessive rate of speed under the circumstances; (b) Failing to have their said vehicle under proper and adequate control; (c) Failing to give proper and sufficient notice of their approach; (d) Operating their said vehicle without due regard for the rights, safety and position of the Plaintiff; (e) Violating the various ordinances and laws of the applicable local municipality, the County of Cumberland and the statutes of the Commonwealth of Pennsylvania pertaining to the operation and control of motor vehicles; (f) Failing to exercise due care and caution under the circumstances; (g) Being inattentive; (h) Operating a vehicle in the wrong lane of travel; (I) Operating a vehicle while under the influence of an illegal and/or controlled substance; and (j) Being otherwise negligent under the circumstances. COUNT I PLAINTIFF v. DEFENDANTS, TYLER BAKER & CAROLYN BAKER (Negligence) 19. Plaintiff, BRITTANY ROTANZ, incorporates herein by reference the averments contained in paragraphs 1 through 18 inclusive, as fully as though the same were herein set forth at length. 20. As a direct result of the DEFENDANTS carelessness, recklessness and negligence as aforesaid, Plaintiff, BRITTANY ROTANZ, sustained severe and permanent internal and external injuries in and about the head, body and limbs, more particularly: transverse fracture of the distal tibia with displacement and angulation and comminuted oblique fracture of the distal fibula with displacement, overlap of the fracture ends and angulation all requiring closed reduction of the right distal tibia / fibula shaft fracture under local sedation followed by open reduction / internal fixation surgical repair using locked intramedullary rodding and Synthes Expert Nail System resulting in a period of non-weightbearing and then partial weightbearing with the use of a walker and/or cane, tree (3) separate permanent surgical scars, left hand abrasions and contusion, left middle finger pain with ecchymosis over the proximal interphalangeal joint dorsally, chest / breast abrasions and contusions, anxiety disorder / emotional distress and a severe and permanent shock to her nervous system, all of which have caused her and will continue to cause her great pain and agony and have prevented her and will continue to prevent her in the future from attending to her daily duties and occupation, all to her great financial damage and loss. 21. Further, by reason of the aforesaid, Plaintiff, BRITTANY ROTANZ, has been obliged to expend various sums of money for medicine and medical attention in and about endeavoring to treat and cure herself of her said injuries, and will be obliged to expend additional sums of money for the same purposes in the future, all to her great financial damage and loss. 22. As a result of the accident and the injuries sustained therein, Plaintiff, BRITTANY ROTANZ, has and may suffer an impairment of her earning capacity and power, which impairment of earning capacity and power has or may exceed the sum recoverable under the limitations of the Pennsylvania Motor Vehicle Financial Responsibility Law. 23. As a direct result of the accident aforesaid, Plaintiff, BRITTANY ROTANZ, has and will hereinafter incur additional financial and/or medical expenses or losses which will exceed amounts, which she may otherwise be entitled to recover under the Pennsylvania Motor Vehicle Financial Responsibility Law. WHEREFORE, Plaintiff, BRITTANY ROTANZ, demands judgment against the Defendants, TYLER BAKER and/or CAROLYN BAKER, jointly and severally, in an amount in excess of Fifty Thousand ($50,000.00) Dollars, plus punitive damages, interest and costs. COUNT II PLAINTIFF v. DEFENDANT, CAROLYN BAKER (Negligent Entrustment) 24. Plaintiff, BRITTANY ROTANZ, incorporate the averments contained in paragraphs 1 through 23 as though they were set forth at length herein. 25. At all times material to this Civil Action, Defendant, CAROLYN BAKER, acted negligently, carelessly and in a reckless disregard for the safety of Plaintiff, BRITTANY ROTANZ, which conduct proximately caused the Plaintiff's serious and permanent personal injuries as described above. 26. The acts of Defendant, CAROLYN BAKER, constituting negligence, carelessness and recklessness are as follows: (a) Entrusting a motor vehicle to Defendant, TYLER BAKER's care, custody and operation; (b) Failing to take reasonable precautions to prevent Defendant, TYLER BAKER, from driving her motor vehicle at a time when Defendant, CAROLYN BAKER, knew or should have known that Defendant, TYLER BAKER, was incapable of operating said motor vehicle safely; (c) Failing to take reasonable precautions to prevent Defendant, TYLER BAKER, from driving her motor vehicle at a time when Defendant, CAROLYN BAKER, knew or should have known of the repeated reckless and negligent course of conduct of Defendant, TYLER BAKER, which conduct would create an unreasonable risk of harm to others; and (d) Failing to take reasonable precautions to prevent Defendant, TYLER BAKER, from driving her motor vehicle at a time when Defendant, CAROLYN BAKER, knew or should have known that Defendant, TYLER BAKER, was under the influence of an illegal and/or controlled substance, which conduct would create an unreasonable risk of harm to others. 27. As a direct and proximate result of the negligence, carelessness and recklessness of Defendant, CAROLYN BAKER, as described above, Plaintiff, BRITTANY ROTANZ, was caused to suffer severe and permanent personal injuries as more fully described above. WHEREFORE, Plaintiff, BRITTANY ROTANZ, demands judgment against the Defendant, CAROLYN BAKER, in an amount in excess of Fifty Thousand ($50,000.00) Dollars, plus punitive damages, interest and costs. Dated: 1°1 3 f �{ Respectfully submitted: VERIFICATION BRI1 I ANY ROTANZ, verifies that the statements made in this Pleading are true and correct. Verifier uriderstands that false statements herein are made subject to the penalties of 18 Pa. C.S. §4904, relating to unsworn falsifications to authorities. Dated: / O/ Exhibit A mcident Number: H02-2160769 Crash Involves: Dui Q Fatality 0. Hit and Run °Commercial Vehicle 0 NIA 0 Work Zone 0 ATV ()Snowmobile ••••••• mmmmmm • 1,111,.. %/S./ 1111.111 • 'V • 'or • •• • ._J v., woo, Police Crash Report REPORTABLE CRASH State Police Vehicle 0. Commonwealth Vehicle 0 Local Police venicie 0 Local Gov Vehicle j a J.. u, a 4 3 a Agency Name PA STATE POLICE - CHAMBERSBURG Case Closed. YES Patrol Zone 21 Investigation Date 12/03/2012 DiSpatch Time 21:13 hre. Arrival Time 2113 nis Investigator GROTE, ALEX Badge Number 11033 Approval Date 12/17/2012 Reviewer FINKLE, CRAIG R Reviewer Bodge Number 07990 Crash Data Date of Crash 12/03/2012 Time of Crash 21:13 hrs, Day of the Week MONDAY Crash Description NEAP ON County CUMBERLAND Municipality SHIPPENSBURG TWP weather ConditiOnSRelation ' NO ADVERSE CONDITIONS to Roadway ON TRAVEL LANES IlluminatiOn DARK -STREET LIGHTS Road Surface Conditions DRY U or Units 002 ... sr or People pp, if. of Injured II NIleci EMS Agency SHIPPENSBURG EMS. ' Medical Facility CHAM.B,EFERI.JR.GHOSPITAL,___ , Schdol Bus Related NO „..90.;:..... School NO . Zone Related .000 n PennDOT NO Notified ;. ,___ .... _„„__._.__ ..___ Type of Intersection MIDBLOCK .., Special Location NOT APPLICABLE a) 0 c N Work Zone NO Work Zone Type Where in Work Zone Speed Limit Wo kers Present Officer Present Work Zone Characteristics Road Closed Work on Shoulder Lane Closure with Detour or Median Intermittent or Li Moving Work Flogger control °tar 7 id ..9• ic a. Rout ra Signing COUNTY ROAD Route Number 0000 Segment Number Travel Lanes 02 Speed Limit 35 MPH Orientation WEST Howie Number Street Name WALNUT BOTTOM , St. Ending ROAD .6 te i Used in Intersection Crashes Route Signing Route Number Segment Number Travel Lanes Speed Limit Orientation Street Name • St. Ending E -0 5 E E 0 i .52 0 Used for Mid -Block Crashes Landmark 1. Route Number Or Mile Post Tenths Or Segment Marker Ramp Use Only Feet Street Name AIRPORT Street Eindrng ROAD Or Miles 00 Tenths 2 eii .1 Route Number Or Mile Post Tenths Or Segment Marker Ramp Use Only The above entry is the distance from the Crash Scene to Landmark 1 Street Name ORANGE Street Ending STREET tn e 0 Latitude: Degrees 40 Minutes 03 • . Simonds 31 • 0Q0irTI01 951 Longitude: Degrees 77 Minutes 29 • ., Seconds 59 . Decimal 086 ca (-) i— Trarfic Control Device NOT APPLICABLE Traffic Control Functioning NO CONTROLS e Lane Cloaed FULLY Lane Closure Direction EAST AND WEST • Traffic Detoured YES Estimated Time Closed < 30 MIN. Event information Environmental (Roadway Potential Factors (E/R) Factor I NONE Factor 2 Factor First Harmful Event In the Crash Most Harmful Ev ntln the Crash Unit, Number 001 Harniful Event HIT UNIT 2. Unit Number 001 'Harmful Event HIT UNIT 2 Indicated Prime Factor DRIVER ACTION . Unit Number 001 Prime Factor Driver Action OTHER IMPROPER DRIVING ACTIONS Prime Factor EnvIromental/Roadway Prime Factor Vehicle Failure Prime Factor Pedestrian AcilOn Road Surface Type Speci I Jurisdiction Printed Al: PA STATE POLICE - CHAMBERSBURG 1/7/2013 12:49 PM Form Si HO2-2168759 Incident Number: Crash Involves: H02-2168769 UI 0 N/A Fatality Work Zone Commonwealth of Pennsylvania Police Crash Report Hit and Run 0 ATV ()Commercial Vehicle ()Snowmobile REPORTABLE CRASH 0 State Police vehicle 0 Commonwealth Vehicle PAGE 2 II Police Vehicle r Local Gov Vehicle Driver/Petiostrlan Information Unit Number 1 Type Unit Motor Vehicle In Transport Commercial Vehicle No First Name TYLER MI J Last Name BAKER Suffix DOB 04/18/1993 Telephone Number Street Address 12 FAIRFIELD ST City NEWV1LLE state PA Zip Code 17241 Gender M License Number 30029177 License State PA Class C Expiration Date 04/19/2013 Owner/Driver PRIVATE VEHICLE NOT OWNED/LEASED BY DRIVER Driver Presence DRIVER OPERATED VEHICLE Physical Condition ILLEGAL DRUG USE Primary Vehicle Code Violation 3309 Person Charged YES Alcohol/Drugs Suspected ILLEGAL DRUGS Alcohol Tel Type TEST NOT GIVEN Alcohol Teat Results, Driver Action OTHER IMPROPER DRIVING ACTIONS Pedestrian Action Pedestrian Signals Pedestrian Clothing Pedestrian Location .. ' HIT UNIT 2 Lee or Riglit'Slae--. " MOSt.1-1-arinn-.11--v- YES Utilify—r5Ole.14uMber ' ,. ..... . ..... .._ .,.. 2nd IlarrafUl Event Left or Right Side Most Harritfui Utility Pole Number rd Harmful Event Left or Right Side Most HarMfUl Utility Pole Number 4th Harmful Event I eft or Right Side Most Harmful Utility Pole Number 0 t c 2 u = Owner First Name CAROLYN Owner LII J Owner Lest Nemo or Business Name BAKER Suffix Street Address 12 FAIRFIELD ST. . City NEWVILLE State PA Zip Code 17241 Vehicle Type AUTOMOBILE Special Usage NOT APPLICABLE Government Equipment Number Model Year 1999 Vehicle Make MAZDA. Vehicle Model UNK Vehicle Color UNKNOWN VIN JM1BJ2213X0147690 License Plate HYF6589 Reg. State PA Est, Speed 045 Velicle Towed YES Towed By CDC TOWING insurance NO Insurance Company Policy Number Expiration Date Direction of Travel WEST vehicle Position OTHER Vehicle Movement GOING STRAIGHT Initial impact Point 11 O'CLOCK Damage Indicator DISABLING Gradient LEVEL Road Alignment STRAIGHT Possible Vehicle Failures NONE ._ E /A Of Units 0 Type Unit1 Tag Number Tag Year Tag State Unit Make Unit Owner Type Unit 2 Tag Number Tag Year Tag State Unit Make . Unit Owner = 16): .9 oi U Engine Size cc Passenger? Saddle Bag/Trunk? Trailer? Driver Education? Driver Helmet Type Hehhei Stayed On? DOT/Snell Designation? Eye Protection? Long Sleeves? Long Pantx? Over Pinkie Boots? Passenger Helmet Type Helmet Stayed On? DOT/Snell Designation? ByeProtection? Long Sleeves? Long Pants? Over Ankle Boots? Lo Passenger? Helmet? Head Lights? Rear Reflectors? Printed At: PA STATE POLICE - CHAMBERSBURG 1/7/2013 12:49 PM 2 Perm 1-102.2168759 nus-c_r on/ no Crash Involves: • DUI 0 N/A 0 Fatality ° Work Zone Police Crash Report 0 Hit and Run 0 ATV °Commercial Vehicle 0 Snowmobile REPORTABLE CRASH State Police Vehicle 0 Commonwealth Vehicle 0, Local Ponce vehicle aLocal Gov Vehicle DiiverlPedestrian Information Unit Number 2 Type Unit Motor Vehicle In Transport Commercial Vehicle No Suffix First Name BRITTANY MI N Last Name ROTANZ Suffix DOB 12/02/1992 Telephone Number Government Equipment Number Street Address 351 WALTER RD City CHALFONT State PA Zip Code 18914 VAN 2T1AE04B7SC065423 Gender F License Number 30088443 Licence State PA elate C Expiration Dote 12/03/2013 Owner/Driver PRIVATE VEHICLE OWNED/LEASED BY DRIVER Insurance Company NATIONWIDE Driver Presence DRIVER OPERATED VEHICLE Physical Condition APPARENTLY NORMAL Primary Vehicle Code Violation NONE Person Charged NO Vehicle Movement GOING STRAIGHT Alcohol/Drugs Suspected NO Alcohol Teat Type TEST NOT GIVEN Alcohol Test Results Rosd Alignment STRAIGHT Driver Action NO CONTRIBUTING ACTION Trailing Units I Pedestrian Action Pedestrian Signals Pedestrian Clothing Pedestrian Location Tag State 1rJJ3accefuLEArea#......_:.._,_ ..... -. ----., , ..., STRUCK BY UNIT 1 Left.or-Ri9ht.Side. Mos Harmful !Jtility.-Pole-Number--.-. YES ._ . .--.... _-_...:._..... 2nd Harmful Event Left or Right Side Most Harmful Utility Pole Number Engine Size cc 3rd Harmful Event Left or Right Side Most Harmful Utility Pole Number Driver Helmet Type 41h Harmful Event Left or Right Side Most Harmful Utility Pole Number Long Pants? • c 0 a Owner First Name BRITTANY Owner MI N Owner Last Nam& or Business Name ROTANZ Suffix Street Address 351 WALTER RD City CHALFONT • State PA Zip Code 18914 Vehicle Type AUTOMOBILE Special Usage NOT APPLICABLE Government Equipment Number Modal Year 1995 Vehicle Make TOYOTA Vehicle Model UNK Vehicle Color UNKNOWN VAN 2T1AE04B7SC065423 License Plate HHF8334 Reg. State PA Eat. Speed 045 Veh cle Towed YES Towed By CDC TOWING Insurance YES Insurance Company NATIONWIDE Policy Number 837E152879 Expiration Date 03/06/2013 Direction of Travel EAST Vehicle Position RIGHT LANE "CURB" Vehicle Movement GOING STRAIGHT Initial Impact Point 11 O'CLOCK Damage Indicator DISABLING Gradient LEVEL Rosd Alignment STRAIGHT Possible Vehicle Failures NONE Trailing Units I # of Units 0 Type Unit 1 Tag Number Tag Year Tag State Unit Make Unit Owner Type Unit 2 Tag Number Tag Year Tag State Unit Make Unit Owner m v A 2 Engine Size cc Passenger? Saddle Beg/Trunk.? Trailer? Driver Education? Driver Helmet Type Helmet Stayed On? DOT/Snell Designation? Eye Protection? Long Sleeves? Long Pants? • Over Ankle Boots? Passenger Helmet Type Helmet Stayed On? DOT/Snell Designation? Eye Protection? Long Sleeves? Long Pants? Over Ankle Boots? d T u 4 o. Passenger? Helmet? Head Lights? Rear Reflectors? Printed At: pA STATE POLICE - CHAMBERSBURG 1/7/2013 12:49 PM 3 Form # NO2-2168769 Incident Number: H02.2168769 Crash Involves: DUI NfA 0 Fatality 0 Work Zone vv111111uIIweQltn yr rC1111ylvs,Uil2t Police Crash Report 0 Hit and Run ATv Q:Commercial Vehicle Snowmobile REPORTABLE CRASH 0 State Police Vehicle Commonwealth Vehicle PAGE 4 Local Police Vehicle 0 Local Gov Vehicle LPeople InformalBon 1 Unit 0 001 Person No. 001 First Name TYLER MI J Last Name BAKER Suffix DOB 0411811993 Street Add ess 12 FAIRFIELD ST City NEWvfLLE State PA Zip Code 17241 Phone Number EMS Transport NO Person Type DRIVER Gender M Injury Savcrity MINOR INJURY Seat Positton DRIVER - ALL VEHICLES Safety Equipment 1 UNKNOWN Safety Equipment 2 UNKNOWN Extrication NOT EXTRICATED Ejection NOT EJECTED Ejection Path NOT EJECTED/NOT APPLICABLE People krformadon Unittt 001 Person No. 002 First Name TIMOTHY MI J Last Name ARMOLT Suffix DOB 06/07/1990 Street Address City .PLAINFIELO-................_ ...,....-._...... _... - .. State . PA. Zip Code -17084 . Phone Number EMS Transport NO Person Type PASSENGER Gender M Injury Severity NOT INJURED Seat Position FRONT SEAT RIGHT SIDE Safety Equipment 1 UNKNOWN Safety Equipment 2 UNKNOWN Extrication NOT EXTRICATED Ejection NOT EJECTED Ejection Path NOT EJECTED/NOT APPLICABLE pPhone ; o k Unit # 002 Peron No. 003 First Name BRITTANY MI N Last Name ROTANZ Suffix D08 12/02/1992 Street Md ess 331 WALTER RD City CHALFONT State PA Zip Code 16914 Number EMS Transport YES Person Type DRIVER Gender F Injury Severity MODERATE INJURY Scat Position DRIVER - ALL VEHICLES Safety Equipment 1 LAP AND SHOULDER BELT USED Safety Equipment 2 UNKNOWN Extrication FREED BY NON-MECHANICAL MEANS Eject9on NOT EJECTED twjeetion Path NOT EJECTED/NOT APPLICABLE m a_ z Person\Business Notified Phone Number Date Notified Time Notified hrs. Reason for Notification Printed At: PA STATE POLICE - CHAMBERSBURG 1/7/2013 12:49 PM 4 Form # H02-2163769 Incident Number Crash Involves H02-2168769 DUI 0 N/A t.,ommonweairn or rennsyivania Police Crash Report REPORTARLE CRASH 0 Fatality Hit and Run Work Zone 0 ATV °Commercial Vol, lore ()Snowmobile 0 State Felice Vehicle 0 Commonwealth Vehicle PAGE 5 Local Police Vehicle 0 Local Gov Vehicle ShippensbufgBco 1/2 Mite Unit It NARRATIVE Crash Synopsis In this crash, Unit#1 was traveling west on Walnut Bottom Rd, and Unit#2 was traveling east on Walnut Bottom Rd. Unit#1 then traveled across the double yellow line and struck Unit#2 head on. Crash Detelle In this crash, Unit#1 was traveling west on Walnut Bottom Rd, and Unit#2 was traveling east on Walnut Bottom Rd. Unit#1 then traveled across the double yellow line and struck Unit#2 head on. I was across a parking lot when this crash occurred. I heard the impact of the two vehicles, and arrived on scene approx 20 seconds after the impact was heard. Both vehicles were at final rest with the front ends of each vehicle still stuck together. Oper#1 was exiting his drivers side of the car upon my arrival. I asked him what had happened and why he crossed the line. Operit1 related that he was "messing" with a cd and a cigarette. Operator#2 was being attended to immediately by medical personnel, and was not interviewed there. Oper#2 was trapped inside the vehicle for approx 15 minutes and was later transported to Chambersburg Hospital. Both vehicles were towed by CDC towing. Refer to initial report H02-2168769 for further investigation regarding DUI. Printed At: PA STATE POLICE - ChIAMBERSOURG 11'7/2012. 12:40 PM ' Form # H02 -21E8765/ Exhibit B Cumberland County Court of Common Pleas Court Summary Baker, Tyler John Newville, PA 17241 Aliases: Tyler J. Baker Closed Cumberland CP -21 -CR -0001034-2012 DOB: 04/18/1993 Proc Status: Awaiting Payment Sex: Male Eyes: Brown Hair: Brown Race: White DC No: OTN:T1494080 Arrest Dt: Disp Date: 03/29/2012 Disp Judge: Cohick, Vivian J. Def Atty: Jividen, Jacob M. - (PR) Seq No Statute Grade Description Disposition 1 35 § 780-113 M Use/Poss Of Drug Paraph Guilty Plea (Lower Court) CP -21 -CR -0001035-2012 Proc Status: Awaiting Payment DC No: OTN:T1540221 Arrest Dt: Disp Date: 03/29/2012 Disp Judge: Cohick, Vivian J. Seq No Statute Grade Description Disposition 1 18 § 3304 M3 Criminal Mischief - Damage Property Guilty Plea (Lower Court) 2 18 § 3304 M3 Criminal. Mischief - Damage Property Guilty Plea (Lower Court) CP -21 -CR -0002906-2012 Proc Status: Sentenced/Penalty Imposed DC No: Arrest Dt: Disp Date: 05/10/2013 Disp Judge: Placey, Thomas A. Seq No Statute Grade Description Disposition Sentence Dt. Sentence Type Program Period Sentence Length - 1 35 § 780-113 M Marijuana -Small Amt Personal Use Guilty Plea 05/10/2013 No Further Penalty 2 75 § 4107 S Oper/Perm Op W/Unsafe Eqmt/ Dismissed. 3 75 § 4524 S Improp Sunscreening Dismissed CP -21 -CR -0003409-2012 Proc Status: Sentenced/Penalty Imposed DC No: Arrest Dt: Disp Date: 05/10/2013 Disp Judge: Placey, Thomas A. Seq No Statute Grade Description Disposition Sentence Dt. Sentence Type Program Period Sentence Length 1 35 § 780-113 M Marijuana -Small Amt Personal Use Guilty Plea 05/10/2013 No Further Penalty 2 35 § 780-113 M Use/Poss Of Drug Paraph Dismissed 3 35 § 780-113 M Use/Poss Of Drug Paraph Dismissed 4 35 § 780-113 M Use/Poss Of Drug Paraph Dismissed CP -21 -CR -0001378-2013 Arrest Dt: Proc Status: Sentenced/Penalty Imposed DC No: Disp Date: 11/20/2013 Disp Judge: Placey, Thomas A. Def Atty: Volpi, Nathan Camille - (PR) Seq No Statute Grade Description Sentence Dt. Sentence Type Program Period Sentence Length Disposition OTN:T1,990505 OTN:T2427596 OTN:L7493673 CPCMS 3541 1 Printed: 10/24/2014 1:01 PM Recent entries made in the court filing offices may not be immediately reflected on the court summary report. Neither the courts of the Unified Judicial System of the Commonwealth of Pennsylvania nor the Administrative Office of Pennsylvania Courts assume any liability for inaccurate or delayed data, errors or omissions on these reports. Court Summary Report information should not be used in place of a criminal history background check which can only be provided by the Pennsylvania State Police. Moreover an employer who does not comply with the provisions of the Criminal History Record Information Act may be subject to civil liability as set forth in 18 Pa.C.S. Section 9183. Please note that if the offense disposition information is blank, this only means that there is not a "final disposition" recorded in the Common Pleas Criminal Court Case Management System for this offense. In such an instance, you must view the public web docket sheet of the case wherein the offense is charged in order to determine what the most up-to-date disposition information is for the offense. 4) Cumberland County Court of Common Pleas Court Summary Baker, Tyler John (Continued) Closed (Continued) Cumberland (Continued) Seq No Statute Grade Description Disposition Sentence Dt. Sentence Type Program Period Sentence Length 1 75 § 3735.1 F2 Aggravated Assault By Vehicle While Guilty Plea Dui 02/18/2014 Probation Supervised Min: 50 Month(s) Max: 50 Month(s) 02/18/2014 Confinement Other Min: 5 Month(s) Max: 10 Month(s) 2 75 § 3802 M1 DUI: Controlled Substance - Dismissed Schedule I - 2nd Offense 3 75 § 3802 M1 DUI: Controlled Substance - Guilty Plea Impaired Ability - 2nd Offense 02/18/2014 Confinement Other Min: 90 Day(s) Max: 180 Day(s) 02/18/2014 Probation Supervised Min: 54 Month(s) Max: 54 Month(s) 4 75 § 3309 S Disregard Traffic Lane (Single) Dismissed 5 75 § 3714 S Careless Driving Dismissed 6 75 § 3736 S Reckless Driving Dismissed 99999 75 § 3802 M DUI: Controlled Substance - Charge Changed Schedule 1 - 1st Offense 99999 75 § 3802 M DUI: Controlled Substance - Charge Changed Impaired Ability - 1st Offense CP -21 -CR -0001577-2013 Proc Status: Awaiting Payment DC No: OTN:T3317462 Arrest Dt: Disp Date: 06/05/2013 Disp Judge: Day, Susan K. Seq No Statute Grade Description Disposition 1 35 § 780-113 M Marijuana -Small Amt Personal Use Dismissed (Lower Court) 2 35 § 780-113 M Use/Poss Of Drug Paraph Guilty Plea (Lower Court) CP -21 -MD -0000262-2012 Proc Status: Completed DC No: OTN:T1494080 Arrest Dt: Disp Date: Disp Judge: •CPCMS 3541 2 Printed: 10/24/2014 1:01 PM Recent entries made in the court filing offices may not be immediately reflected on the court summary report. Neither the courts of the Unified Judicial System of the Commonwealth of Pennsylvania nor the Administrative Office of Pennsylvania Courts assume any liability for inaccurate or delayed data, errors or omissions on these reports. Court Summary Report information should not be used in place of a criminal history background check which can only be provided by the Pennsylvania State Police. Moreover an employer who does not comply with the provisions of the Criminal History Record Information Act may be subject to civil liability as set forth in 18 Pa.C.S. Section 9183. Please note that if the offense disposition information is blank, this only means that there is not a "final disposition" recorded in the Common Pleas Criminal Court Case Management System for this offense. In such an instance, you must view the public web docket sheet of the case wherein the offense is charged in order to determine what the most up-to-date disposition information is for the offense. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ v. TYLER BAKER and CAROLYN BAKER, Plaintiff, : No: 14-4399 Defendants. van's,: : JURY TRIAL DEMANDED: PRAECIPE FOR RULE TO FILE COMPLAINT TO THE PROTHONOTARY: Please issue a Rule upon Plaintiff, Brittany Rotanz, in the above -captioned matter to file a Complaint against Defendants, Tyler Baker and Carolyn Baker, within twenty (20) days of the Rule or suffer a judgment of non pros. F ANAGA d DIBERNARDO, LLP By: isa M. DiBernardo, Esquire I.D. No. 56684 150 East Chestnut Street Lancaster, PA 17602 (717) 397-9444 Attorney for Defendants, Tyler Baker and Carolyn Baker RULE AND NOW this (D day of Iv tv • , 2014, a Rule is issued upon Plaintiff, Brittany Rotanz, to File a Complaint against Defendants, Tyler Baker and Carolyn Baker, within twenty (20) days or suffer a judgment of non pros. 1 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ v. TYLER BAKER and CAROLYN BAKER, On this Plaintiff, : No: 14-4399 Defendants. : JURY TRIAL DEMANDED CERTIFICATE OF SERVICE day of , 2014, I, Lisa M. DiBernardo, Esquire do herebycertify that I served a true and correct copy of Praecipe for Rule to File Complaint, upon the following and in the manner indicated below. Service was made by First Class Mail, addressed as follows: DATE: Fred Karpf, Esquire Hoffman, Michels & Sternberg, LLC 737 Second Street Pike Southampton, PA 18966 Attorney for Plaintiff, Tiffany Rotanz By: 2 FL¢,NAGAN and DIBERNARDO, LLP Lisa M. DiBernardo, Esquire ' I.D. No. 56684 150 East Chestnut Street Lancaster, PA 17602 (717) 397-9444 Attorney for Defendants, Tyler Baker and Carolyn Baker FREDRIC S. KARPF, ESQUIRE HOFFMAN, MICHELS & STERNBERG, LLC 737 SECOND STREET PIKE SOUTHAMPTON, PA 18966 (215) 953-8955 IDENTIFICATION NO. 76294 BRITTANY ROTANZ vs. TYLER BAKER and CAROLYN BAKER C, .: •.. F D COM ;: 3 ATTORNEYFOR' PLAINTIFF COURT OF COMMON PLEAS CUMBERLAND COUNTY LAW DIVISION NO: 14-4399 CERTIFICATION OF SERVICE I do hereby certify that I have served a time -stamped copy of the Notice to Defend and Complaint upon Counsel for the Defendant, Lisa M. DiBernardo, Esquire, Flanagan and DiBernardo, LLP, 150 E Chestnut Street, Lancaster, PA 17602-2741 by First Class Mail on November 6, 2014. Sworn to and Subscribed before me this 1st day of December, 2014 Notary Public ate, COMMONWEALTH OF PENNSYLVANIA Notarial Seal Shirley Ann Wood, Notary Public Upper Southampton Twp., Bucks County My Commission Expires May 10, 2015 MEMBER, PENNSYLVANIA ASSOCIATION Cl' NOTAIES Sistine Minguez FLANAGAN and DiBERNARDO, LLP BY: LISA M. DIBERNARDO, Esquire I.D. No. 56684 150 East Chestnut Street Lancaster, PA 17602 (717) 397-9444 Attorne'ys'for Defendants, Tyler Baker and Carolyn Baker No: 14-4399 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ v. TYLER BAKER and CAROLYN BAKER, Plaintiff, : No: 14-4399 Defendants. : JURY TRIAL DEMANDED CERTIFICATE PREREQUISITE TO SERVICE OF SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of subpoena for documents and things pursuant to Rule 4009.22, Defendants, Tyler Baker and Carolyn Baker, certifies that: (1) a Notice of Intent to Serve Subpoena with a copy of the subpoena(s) attached thereto was mailed or delivered to each party at least 20 days prior to the date on which the subpoena(s) is sought to be served (a copy of the Notice of Intent to Serve Subpoena served on December 2, 2014, is attached as Exhibit "A"). A letter signed and dated on December 4, 2014, by Plaintiff counsel is considered a waiver of 20 days and no objection to the service of the Subpoenas, (a copy is attached as Exhibit B). (2) no objection to the subpoena(s) has been received; and (3) the subpoena(s) which will be served is identical to the subpoena(s) which is attached to the Notice of Intent to Serve Subpoena. Date: 12/08/2014 By: FLANAGAN and DiBERNARDO, LLP Lk a( JD Lisa M. DiBernardo, Esquire _l Attorney I.D. No. 56684 �o Attorney for the Defendants ,, No: 14-4399 FLANAGAN and DiBERNARDO, LLP BY: LISA M. DIBERNARDO, Esquire I.D. No. 56684 150 East Chestnut Street Lancaster, PA 17602 (717) 397-9444 Attorneys for Defendants, Tyler Baker and Carolyn Baker IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ v. TYLER BAKER and CAROLYN BAKER, Plaintiff, : No: 14-4399 Defendants. : JURY TRIAL DEMANDED NOTICE OF INTENT TO SERVE SUBPOENAS TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO Pa.R.C.P. 4009.21 TO: Fred Karpf, Esquire Hoffman, Michels & Sternberg, LLC 737 Second Street Pike Southampton, PA 18966 Attorney for Plaintiff YOU ARE HEREBY notified that Defendants, Tyler Baker and Carolyn Baker, intend to serve a subpoena identical to the one that is attached to this Notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned counsel for serving party an objection to the subpoena. If no objection is made, the subpoena may be served. DATE: 12/02/2014 FLANAGAN and DiBERNARDO, LLP By: k -15q DZerr-D--1Zn Lisa M. DiBernardo, Esquire I.D. No. 56684 Attorney for Defendants r)11----- • COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399. V. TYLER BAKER and CAROLYN BAKER, Defendants. JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO, RULE 4009.22 TO: Chambersburg Hospital Attention: Custodian of Records 112 North 7th Street Chambersburg, PA 17201 Within twenty (20) days after service of this subpoena, you are ordered by the Court to produce the following documents or things: A copy of the entire medical records file, including but not limited to, patient histories, questionnaires, intake forms, progress notes, nurses' notes, office notes, evaluations, assessments, medical/consultation reports, statements of diagnosis/prognosis, reports of diagnostic testing, reports of diagnostic films, physical therapy records, chiropractic records, memoranda, and correspondence, concerning Brittany Rotanz (D.O.B.:12/02/1992) for all dates of treatment and services rendered from 12/02/1992 to the present. At: Flanagan and DiBemardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the Certificate of Compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a Court Order compelling you to comply with it. This subpoena was issued at the request of the following person: Name: Address: Telephone: Supreme Court ID #: Attorney for: (SEAL) Lisa M. DiBemardo, Esquire Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 (717) 397-9444 56684 Defendants WITNESS the Honorable Kevin A. Hess President Judge, at Carlisle, the day of A.D., CLERK OF COURTS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 v. TYLER BAKER and CAROLYN BAKER, Defendants. NOTICE TO: Chambersburg Hospital Attention: Custodian of Records 112 North 7th Street Chambersburg, PA 17201 : JURY TRIAL DEMANDED You are required to complete the following Certificate of Compliance when producing documents and/or things pursuant to the Subpoena. CERTIFICATE OF COMPLIANCE WITH SUBPOENA TO PRODUCE DOCUMENTS OR THINGS PURSUANT TO RULE 4009.23 certify to the best of my knowledge, information and belief that: (1) All documents and/or things required to be produced pursuant to the subpoena issued on (Date of Subpoena) have been produced. Date: --OR--- Signature (2) Documents and/or things have not been produced pursuant to the subpoena issued on (Date of Subpoena) due to: (check one) After thorough investigation, this facility is not in possession of documents regarding the individual. After thorough investigation, this facility does not have the specific documents/dates in the files. This facility purges documents after years. The documents are in possession of: Other (please specify): Date: Signature COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. : JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Richards Orthopaedic Center Sports Medicine Attention: Custodian of Records 144 South 8th Street, Suite 107 Chambersburg, PA 17201 Within twenty (20) days after service of this subpoena, you are ordered by the Court to produce the following documents or things: A copy of the entire medical records file, including but not limited to, patient histories, questionnaires, intake forms, progress notes, nurses' notes, office notes, evaluations, assessments, medical/consultation reports, statements of diagnosis/prognosis, reports of diagnostic testing, reports of diagnostic films, physical therapy records, chiropractic records, memoranda, and correspondence, concerning Brittany Rotanz (D.O.B.:12/02/1992) for all dates of treatment and services rendered from 12/02/1992 to the present. At: Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the Certificate of Compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a Court Order compelling you to comply with it. This subpoena was issued at the request of the following person: Name: Address: Telephone: Supreme Court ID #: Attorney for: (SEAL) Lisa M. DiBernardo, Esquire Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 (717) 397-9444 56684 Defendants WITNESS the Honorable Kevin A. Hess President Judge, at Carlisle, the day of A.D., CLERK OF COURTS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. NOTICE TO: Richards Orthopaedic Center Sports Medicine Attention: Custodian of Records 144 South 8th Street, Suite 107 Chambersburg, PA 17201 : JURY TRIAL DEMANDED You are required to complete the following Certificate of Compliance when producing documents and/or things pursuant to the Subpoena. CERTIFICATE OF COMPLIANCE WITH SUBPOENA TO PRODUCE DOCUMENTS OR THINGS PURSUANT TO RULE 4009.23 , certify to the best of my knowledge, information and belief that: (1) All documents and/or things required to be produced pursuant to the subpoena issued on (Date of Subpoena) have been produced. Date: OR -- Signature (2) Documents and/or things have not been produced pursuant to the subpoena issued on (Date of Subpoena) due to: (check one) After thorough investigation, this facility is not in possession of documents regarding the individual. After thorough investigation, this facility does not have the specific documents/dates in the files. This facility purges documents after years. The documents are in possession of: Other (please specify): Date: Signature COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. : JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Kole Plastic Surgery Center Attention: Custodian of Records 1003 Street Road Southampton PA 18966 Within twenty (20) days after service of this subpoena, you are ordered by the Court to produce the following documents or things: A copy of the entire medical records file, including but not limited to, patient histories, questionnaires, intake forms, progress notes, nurses' notes, office notes, evaluations, assessments, medical/consultation reports, statements of diagnosis/prognosis, reports of diagnostic testing, reports of diagnostic films, physical therapy records, chiropractic records, memoranda, and correspondence, concerning Brittany Rotanz (D.O.B.:12/02/1992) for all dates of treatment and services rendered from 12/02/1992 to the present. At: Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the Certificate of Compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a Court Order compelling you to comply with it. This subpoena was issued at the request of the following person: Name: Address: Telephone: Supreme Court ID #: Attorney for: (SEAL) Lisa M. DiBernardo, Esquire Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 (717) 397-9444 56684 Defendants WITNESS the Honorable Kevin A. Hess President Judge, at Carlisle, the day of A.D., CLERK OF COURTS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. NOTICE TO: Kole Plastic Surgery Center Attention: Custodian of Records 1003 Street Road Southampton PA 18966 JURY TRIAL DEMANDED You are required to complete the following Certificate of Compliance when producing documents and/or things pursuant to the Subpoena. CERTIFICATE OF COMPLIANCE WITH SUBPOENA TO PRODUCE DOCUMENTS OR THINGS PURSUANT TO RULE 4009.23 , certify to the best of my knowledge, information and belief that: (1) All documents and/or things required to be produced pursuant to the subpoena issued on (Date of Subpoena) have been produced. Date: --- OR --- Signature (2) Documents and/or things have not been produced pursuant to the subpoena issued on (Date of Subpoena) due to: (check one) After thorough investigation, this facility is not in possession of documents regarding the individual. After thorough investigation, this facility does not have the specific documents/dates in the files. This facility purges documents after years. The documents are in possession of: Other (please specify): Date: Signature COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. : JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Chalfont Family Practice Attention: Custodian of Records 65 East Butler Avenue, Suite 201 Doylestown PA 18901 Within twenty (20) days after service of this subpoena, you are ordered by the Court to produce the following documents or things: A copy of the entire medical records file, including but not limited to, patient histories, questionnaires, intake forms, progress notes, nurses' notes, office notes, evaluations, assessments, medical/consultation reports, statements of diagnosis/prognosis, reports of diagnostic testing, reports of diagnostic films, physical therapy records, chiropractic records, memoranda, and correspondence, concerning Brittany Rotanz (D.O.B.:12/02/1992) for all dates of treatment and services rendered from 12/02/1992 to the present. At: Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the Certificate of Compliance, to the party making this request at the address listed above. You have the right to, seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a Court Order compelling you to comply with it. This subpoena was issued at the request of the following person: Name: Address: Telephone: Supreme Court ID #: Attorney for: (SEAL) Lisa M. DiBemardo, Esquire Flanagan and DiBemardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 (717) 397-9444 56684 Defendants WITNESS the Honorable Kevin A. Hess President Judge, at Carlisle, the day of . A.D., CLERK OF COURTS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 v. TYLER BAKER and CAROLYN BAKER, Defendants. NOTICE TO: Chalfont Family Practice Attention: Custodian of Records 65 East Butler Avenue, Suite 201 Doylestown PA 18901 : JURY TRIAL DEMANDED You are required to complete the following Certificate of Compliance when producing documents and/or things pursuant to the Subpoena. CERTIFICATE OF COMPLIANCE WITH SUBPOENA TO PRODUCE DOCUMENTS OR THINGS PURSUANT TO RULE 4009.23 , certify to the best of my knowledge, information and belief that: (1) All documents and/or things required to be produced pursuant to the subpoena issued on (Date of Subpoena) have been produced. Date: OR --- Signature (2) Documents and/or things have not been produced pursuant to the subpoena issued on (Date of Subpoena) due to: (check one) After thorough investigation, this facility is not in possession of documents regarding the individual. After thorough investigation, this facility does not have the specific documents/dates in the files. This facility purges documents after years. The documents are in possession of: Other (please specify): Date: Signature COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, • No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. • JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Shippensburg Physical Therapy Attention: Custodian of Records 200 S. Fayette Street, Suite 101 Shippensburg PA 17257 Within twenty (20) days after service of this subpoena, you are ordered by the Court to produce the following documents or things: A copy of the entire medical records file, including but not limited to, patient histories, questionnaires, intake forms, progress notes, nurses' notes, office notes, evaluations, assessments, medical/consultation reports, statements of diagnosis/prognosis, reports of diagnostic testing, reports of diagnostic films, physical therapy records, chiropractic records, memoranda, and correspondence, concerning Brittany Rotanz (D.O.B.:12/02/1992) for all dates of treatment and services rendered from 12/02/1992 to the present. At: Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the Certificate of Compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a. Court Order compelling you to comply with it. This subpoena was issued at the request of the following person: Name: Address: Telephone: Supreme Court ID #: Attorney for: (SEAL) Lisa M. DiBernardo, Esquire Flanagan and DiBemardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 (717) 397-9444 56684 Defendants WITNESS the Honorable Kevin A. Hess President Judge, at Carlisle, the day of A.D., CLERK OF COURTS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 v. TYLER BAKER and CAROLYN BAKER, Defendants. NOTICE TO: Shippensburg Physical Therapy Attention: Custodian of Records 200 S. Fayette Street, Suite 101 Shippensburg PA 17257 JURY TRIAL DEMANDED You are required to complete the following Certificate of Compliance when producing documents and/or things pursuant to the Subpoena. CERTIFICATE OF COMPLIANCE WITH SUBPOENA TO PRODUCE DOCUMENTS OR THINGS PURSUANT TO RULE 4009.23 , certify to the best of my knowledge, information and belief that: (1) All documents and/or things required to be produced pursuant to the subpoena issued on (Date of Subpoena) have been produced. Date: OR - Signature (2) Documents and/or things have not been produced pursuant to the subpoena issued on (Date of Subpoena) due to: (check one) After thorough investigation, this facility is not in possession of documents regarding the individual. After thorough investigation, this facility does not have the specific documents/dates in the files. This facility purges documents after years. The documents are in possession of: Other (please specify): Date: Signature COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 v. TYLER BAKER and CAROLYN BAKER, Defendants. JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: West Shore EMS Attention: Custodian of Records 205 Grandview Avenue Camp Hill PA 17011 Within twenty (20) days after service of this subpoena, you are ordered by the Court to produce the following documents or things: A copy of the entire records file, including but not limited to, trip sheet(s), results of diagnostic testing, notes, memoranda, correspondence, any and all medical reports, and billing information concerning Brittany Rotanz (D.O.B.:12/02/1992), as a result of a motor vehicle accident that occurred on 12/03/2012. At: Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the Certificate of Compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a Court Order compelling you to comply with it. This subpoena was issued at the request of the following p.erson: Name: Address: Telephone: Supreme Court ID #: Attorney for: (SEAL) Lisa M. DiBernardo, Esquire Flanagan and DiBemardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 (717) 397-9444 56684 Defendants WITNESS the Honorable Kevin A. Hess President Judge, at Carlisle, the day of A.D., CLERK OF COURTS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. NOTICE TO: West Shore EMS Attention: Custodian of Records 205 Grandview Avenue Camp Hill PA 17011 JURY TRIAL DEMANDED You are required to complete the following Certificate of Compliance when producing documents and/or things pursuant to the Subpoena. CERTIFICATE OF COMPLIANCE WITH SUBPOENA TO PRODUCE DOCUMENTS OR THINGS PURSUANT TO RULE 4009.23 I, , certify to the best of my knowledge, information and belief that: (1) All documents and/or things required to be produced pursuant to the subpoena issued on (Date of Subpoena) have been produced. Date: -- OR - -- Signature (2) Documents and/or things have not been produced pursuant to the subpoena issued on (Date of Subpoena) due to: (check one) After thorough investigation, this facility is not in possession of documents regarding the individual. After thorough investigation, this facility does not have the specific documents/dates in the files. This facility purges documents after years. The documents are in possession of: Other (please specify): Date: Signature COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 v. TYLER BAKER and CAROLYN BAKER, Defendants. : JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Shippensburg EMS Attention: Custodian of Records 711 East Orange Street Shippensburg, PA 17257 Within twenty (20) days after service of this subpoena, you are ordered by the Court to produce the following documents or things: A copy of the entire records file, including but not limited to, trip sheet(s), results of diagnostic testing, notes, memoranda, correspondence, any and all medical reports, and billing information concerning Brittany Rotanz (D.O.B.:12/02/1992), as a result of a motor vehicle accident that occurred on 12103/2012. At: Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the Certificate of Compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a Court Order compelling you to comply with it. This subpoena was issued at the request of the following person: Name: Address: Telephone: Supreme Court ID #: Attorney for: (SEAL) Lisa M. DiBernardo, Esquire Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 (717) 397-9444 56684 Defendants WITNESS the Honorable Kevin A. Hess President Judge, at Carlisle, the day of A.D., CLERK OF COURTS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. NOTICE TO: Shippensburg EMS Attention: Custodian of Records 711 East Orange Street Shippensburg, PA 17257 JURY TRIAL DEMANDED You are required to complete the following Certificate of Compliance when producing documents and/or things pursuant to the Subpoena. CERTIFICATE OF COMPLIANCE WITH SUBPOENA TO PRODUCE DOCUMENTS OR THINGS PURSUANT TO RULE 4009.23 , certify to the best of my knowledge, information and belief that: (1) All documents and/or things required to be produced pursuant to the subpoena issued on (Date of Subpoena) have been produced. Date: --- OR --- Signature (2) Documents and/or things have not been produced pursuant to the subpoena issued on (Date of Subpoena) due to: (check one) After thorough investigation, this facility is not in possession of documents regarding the individual. After thorough investigation, this facility does not have the specific documents/dates in the files. This facility purges documents after years. The documents are in possession of: Other (please specify): Date: Signature COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. : JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: PA State Police Barracks Attention: Custodian of Records 679 Franklin Farm Lane Chambersburg PA 17202-3068 Within twenty (20) days after service of this subpoena, you are ordered by the Court to produce the following documents or things: Any and all records relating to the investigation of a motor vehicle accident which occurred on 12/03/2012, Incident No. H02-2168769; Investigated By State Police, Chambersburg, Investigator Alex Grote, including but not limited to, investigative reports, accident reports, measurements, accident reconstruction, supplemental reports, recorded statements, written statements, transcribed statements, notes, photographs, video, including further investigation regarding possible DUI, and/or other documentary materials. At: Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the Certificate of Compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a Court Order compelling you to comply with it. This subpoena was issued at the request of the following person: Name: Address: Telephone: Supreme Court ID #: Attorney for: (SEAL) Lisa M. DiBernardo, Esquire Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 (717) 397-9444 56684 Defendants WITNESS the Honorable Kevin A. Hess President Judge, at Carlisle, the day of A.D., CLERK OF COURTS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. NOTICE : JURY TRIAL DEMANDED TO: PA State Police Barracks Attention: Custodian of Records 679 Franklin Farm Lane Chambersburg PA 17202-3068 You are required to complete the following Certificate of Compliance when producing documents and/or things pursuant to the Subpoena. CERTIFICATE OF COMPLIANCE WITH SUBPOENA TO PRODUCE DOCUMENTS OR THINGS PURSUANT TO RULE 4009.23 , certify to the best of my knowledge, information and belief that: (1) All documents and/or things required to be produced pursuant to the subpoena issued on (Date of Subpoena) have been produced. Date: OR -- Signature (2) Documents and/or things have not been produced pursuant to the subpoena issued on (Date of Subpoena) due to: (check one) After thorough investigation, this facility is not in possession of documents regarding the individual. After thorough investigation, this facility does not have the specific documents/dates in the files. This facility purges documents after years. The documents are in possession of: Other (please specify): Date: Signature COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. : JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: ' Nationwide Insurance Attention: Custodian of Records 1000 Nationwide Drive Harrisburg .PA 17110 Within twenty (20) days after service of this subpoena, you are ordered by the Court to produce the following documents or things: All records referencing a first -party claim for benefits, or other benefits of any kind whatsoever, (including UM or UIM) made by or on behalf of Brittany Rotanz (D.O.B.:12/02/1992)„ as a result of an accident that occurred on 12/03/2012. This request is for all correspondence, notes, first -party payout sheets for medical expenses, medical records, wage Toss paid, wage and salary verification, peer review or IME reports or correspondence, a copy of the declaration page that was in effect on 12/03/2012, any photographs showing property damage to any vehicles involved inthe accident, any recorded statements or other accident investigation, any records relevant to claims made under any collision or liability coverage on the policy. At: Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the Certificate of Compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a Court Order compelling you to comply with it. This subpoena was issued at the request of the following person: Name: Address: Telephone: Supreme Court ID #: Attorney for: (SEAL) Lisa M. DiBernardo, Esquire Flanagan and DiBemardo,.LLP, 150 East Chestnut Street, Lancaster, PA 17602 (717) 397-9444 56684 Defendants WITNESS the Honorable Kevin A. Hess President Judge, at Carlisle, the day of A.D., CLERK OF COURTS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. NOTICE : JURY TRIAL DEMANDED TO: Nationwide Insurance Attention: Custodian of Records 1000 Nationwide Drive Harrisburg PA 17110 You are required to complete the following Certificate of Compliance when producing documents and/or things pursuant to the Subpoena. CERTIFICATE OF COMPLIANCE WITH SUBPOENA TO PRODUCE DOCUMENTS OR THINGS PURSUANT TO RULE 4009.23 , certify to the best of my knowledge, information and belief that: (1) All documents and/or things required to be produced pursuant to the subpoena issued on (Date of Subpoena) have been produced. Date: --- OR --- Signature (2) Documents and/or things have not been produced pursuant to the subpoena issued on (Date of Subpoena) due to: (check one) After thorough investigation, this facility is not in possession of documents regarding the individual. After thorough investigation, this facility does not have the specific documents/dates in the files. This facility purges documents after years. The documents are in possession of: Other (please specify): Date: Signature COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. : JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Shippensburg University Attention: Custodian of Records 1871 Old Main Drive Shippensburg, PA 17257 Within twenty (20) days after service of this subpoena, you are ordered by the Court to produce the following documents or things: A copy of the entire scholastic file concerning Brittany Rotanz (D.O.B.:12/02/1992), including but not limited to, transcripts, academic/educational reports, correspondence, attendance records, disciplinary records, notes/memorandums, evaluations, nurses' notes and/or medical records and any and all other records contained within the scholastic file concerning Brittany Rotanz (D.O.B.:12/02/1992). At: Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, • together with the Certificate of Compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a Court Order compelling you to comply with it. This subpoena was issued at the request of the following person: Name: Address: Telephone: Supreme Court ID #: Attorney for: (SEAL) Lisa M. DiBernardo, Esquire Flanagan and DiBernardo, LLP, 150 East Chestnut Street, Lancaster, PA 17602 (717) 397-9444 56684 Defendants WITNESS the Honorable Kevin A. Hess President Judge, at Carlisle, the day of A.D., CLERK OF COURTS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ Plaintiff, : No: 14-4399 V. TYLER BAKER and CAROLYN BAKER, Defendants. NOTICE TO: Shippensburg University Attention: Custodian of Records 1871 Old Main Drive Shippensburg, PA 17257 JURY TRIAL DEMANDED You are required to complete the following Certificate of Compliance when producing documents and/or things pursuant to the Subpoena. CERTIFICATE OF COMPLIANCE WITH SUBPOENA TO PRODUCE DOCUMENTS OR THINGS PURSUANT TO RULE 4009.23 certify to the best of my knowledge, information and belief that: (1) All documents and/or things required to be produced pursuant to the subpoena issued on (Date of Subpoena) have been produced. Date: -- OR --- Signature (2) Documents and/or things have not been produced pursuant to the subpoena issued on (Date of Subpoena) due to: (check one) After thorough investigation, this facility is not in possession of documents regarding the individual. After thorough investigation, this facility does not have the specific documents/dates in the files. This facility purges documents after years. The documents are in possession of: Other (please specify): Date: Signature FLANAGAN and DiBEFtNARDO, LLP BY: LISA M. DIBERNARDO, Esquire I.D. No. 56684 150 East Chestnut Street Lancaster, PA 17602 (717) 397-9444 Attorneys for Defendants, Tyler Baker and Carolyn Baker No: 14-4399 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ v. TYLER BAKER and CAROLYN BAKER, Plaintiff, : No: 14-4399 Defendants. : JURY TRIAL DEMANDED CERTIFICATE OF SERVICE I hereby certify that I served a true and correct copy of the foregoing upon the following and in the manner indicated below. Service was made by First Class Mail, addressed as follows: Fred Karpf, Esquire Hoffman, Michels & Sternberg, LLC 737 Second Street Pike Southampton, PA 18966 Attorney for Plaintiff DATE:12/02/2014 FLANAGAN and DiBERNARDO, LLP By: Lisa M. DiBernardo, Esquire ID. No. 56684 Attorney for Defendants FLANAGAN AND DIBERNA1DO, LLP F•D ATTORNEYS AT LAW J. MIC]iAEL FLANAGAN LISA M. DIBERNARUU JASON P. MCNICHOU Fred Karpf, Esquire . Hoffman, Michels & Sternberg,. LLC 737 Second Street Pike Southampton, PA 18966 www.flanagananddibernardo.com Email: calitwin.flanlaw@verizon.net December 2, 2014. Re:' .Brittany Rotanz v. Tyler Baker and Carolyn Baker. Cumberland. County Docket Number Our File Number, 24-133LMD 150 EAST CHESTNUT STREET LANCASTER, PA. ]:7602-2741 PHONE; @r.7) 397-9444. PAX: (717) 397-2397 Dear Attorney Karpf: Enclosed please find a Notice of Intent to serve a Subpoena to obtain records regarding the above captioned matter. !f you are willing to waive the twenty -day (20) waiting period and have no •objections to serve the subpoena please sign this letter and returnit to me either by facsimile or regular mail service. Thank you in advance for your prompt attention to this matter. Veryi sincerely, FLAN AN AND DiBERNARDO, LLP Enclosure I, Fred Karpf, Esquire, counsel for Plaintiff,, have no objection to the serving of the subpoena identified in te enclosed Notice of Intent and., = * 'waive the twenty (20) days. FLANAGAN and DiBERNARDO, LLP BY: LISA M. DIBERNARDO, Esquire I.D. No. 56684 150 East Chestnut Street Lancaster, PA 17602 (717) 397-9444 Attorneys for Defendants, Tyler Baker and Carolyn Baker No: 14-4399 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION BRITTANY ROTANZ v. TYLER BAKER and CAROLYN BAKER, Plaintiff, : No: 14-4399 Defendants. : JURY TRIAL DEMANDED CERTIFICATE OF SERVICE I hereby certify that I served a true and correct copy of the foregoing upon the following and in the manner indicated below. Service was made by First Class Mail, addressed as follows: Fred Karpf, Esquire Hoffman, Michels & Sternberg, LLC 737 Second Street Pike Southampton, PA 18966 Attorney for Plaintiff DATE: 12/08/2014 FLANAGAN and DiBERNARDO, LLP By: -I Sq Lisa M. DiBernardo, Esquire Attorney I.D. No. 56684 "\ Attorney for the Defendants FREDRIC S. KARPF, ESQUIRE HOFFMAN, MICHELS & STERNBERG, LLC 737 SECOND STREET PIKE SOUTHAMPTON, PA 18966 (215) 953-8955 IDENTIFICATION. NO. 76294 BRITTANY ROTANZ vs. TYLER BAKER and CAROLYN BAKER ~PiOTHONOu 2015JAN -2 Pjf 1: 21 CUMBERLAND COUNTY PENNSYLVANIA ATTORNEY FOR PLAINTIFF COURT OF COMMON PLEAS CUMBERLAND COUNTY LAW DIVISION NO: 14-4399 ORDER TO SETTLE, DISCONTINUE AND END TO THE PROTHONOTARY: Kindly mark the above captioned matter settled, discontinued and ended with prejudice. Thank you.