HomeMy WebLinkAbout08-08-14 --J REV-1500 EX(02-11) 1505610143
PA Department of Revenue 14 OFFICIAL USE ONLY
P pennsylvania
Bureau of Individual Taxes oePAFiOFREVENUE county code year File Number
PO BOX.280601 INHERITANCE TAX RETURN 2 1 07 0 7 9 0
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
07 27 2007 08 09 1930
Decedent's Last Name Suffix Decedent's First Name MI
PLEDGER WALTER R
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
PLEDGER JANE R
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
❑ 1. Original Return ® 2. Supplemental Return ❑ 3,Remainder Return(Date of Death
Prior to 1243-82)
❑ 4. Limited Estate ❑ 4a. Future Interest Compromise 5. Federal Estate Tax Return Required
(date of death after 12-12-82) ❑ g
❑ 8 Decedent Died Testate ❑ Living Twat
Decedent Maintained a Twat
(Attach Copy of Will) (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes
® 9. Litigation Proceeds Received ❑ 10.Spousal Poverty Credit(Date of Death [3 11,Election to tax under Sec.9113(A)
between 12-31- 1 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name
Daytime Telephone Number
WILLIAM SCOTT ARNOULT 717 261 [6645 'E'
=O I USE _
REGISTER OF �-3 f
W 0NS� i-n T
_
First Line of Address G v.-' CIO ---I
D _.I C
14 NORTH MAIN STREET ; S ncl
CD=
Second Line of Address � — _ i•— mT
D N Cn O
CR T
City or Post Office State ZIP Code DATE FILED
CHAMBERSBURG PA 17201
Correspondent's e-mail address: WSCOttarnoult @hotmail.com
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN PATE
Victoria P. Krenitsky - C
ADDRESS
6539 Little Mountain Terrace, Chambersburg, PA 17202
SIG AT R OF PREPARER OT HER THAN REPRESENTATIVE DATEU
William Scott Arnoult
ADDRESS
Arnoult Law Office, LLC
14 North Main Street; Suite 314, Chambersburg, PA 17201
Side 1
L 1505610143 1505610143
J 1505610243
REV-1500 EX
Decedent's Social Security Number
Dac.de,Ps Name, PLEDGER, WALTER R
RECAPITULATION
1. Real Estate(Schedule A).......................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................... 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3.
4. Mortgages&Notes Receivable(Schedule D).......................................................... 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 123 , 309 . 71
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............. 7,
8. Total Gross Assets(total Lines 1 through 7).......................................................... 8. 123 , 309 . 7 1
9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9.
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................. 10.
11. Total Deductions(total Lines 9 and 10).................................................................. 11. 0 . 00
12 Net Value of Estate(Line 8 minus Line 11)............................................................. 12. 123 , 30 9 . 7 1
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)................................................. 13,
14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14. 123 , 309 . 7 1
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)x.00 123 , 309 . 71 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .045 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18.
19. TAX DUE................................................................................................................... 19. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
L 1505610243 1505610243
REV-1500 EX Page 3 File Number 21 - 07 - 0790
Decedent's Complete Address:
DECEDENT'S NAM
Pledger, Walter R
STREET ADDRESS
20 Ridge Lane
CITY __ ---- -- - --- STATE ZIP
Newville PA 17241
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount
Total Credits(A +B) (2) 0,00
3. Interest —
(3) 0.00
4, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund - —
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;........ .................. ......................... x
b. retain the right to designate who shall use the property transferred or its income;...._.......
.._._................
c. retain a reversionary interest:or........__........................................._......-.__............................................. x
d. receive the promise for life of either payments,benefits or care?.............................................................. x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?...............................................................__................................................. ❑
3. Did decedent own an`in trust for" or payable upon death bank account or security at his or her death?......... ❑ o
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?...........................__....................................................___........___............ ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after Julyy 1, 1994 and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is 3 percent[72 P.S.§9t 16
For dates of death on or after January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)fii)]. The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of
assets and filing a tax ratturn are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
•The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)1.
•The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in
[72 P.S.§9116(a)(1)].
•The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent(72 P.S.0C9116((a)(1.3). A
sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,wfiether by bloo�or adoption.
di Pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH
INHERITANCE TAX RETURN , BANK DEPOSITS AND MISC.
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF Pledger, Walter R FILE NUMBER
21 -07 -' 0790
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE OF
NUMBER DESCRIPTION
DEATH
1 Proceeds from Settlement of a Survival Action 123,309.71
Court of Common Pleas of Philadelphia County
Civil Action July Term, 2009 No, 002547
TOTAL(Also enter on Line 5, Recapitulation) 123,309.71
REV-1513 EX.(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF
Pledger, Walter R FILE NUMBER
21 -07 - 0790
NUMBER NAME AND ADDRESS OF PERSON(S) ELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
RECEIVING PROPERTY ) DECEDENT (Words) ($$$)
Do Not List Toostee(s)
I, TAXABLE DISTRIBUTIONS[include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
1 Jane R. Pledger Wife entire estate 123,309.71
6539 Little Mountain Terrace
Chambersburg, PA 17201
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
II. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
REV-1649 EX.(09-12)
pennsylvania SCHEDULEO
DEPARTMENT OF REVENUE ELECTION UNDER SEC.9113(A)
INHERITANCE TAX RETURN pry /�' p1
RESIDENT DECEDENT (Sr OUS&DISTRIB TIONS)
ESTATE OF �V IIAYJ
FILE NUMBER
Pledger, Walter R 21 -07-0790
PART A- DEFERRING STATEMENT
For all trust assets reportable far Pennsylvania inheritance tax purposes for which a deferral of tax is being elected under
Section 9113,a), the personal representative responsible for filing the return and the trustees)of the trust in question hereby
acknowledge the department's Statement of Policy set forth at 61 Pa. Code§94.3 concerning any potential termination of the
trust under 20 Pa.C.S. § 7710.1 that occurs after the return was filed. Specifically, the signatories recognize each individual's
assumption of liability for inheritance tax consequences that result from any termination of the trust under 20 Pa.C.S. §7710.1
that occurs after a return has been filed.
Signature of Person Responsible for Filing Return Signature(s)of Trustee(s)
PART B — ELECTION TO TAX AMOUNTS
Complete this section only if making the election to tax available under Section 9113(a) of the Inheritance&
Estate Tax Act.
If the election applies to more than one trust or similar arrangement,a separate form must be filed for each trust. This election
applies to the Trust(marital,residual A,B,bypass,unified credit,etc.).
Enter the description and value of all interests for which the Section 9113 (A) election to tax is made.
DESCRIPTION VALUE
Total 0.00
(If more space is needed, insert additional sheets of the same size)
°ac
9
VICTORIA KRENITSKY and LINDA S. IN THE COURT OF COMMON PLEAS NisT�N/
LOWERY, EXECUTORS OF THE ESTATE PHILADELPHIA COUNTY, PA 4,1/O/1,
OF WALTER R. PLEDGER,DECEASED,
Plaintiffs CIVIL ACTION—LAW
MEDICAL PROFESSIONAL LIABILITY
V. ACTION
Pledger Vs Thomas Jeffe-ORWOX
THOMAS JEFFERSON UNIVERSITY JULY TERM, 2009 I IIII II 1111111 II Ilillllllll III
HOSPITALS, INC.; GRAHAM MEDICAL
CLINIC, P.C.; and JAY A. TOWNSEND, NO. 002547 09070254700117
M.D.,
Defendants JURY TRIAL DEMANDED
ORDER
AND NOW, this day of 3y,NE 2013, upon consideration of the
Petition for Approval of Wrongful Death and Survival Action, it is hereby ORDERED and
DECREED that said Petition is GRANTED. Victoria Krenitsky and Linda S. Lowery as
Personal Representatives of the Estate are hereby authorized to enter into a settlement with
Defendants in the gross amount of Four Hundred Fifty Thousand Dollars ($450,000.00) and are
authorized to execute the Release releasing the Defendants. The settlement funds shall be
distributed as follows:
(a) Angino & Rovner, P.C. $180,000.00
40% attorney's fee
(b) Expenses $20,168.13
(c) Medicare $3,052.28
(d) TRICARE $160,17
(e) Wrongful Death Benefits in the amount of$123,309.71 to be apportioned as
follows:
520925
To: Victoria Krenitsky(daughter) $41,103.24
i
To: Linda S. Lowery (daughter) $41,103.24 !
To: Walter E. Pledger(son) $41,103.23
(f) Survival Action
$123,309.71
To: Victoria Krenitsky and Linda S. Lowery,
as Co-Executrixes of the Estate of Walter R. Pledger,
Deceased,provided however,that counsel shall not
distribute any funds until additional security,
as may be required by the Register of Wills, is posted.
20 Pa.C.S. §3323(b)(3).
TOTAL: $450,000.00
j
BY THE COURT:
J.
I_
520925
ANGINO&ROWER,P.C.
Neil J.Rovner,Esquire
I.D.No.22108
4503 North Front Street
Harrisburg,PA 17110-1708
(717)238-6791
FAX(717)238-5610
Attorneys for Plaintiffs
Email:nrovner @angino-rovner.com
VICTORIA KRENITSKY and LINDA S. IN THE COURT OF COMMON PLEAS
LOWERY, EXECUTORS OF THE ESTATE PHILADELPHIA COUNTY, PA
OF WALTER R. PLEDGER, DECEASED,
Plaintiffs CIVIL ACTION—LAW
MEDICAL PROFESSIONAL LIABILITY
V. ACTION
THOMAS JEFFERSON UNIVERSITY JULY TERM, 2009
HOSPITALS, INC.; GRAHAM MEDICAL
CLINIC, P.C.; and JAY A. TOWNSEND, NO. 002547
M.D.,
Defendants JURY TRIAL DEMANDED
CONFIDENTIAL
PETITION FOR APPROVAL OF A WRONGFUL DEATH AND
SURVIVAL SETTLEMENT PURSUANT TO Pa.R.C.P. 2206
AND NOW, comes Petitioners Victoria Krenitsky and Linda S. Lowery, Executors of the
Estate of Walter R. Pledger, Deceased, seeking Court approval of the settlement on behalf of the
Estate of Walter R. Pledger, and respectfully represents the following:
1. Petitioners Victoria Krenitsky and Linda S. Lowery are the daughters of the
Decedent, Walter R. Pledger, and have been appointed Personal Representatives of the Estate of
Walter R. Pledger, by virtue of Letters Testamentary granted to them by the Register of Wills of
Cumberland County, Pennsylvania, on April 7th, 2011. See Letters of Administration attached
hereto as Exhibit A.
516142
2. Defendant Jay A. Townsend, M.D. is a physician practicing in the specialty of
family medicine and an employee of Graham Medical Clinic, P.C. located at 100 South High
Street, Newville, Cumberland County, Pennsylvania 17 in Cumberland County, Newville,
Pennsylvania 17241.
3. Defendant Thomas Jefferson University Hospitals, Inc, is a corporate medical
institution providing medical care at I I I South I Ith Street,Philadelphia, Pennsylvania 19107.
4. Defendants are medical providers who provided care to Decedent during a
hospitalization and subsequent care between July 17, 2007 and July 27, 2007.
5. The Decedent Walter R. Pledger was 76-years-old at the time of his death with a
date of birth of August 9, 1930, he died on July 27, 2007.
6. The Decedent Walter R. Pledger underwent surgery for bladder cancer on
July 17, 2007, and was discharged home on July 24, 2007 with numerous bouts of diarrhea.
7. Decedent Walter R. Pledger had been administered various antibiotics during his
admission, post-surgery, and it could be safely assumed by his symptoms thdt he had contracted
clostridium difficile during his hospitalization.
8. Decedent followed up with his family physician several times on his symptoms of
explosive diarrhea, loss of appetite and weakness, and a stool sample was taken, but by the time
the results were known, Decedent Walter R. Pledger had already passed away on July 27, 2007
with cause of death being overwhelming sepsis with clostridium difficile.
9. Petitioners' claim arises out of allegedly negligent medical care provided by the
named Defendants between July 24, 2007 and July 27, 2007, which resulted in Decedent's
illness and subsequent death on July 27, 2007.
516142
10. At the time of his death, Decedent Walter R. Pledger was a retired Array
lieutenant colonel.
11. Decedent Walter R. Pledger's medical bills related to this matter were paid by a
number of different insurers which have asserted a right of subrogation and seek repayment for
the medical expenses.
12. These insurers include Medicare who has asserted a lien in the amount of
$5,592.51. See Medicare Conditional Payment letter of August 24, 2011 attached hereto as
Exhibit B. Medicare has since reduced their lien to $3,052.28 per their demand letter of March
22, 2012 which is attached hereto as Exhibit C.
13. Decedent Walter R. Pledger received medical insurance through TRICARE as a
retirement benefit through the United States Army. TRICARE paid for medical claims related to
this action in the amount of$160.17. See May 31, 2011 TRICARE statement of claims attached
hereto as Exhibit D.
14. A Complaint was filed against Defendants Thomas Jefferson University Hospital,
Jay A. Townsend, M.D. and the Graham Medical Clinic, P.C. in the Court of Common Pleas of
Philadelphia County on August 26, 2009, seeking to recover wrongful death and survival action
damages as a result of Petitioners' Decedent's injuries.
15. Although not admitting liability, Defendants agreed to a global settlement of all
claims in the amount of four hundred fifty thousand ($450,000.00) dollars which was acceptable
to the Petitioners. See, copy of settlement release attached hereto as Exhibit E.
16. This case was scheduled for trial on December 12, 2011, for five (5) days before
The Honorable Joseph I. Papalini, J.
516142
17. On Friday, December 9, 2012, prior to trial, the parties agreed to the above
mentioned settlement.
18, Based upon the elements of damages recoverable under the Wrongful Death Act
and those recoverable tinder the Survival Act, Petitioners' sought approval of the Pennsylvania
Department of Revenue Inheritance Tax Division for an allocations of 50% of the recovery to the
wrongful death act and 50%of the recovery to the Survival Act
19. Petitioners proposed the above allocation to the Pennsylvania Department of
Revenue which was approved as set forth in the letter of December 17, 2012, which is attached
hereto as Exhibit F.
20. The sole beneficiaries of the Estate of Walter R. Pledger are his adult children,
Victoria Krenitsky, Linda S. Lowery and Walter E. Pledger. See initial letter of administration
attached as Exhibit G. Walter E. Pledger renounced his right to administer the Estate on ___
and therefore Victoria Krenitsky and Linda S. Lowery, Petitioners, are the sole beneficiaries of
the Estate of Walter Pledger. See Walter E. Pledger Renunciation Form attached hereto as
Exhibit H. There are no minors or incapacitated parties who are beneficiaries to the Estate.
21. The Estate has no liens and no claims have been filed against the Estate that was
opened in Cumberland County,
22. Attorney W. Scott Arnoult, of the Arnoult Law Office, will handle Estate matters
on behalf of the Estate and will deal with the final inheritance tax returns.
23. Pursuant to Senate Bill 1205, a lien search has been performed on Decedent and
beneficiaries, Victoria Krenitsky and Linda S. Lowery, regarding child support. See, lien search
statement attached hereto as Exhibit I(social security number has been redacted).
5t61h2
24. Angino & Rovner, P.C. has incurred expenses of$24,037.52 in obtaining medical
records, filing a Complaint/Writ of Summons, mediation, and pursuing the claim. See,
Distribution Sheet and list of expenses attached hereto as Exhibit J.
25. Your Petitioners retained the fine of Angino & Rovner, P.C. to prosecute this
action to recover against the Defendants and entered into a contingency fee agreement with said
attorneys providing fees for the professional services and a percentage of any amount recovered
plus expenses. Your Petitioners have agreed, subject to approval of Your Honorable Covet to
pay Angino & Rovner the sum of$180,000.00 for work it has performed on Petitioners' claim
which amounts to a fee of 40% of the four hundred fifty thousand($450,000.00) dollars.
26. Your Petitioners believe in light of the facts set forth in the Petition, that a fair,
just, and equitable distribution would be as follows:
(a) Estate of Walter R. Pledger $ 121,375.02
(b) Wrongful Death $ 121,375.02
(c) Medicare $ 3,05128
(d) TRICARE $ 160.17
(e) Angino & Rovner, P.C. $ 180,000.00
40% attorney's fee
(I) Expenses $ 24,037.52
TOTAL: $ 454,000.00
WHEREFORE, your Petitioners pray your Honorable Court to enter an order approving
said compromise settlement, directing the distribution of the proceeds thereof in accordance with
the averment of this Petition, and authorizing your Petitioners, upon payment of the aforesaid
sums and payment of the record costs by the Defendants, to mark the action settled and
discontinued and to execute and deliver to Defendants, a good and sufficient release discharging
516142
it, its heirs, and assigns and any and all other persons, associates or corporations from any claim,
demand, right of cause of action arising from or as a result of the injuries and ultimate death
suffered by Walter R. PIedger, Decedent.
Respectfully submitted,
ANGINO &ROVNER, P.C.
/dl �NeZI�.(JQQVneK
Neil I Rovner, Esquire
PA LD. No. 22108
4503 N. Front Street
Harrisburg, PA 17110
(717) 238-6741
nrovner @angino-rovner.com
Counsel for Plaintiffs)
Date:
s16142
VICTORIA KRENITSKY and LINDA S. IN THE COURT OF COMMON PLEAS
LOWERY, EXECUTORS OF THE ESTATE PHILADELPHIA COUNTY, PA
OF WALTER R. PLEDGER, DECEASED,
Plaintiffs CIVIL ACTION—LAW
MEDICAL PROFESSIONAL LIABILITY
V. ` ACTION
THOMAS JEFFERSON UNIVERSITY it JULY TERM, 2009
HOSPITALS, INC.; GRAHAM MEDICAL
CLINIC, P.C.; and JAY A. TOWNSEND, NO. 002547
M.U.,
Defendants JURY TRIAL DEMANDED
ORDER
AND NOW, this day of 2013, upon consideration of the
Petition for Approval of Wrongful Death and Survival Action, it is hereby ORDERED and
DECREED that said Petition is GRANTED. Victoria Krenitsky and Linda S. Lowery as
Personal Representatives of the Estate are hereby authorized to execute the Release releasing the
Defendants. The settlement funds shall be distributed as follows:
(a) Estate of Walter R. Pledger $ 121,375.02
(b) Wrongful Death $ 121,375.02
(c) Medicare $ 3,0522$
(d) TRICARF. $ 160.17
(e) Angino & Rovner, P.C. $ 1$0,000.00
40% attomey's fee
(f) Expenses $ 24,037.52
TOTAL: $ 450,000.00
BY THE COURT:
7.
516142
CERTIFICATE OF SERVICE
I, Katelyn M. Helman, an employee of the law firm of Angino & Rovner, P.C., do hereby
certify that I am this day serving a true and connect copy of the foregoing Confidential—Plaintiffs'
Petition for Approval of a Wrongful Death and Survival Settlement to all counsel of record via
postage prepaid first class United States maid addressed as follows:
Amalia V. Romanowicz, Esquire
Post & Schell, P.C.
Four Penn Center
1600 John F. Kennedy Blvd.
Philadelphia, PA 19103
Attorney for Defendant Thomas Jefferson
University Hospitals, Inc.
via electronic mail
Leigh A.J. Ellis, Esquire
Cindy Ellis, Esquire
Foulkrod Ellis, P.C.
4000 Market Street
Camp Hill, PA 17011
Counsel for Townsend and Graham Medical Center
via electronic mail
!n! l�r/7.rfEelman
Katelyn M. Helman,Paralegal
Date:
516142
VICTORIA KRENITSKY and LINDA S. IN THE COURT OF COMMON PLEAS
LOWER.Y, EXECUTORS OF THE ESTATE PHILADELPHIA COUNTY, PA
OF WALTER R. PLEDGER,DECEASED,
Plaintiffs CIVIL ACTION—LAW
MEDICAL PROFESSIONAL LIABILITY
v. ACTION
THOMAS JEFFERSON UNIVERSITY JULY TERM, 2009
HOSPITALS, INC.; GRAHAM MEDICAL
CLINIC, P.C.; and JAY A. TOWNSEND, NO. 002547
M.D.,
Defendants JURY TRIAL DEMANDED
ORDER
AND NOW, this day of 2413, upon consideration of the
Petition for Approval of Wrongful Death and Survival Action, it is hereby ORDERED and
DECREED that said Petition is GRANTED. Victoria Krenitsky and Linda S. Lowery as
Personal Representatives of the Estate are hereby authorized to execute the Release releasing the
Defendants. The settlement funds shall be distributed as follows:
(a) Estate of Walter R. Pledger $ 121,375.02
(b) Wrongful Death $ 121,375.02
(c) Medicare $ 3,052.28
(d) TRICARE $ 160.17
(c) Angino & Rovner, P.C. $ 180,000.00
40%attorney's fee
(f) Expenses $ 24,037.52
TOTAL: $ 450,000.00
BY THE COURT:
520925