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HomeMy WebLinkAbout05-6225 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA TREVOR HARNER a Minor by JEFFREY HARNER, Parent and Natural Guardian, NO. O!;' - ~~S C! t 0 ~L ';- &U-',\ Petitioners CIVIL ACTION - LAW v. EAST PENNSBORO TOWNSHIP, Respondents. PETITION FOR MINOR'S SETTLEMENT AND NOW, TO WIT, comes the Petitioner, Jeffrey Hamer, ("Petiti~ner") parent and natural guardian of Trevor Hamer ("Minor") and files this Petition to cq/npromise action for approval of settlement and avers the following in support thereof: I I. Petitioner is an adult individual, residing at 612 Strites Road,',iHarrisburg, Pennsylvania 17111. 2. Petitioner is the parent and natural guardian ofthe Minor, boI[n June I, 1994, and who lives at the above-noted address with Petitioner. 3. Respondent is East Pennsboro Township with offices at 98 S<jluth Enola Drive, Enola, Pennsylvania, 4. This Petition is filed as a result of injuries sustained by the M~or child, , Trevor Harner, while playing at his uncle's house located at 114 Front Stree~in Enola. At that time, the Minor child sustained an 8 to 9 centimeter laceration acrossilhe anterior part of his shin when his right leg went through a metal grate covering a SIOrju water drain that was rusted with rungs broken off exposing a large gap. The Mino~ child has ! I essentially recovered from said injuries and has reached maximum recovery. i A true and correct copy ofthe June 25, 2003 office notes from Richard A. BoaI, M.D, attached hereto and indicates that Trevor "will return to see me only as needed." Exhibit "A." 5. The Minor child was born on June I, 1994 and is currently 11 years of age, The minor child's mother, Billy A. Smith, currently residing at 319South Tenth Street, Lebanon, Pennsylvania 17042. 6. At the time of the incident the Minor child was under the ma~ority care I' and control of the Petitioner and continues so to be. , 7. Petitioners has incurred medical expenses in the caring and ~atrnent of the Minor child. Said medical expenses have resulted in outstanding medic~1 expenses ,I. totaling $1,627.93. A true and correct copy of the medical expenses are att~ched hereto, ';\ :1 incorporated herein by reference and marked Exhibit "B." There was no m~~ical coverage available for these medical expenses. 8. East Pennsboro Township has agreed to pay and Petitioner w~nts to accept i: 'I the payment of $17,500.00 to resolve the case against Respondent. A true a~d correct copy of East Pennsboro Township's proposed Release and letter of the settl~ent offer is attached hereto, incorporated herein by reference and marked Exhibits "C" ~d "D" ,I , 'I respectively, 9. Petitioner has made a careful and diligent inquiry and investi~ation into i: the facts surrounding the incident, the responsibility therefore, and the natur~ extent and , seriousness of the Minor's injuries. ,i " , 10. Petitioner has a Contingent Fee Agreement with the undersi~ed. A true I' and correct copy of said Fee Agreement is attached hereto incorporated herel\1 by !' reference and marked Exhibit "E." ii I , I " II. Petitioner intends to fully invest the proceeds of this settlement and maintain same for the care and use of the Minor child. 12. Petitioner proposes to distribute the gross settlement procee4s of $17,500.00 as follows: a. Trevor Harner, a Minor, in a restricted account not to be withdrawn before majority or upon leave of Court TOTAL ~ 9,940.77 I' .! Ii ,I ~i 5,832.75 ~I, 1,515,93 ~I 112,00 " 'I Ji 98.55 ,! ~f 7,500.00 I, b, To Menges, McLaughlin, Cunningham & Kalasnik, P.C. Counsel fees (33.33%) c. Holy Spirit Hospital d. Orthopaedic Institute of P A e. To Menges, McLaughlin, Cunningham & Kalasnik, P.C. reimbursement of costs Ii WHEREFORE, Petitioner, Jeffrey Harner, prays this Honorable Cot enter an I Order approving the Minor settlement and awarding the appropriate counsellifees as I , requested herein, ' IfJ~ Ie? n P. McLaughlin, Sup. Ct. LD. 62737 145 East Market Street York PA 17401 717-243-8046 Attorney for Petitioners "A" ORTHOPEDIC INSTITUTE OF PENNSYLVANIA (717) 761-5530 Patient: Trevor A. Harner DOB: 06/01/94 SSN: 205 74 1350 Chart #: 21753006 Page # 1 ----------------~------------------------------------------------------------- 6/16/2003 RICHARD J. BOAL, M.D. OFFICE VISIT Poplar Church Road Office CHIEF COMPLAINT, Trevor is a 9 year old young man In generally good health who was playing on 6-12-03 when he fell onto a sewer drain injuring his right leg. He had a large laceration on the anterior aspect of the rlght leg. He was treated at Holy Spirit Hospital with cleansing of the wound and su~ure of the wound. X-rays of his tibia were taken. I have reviewed those x-rays a~d they! are essentially within normal limits. REVIEW OF SYSTEMS, The patient's review of systems, past medical his~bry, family history, and social history have been recorded and reviewed. ! PHYSIC~L EXAM, He lS a well developed, well nourished male in no acuce distress. He is alert and oriented x 3. On examination this young man's knee is normal. His ankle is normal. i He does have about a six inch laceration on the anterior aspect of his l8~ which has been sutured and appears to not be inflamed or infected. DIAGNOSIS: Laceration of the anterior aspect of the left leg. PLAN: I am going to have this young man slowly increase his activiti~~. is not to do anything rough with the leg. He is going to retur~ to s~~ believe on the 24th or the 25th of June and we will remove his sutures:;. He me I His dad told me they would like him to play in one more baseball game I am not optimistic that this will occur but I will see how he is ge=ting a~ong when he returns. RJB/raf LTR-DR BOAL CORRESPONDENCE (Ref) COX, D.O., LAWRENCE 6/25/2003 RICHARD J. BOAL, M.D. OFFICE VISIT Powers Avenue Office CHIEF COMPlJI..INT: Trevor returned for follow-up of the laceration to hILS right leg. REVIEW OF SYSTEMS: The patient's review of systems, past medical his~ory, family history, and social history have been re-evaluated and reviewecl- PHYSICAL EXAM: He is a well developed, well nourished male in no acu~e distress. He is alert and oriented x 3. On examination today his wounds look good. Stitches have been removed and steri-strips applied. --------------------------------------------------------------,---------------- ORTHOPEDIC INSTITUTE OF PENNSYLVANIA (717) 761-5530 Patient: Trevor A. Harner DOB: 06/01/94 SSN: 205 74 1350 Chart #: 21753006 Page # 2 ------------------------------------------------------------------------------- 6/25/2003 OFFICE VISIT RICHARD J, BOAL, M.D. -CONTINUED- PLAN: He is going to increase his activities as tolerated. He is not to swim for another week. He will return to see me only as needed. RJB IJ ep cc: Lawrence Cox, D.O., via fax -------------------------------------------------------------+,---------------- "B" Medical Expenses Summary Incident of June 12, 2003 RE: Trevor Harner (minor) No. Provider Datelsl 1 ' Holy Spirit Hospital 6112103 2. Orthopaedic Institute of PA, 6116103, 6125103 Treatment Charoe Total $ ERTreatment $1,515ir13 Orthopaedic Treatment $112,Ob TOTAL MEDICAL EXPENSES THIS LIST .,.,...,..."....'......,..,.. .,."..",. $1,627,93 HeI # TYPE OF BILL ,; . DATE OF BilL DATE OF PREVo BILL ':; r OUTP, P E PATIENT NAME HARfoi.tcR ,TRlNOR p, HOLY SPIRIT HOSPITAL 503 N 21ST 5T CAMP HILL, PA 717 763-2141 FEI # 23-1512747 PATIENT NUMBER SEX AGE ADMISSION DATE ~~ 17011 BIRTH-DATE 06/01/94 211595..\8 M 9 06/12/03 C.O.B. INSURANCE COMPANY NAME GAOUPNUMBER POLICY NUMBER GUARANTOR wIEFFRE', Ht~RNER NAME 99 FRONT 5T AND .JEST FAIRVIBJ P(~ 1"7025 ADDRESS DUB IN JON A . :1 PLEASE RETURN THIS PORTION WITH YOUR PAYMENT, 7~ *,lUt ,! AMOUNT OF 1$ PAYMENT - DATE DESCRIPTION OF I SERVICE TOTAL EST. COVERAGE EST. COVERAGE EST. COY AGE EST. COVERAGE PATIENT POSTED HQSPIT AL SERVICES CODE CHARGES INS. CO. NO.1 INS. CO. NO.2 INS. CO. 0.3 INS. CO. NO.4 AMOUNT DETAr _ OF CURRENT CH(,RGES, PA', 1ENT5 AND AD,)l)STr1E rrs )6/12 ~ur1P SET -;:'.. T'{POI16139313 48.00 48,00 ~, )6/12 3ECOND,~RY SET 0116139339 20,00 20,00 )6/12 :EFAZOLIN 50011GO 144080364 11.00 11,00 ]6/12 _IDOCA 1/; 2~iL 0144720100 27.00 27.00 )6.1 12 TETMJUS/DIPT A 0144'790026 47,00 47,00 )6/12 BANDAGE p,CE 4.(\ 0114101372 2.18 2. ~8 )6/12 3UTl.IRE TRAY 0114120000 53.75 53.75 )6/12 ~DAPT DRESS 3:<80114124549 5,00 5.00 )6/12 BM,IDAGE 5TATITE0114125660 1,00 1. 00 )6/12 3TRIPS TEL FA 4:<0114127211 1,00 i 1.00 )6/12 '4ACL 0.9 500 011613064.; 11,00 11,00 )6/12 ',ACL 0.9/; :LOO 0116131278 13.00 13,00 )6/ 12 I'J CATH 0117207002 14,00 14,00 )6/12 TRANSpr,RENT DRE0117207028 1.00 1,00 )6/12 RIGHT LEG 013650165E 158,00 158,00 )6/12 LEVEL IV FG 011710575t" 447.00 447,00 )6! 12 ED I..EVEL IV PC 0117105834 235,00 235,00 )6/12 fEP LAG SP I N~\, T011730690J 421,00 421,00 BALA~ CE FORW\RD 0,00 SU1111I' RY OF CURRENT CHp,RGES PHARt'IACY 250 153.00 153,00 11/5 SUPPLIES 270 101.93 101,93 DX X-RAY 320 158.00 158,00 Et1ERGENCY ROiJI1 450 1103.00 1103.00 5UB-l OTi~L OF CURRo CH?,RGES 1515.93 1515,93 :v I A-tf IV OS /..5 gCJj.D '6'1; 0 FEOERAlIDENT. NO. 23-1512747 T 0 T A L S 1515,93 1515.93 PATIENT NUMBER I REFER ALL QUESTIONS TO THE PLEASE SEND PAYMENT TO: I PAY , BUSINESS OFFICE i 211595381 (717) 763-2138. HOLY SPIRIT HOSPITAL HIS Ar10UNT 1515.93 503 NORTH 21ST ST EET ADDITIONAL P TlENT BiLLING MAYBE NECESSARY FOR ANY CHARGE NO OSlE HOL Y SP I R IT HOSP IT (,L CAt1P HILL., PA R CAMP Hill, PA, 17011,2288 S,P D WHEN THIS BILL WAS PREPARED OR IF fNSURAI'JCE CARRIERS DO NOT PAY ANY PART OF THE AMOUN1'$ SHOWN UNDER ESTIMATED INSURANCE COVERAGE. OSL DBR ORTH INSTITUTE OF PA 875 POPLAI~ CHURCI~ rO~~D 12: 7" -.- 1 L;. --- (j.3 CRMP HILL PA 17011 'f' ll--"/b 1'-~3~.5:j~:: TAX ID #: 23-1875547 PATIENT: 217530 l-iARNER i-REVOR A Pi~'T BAL' Ids BnL" 01i,H Bi=~iL ~ 1. ]. 2. ~~;Zi . ~l~o .00 -------.-.-------------------------------------.----------------.--.---.-------------------- SEF:;;i) C DA1-E INV RP S DR PROC DESC IN", n COMMEN1" co C#A PL LINE INVOICE RUNNING AMOUN~i BALANCE BALANCE I .~.~_. - - __ __~_ - - .__ __. __.~____ ______.... __ _. ~_ ____ __.~~_ ___~___ - __ __ __ __ __'__' __ - ___. __~._ - ___ ..___ ~ ___ _1....__-- ... ._u ____ ________ _. __u 051603 1 5 1 55 CLATE CHGE LA1-ER 05 ~00 .00 .0Q! RICHARD J BUAL MD DIAG: 0525(;3 C~ E.. 1 5~j CL.ATE CHGE L.~lTEP 02.. 00 . 1L1Q'1 .0.Q\ RICHARD J BOAL MD DIAG, 051603 ~ 5 i 55 99202 OFFICE OUT 05 70.00 70.00 70.0C RICHARD J BOAL MD DrAG: 891.0 E84S.0 EB85.9 tZ.\bc:502:0 Lt b 1 5::'; r::Y:)~:::1~~~ OFFICE OUT Oi.~: L~2. 0:L'l L~c~. 00 l1e:. Ql~) RICHRRD J BOAL MD DIAG: 891.0 E849.0 E885.9 --------------.----------- END OF' PQTIENT HISTORY --------------~------.-----.----- *** TOTALS ***, CHRRGES: 112.00 PAY01ENTS: .00 ADJWSTS: .00 ======================:==========~=============================~=============== "C" GENERAL RELEASE OF ALL CLAIMS FOR AND IN CONSIDERATION of Seventeen Thousand Five Hundred -----001100 ($17,500,00) Dollars, receipt of which is hereby acknowledged, I, Jeffrey Harner as Legal Guardian for Trevor Harner, a Minor, DO HEREBY RELEASE AND FOREVER DISCHARGE, East Penn.boro Township, and any and all of its agencies, predecessor and successor agencies, and any anp all agents, insurers, servants, employees, officers, officials and assigns (hereinafter referred to as the 'IEast Pennsboro Township", from any and all actions, including any and all claims for contribution and/or ijIdemnification, causes of action, claims, demands, damages, costs, consequential damage or any other thing whatsoever on account of and in any way growing out of Bodily Injury and all known and unknown pers~na1 injuries, unknown property damages or loss of any nature which I now have or may hereafter have, resulting or to result from or rising out of an accident which occurred on or about June 12, 2003, in East lPennsboro Township, Penusylvania, I I hereby acknowledge and assume all risk, chance or hazard that the said damage~aY be or become permanent, progressive, greater or more extensive than is now known, anticipated r expected. No promise or inducement which is not herein expressed has been made to us, and in executin i this Release I do not rely upon any statement or representation made by any of the above named East Pe ',nsboro Township, or any person, firm, corporation or agent representing the East Pennsboro To :nship concerning the nature, extent or duration of said damage or the legal liability therefore, I I I understand that this settlement is the compromise of a doubtful and disputed clai~. and that the payment is not to be construed as an admission of liability on the part of anyone, including e above named East Pennsboro Township hereby released by whom liability is expressly denied, This release contains the entire agreement between the parties hereto and the termlofthis Release are contractual and not a mere recital. i In further consideration of the above payment, I, the Releasor, for myself, my heir, next of kin, executors, administrators, successors, successors in title, and assigns convenant and agree t indenmify and hold hannless the said East Pennsboro Township and any and all predecessor and success r parties for any and all claims, demands and suits for damages, costs, expenses or compensation which I or my heirs, next of kin, executors, administrators, successors, successors in title or assigns have or may have on account of or in any way growing out of said occurrence or its results. I certify that I am over eighteen (18) years and I FURTHER STATE THAT I HA~ECAREFULY READ THE FOREGOING RELEASE OF ALL CLAIMS AND KNOW THE CONTENT 'THEREOF and I sign same as my own free act. I WITNESS my hand and seal this day of ,2005, " - i WITNESS: I I Jeffrey Hamer Legal Guardian of Trevor HaJ;or I ! COMMONWEALTH OF PENNSYLVANIA : s.s. COUNTY OF YORK i I Before me the undersigned official, personally appeared Jeffrey Hamer, Legal GUatdian of Trevor Harner, Minor, who being by me fIrst duly sworn did depose and say that they had executed the foregoing RELEASE as their own true act and deed and desires the same to be recorded as such, I Notary Public "D" MENGES MCLAUGHLIN CUNNINGHAM KALASNIK. PC AITORNEYS AT LAW N, CHRISTOPHER MENGES SHA WN P. MCLAUGHLIN DARRYL W. CUNNINGHAM JOSEPH A KALASNIK GUNNARL.ARMSTRONG SYDNEY C. H. BENSON OF COUNSEL: FRED E, KILGORE October 31, 2005 (Dictated on October 24, 2005) FI~E COpy I: I I VIA FACSIMILE: (717) 671-7351 and first class mail Michael A. Rolko, Claim Representative St. Paul Travelers 6360 Flank Drive, Suite 1200 Harrisburg, P A 12112-2766 RE: Tracking Number: Our Client: Insured: Claim No: Date of Loss: Dear Mr. Rolko: UW11324 Trevor Harner (a minor) East Pennsboro Township GP0931023509T003 June 12, 2003 ii, Ii I, I I: I' \ I Ii This letter is a follow-up to our telephone conversation of October 14,2 P5, Please be advised that Mr. Harner has authorized me to accept a final settlement of $17,50 ,00 on behalf of his son, Trevor. Therefore, please forward any release you may require, Of course, II will need to put together a Minor Petition for presentation to the Court. If you have any comme ts or questions in the meantime, please let me know, otherwise thank you for your work to date in 'esolving this claim, II " Thank you. I' SPM/sms CC: Jeffrey Harner PLEASE REPLY To: 11145 EAST MARKET STREET YORK,PA 17401 TELEPHONE (717) 843-8046 FAX (717) 854-4362 E-mail YorkfWYQurLawFinnForLife.com Very truly yours, i: I I I i \ I; I I. I I I I , McLaughlin www.YoURLAWFIRMFORLlFE.COM 021! KENNEDVCOURT, SUITES HANOVER, P A 17331 TELEPHONE (717) 632,1784 FAX (717) 632-2433 E-mail Hanover(wYourLawFimlForLife.com o 18 E I 5T KING STREET, 21\D FLOOR NCASTER, PA 17602 TEIEPHONE(717)560-5068 FAX (7 J 7) 735,7709 E~mail an aste a~ YourLawFirmFor ife.com TOLL FREE 1-866-464-5297 "E" \ I, CLIENT REPRESENTATION OPTION IIW e, the undersigned request that our file and all pertinent documentation and infomtation: i- i I Be transferred to Menges, McLaughlin, Cunningham & Kalasnik, LLf to assume representation of me/us in this matter. IIW e understand that no additlbnal attorney fees will be incurred as a result of this change, I, I , , Be delivered to the law firm of at i , P A and that all monies and costs due on m ',file for I representation must be paid in full to Stambaugh, Rickards & Franke I prior to the file being forwarded to my new attorney, ' -:5~~'1 A Hc,-c (\E::.{ Client Name, Printed I , I ~ ) ~/'J C1ien i ~ I Client Name, Printed Client signature (; I ~ ~y , I (\~ PLEASE REPLY To: ./ '" 145 EAST MARKET STREET YORK,PA 17401 TELEPHONE (7 17) 843-8046 FAX (717) 854-4362 TOLL FREE 1,866-464-5297 E~majl mtlm@vorklawoffice.com o 1157 E1CHELBERGER STREET HANOVER, P A 17331 TELEPHONE (717) 632,1784 FAX (717) 632-2433 E-mail m~m@hanoverlaw.coro o 18 EAST G STREET, 2ND FLOOR LANC ~TER, P A 17602 TELEPH !<E (717) 560-5068 FAX rI7)735-7709 E-mail mlllncasterra2de"azzd.com FRANKEL CUNNINGHAM STAMBAUGH 8: ASSOCIATES ATTORNEYS AT LAW l4WEST KING STREET IRK. PENNSYLVANIA 17401 CONTINGENT FEE AGREEMENT The Client employs the law firm of FRANKEL, CUNNINGHAM, STAMBAUGH & ASSOCIATES, as my attorneys in the representation, trial, or settlemw.e .1 a~, clail}' regar.d)ng: . I 'L ~~ 1\ r'r Ie - I 'i - 0, \ ,"" '3fnr........ ~ Cool '" v . with full power and authority to appear on my behalf. For all services performed, the client agrees that the attorn~\ shall receive . of any recovery, including all u I derinsurance, insurance, and liability payments, as full payment of the profesi.ional services, The employment is on a contingent basis and if no recovery i' received, no attorneys' fees are due. ,i , , The contingent fee shall be calculated from the gross reco ~ry and before any expenses are deducted. This fee is valid through proceedin S at trial. Any fees for proceedings to a higher court will be negotiated separalely. , The attorney shall be paid the same percentage as state ! above of any oral or written settlement offer or award from any recovery plus II costs if this contract is terminated by either party. The client shall be responsible to pay for all costs incurre be a recovery or no recovery. The costs may include, but are medical reports, stenographic services, office expenses, com fees, filing fees, Sheriff's costs, investigation costs, medical-p and expert costs. These costs shall be paid in advance arrangements are made. should there ot limited to, 'uter research ralegal costs, ',unless other This agreement has been signed on /, - It; i ,20V il The Client acknowledges receipt of a copy of this Agreement. OA H) (_l WITNESS: C~ntingent I i., , Fee Jill {fiLii J fvl./t,Kt.l''I^.._ I I' If , I I I ! I i Client VERIFICATION I verify that the statements made in this Petition for Minor's Settlemen~ are true and ! correct. I understand that false statements herein are made subject to the pen~ties of 18 Pa. C.S, Section 4904, relating to unsworn falsification to authorities. ! ') ,} ) v) It1Vv~ Dated: ( 1/)/0> i1J't! '- ';'';'-..r.. Jeffrey 'darner, atural Guardian for Trevor Harner, Minor .... \] 11' TJ G "G.. t ~ ~ W rJt ~ }.J \) ~ ~ ~ ~ ( ~ J? ~ +- ~-L. ~ )\')~~ ""IlL \ ~ I\O~ ~_ -J3{\\3~:Y3~ q,~ ..' ../ , f'-...; (...) " ,.' (,.-" IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DEe 0 5 2005 ;:(J1f TREVOR HARNER a Minor by JEFFREY HARNER, Parent and Natural Guardian, NO. OS- -~J..4S c."utl ~8I...\ Petitioners CIVIL ACTION - LAW v, EAST PENNSBORO TOWNSHIP Respondents ORDER AND NOW, this (, ~ day of ~ ,2005, upon Petitioner, Shawn P. McLaughlin, Esquire, and in consideration of the attached Petition For Minor's Settlement is it hereby Ordered that a Hearing shall be held on (~).!( , 2005 beginning at <'6jA.m., in Courtroom number 5 of the Cumberland County Courthouse, Judge ~ , t: '~ ,..... \'!, J c r.-] ,'~j , 'J . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA TREVOR HARNER a Minor by JEFFREY HARNER, Parent and Natural Guardian, NO. 0 S - (PlZ S- (;01) 1 er IV) Petitioners CIVIL ACTION - LAW v. EAST PENNSBORO TOWNSHIP, Respondents. ORDER AND NOW, this J&' ~ day of ~ 2005, upon Petition for Minor's Settlement of Menges, McLaughlin, Cunningham and Kalasnik, P.C. and Shawn P. McLaughlin, Esquire, and after hearing of the same, is hereby Ordered as follows: 1. The Minor settlement with East Pennsboro Township, Respondent is hereby approved in the amount of$17,500.00. Attorney's fees and costs to the law firm of Menges, McLaughlin, Cunningham and Kalasnik, P.C. are approved in the amount of $5,931.30 ($5,832.75 fees + $98.55 costs). 2. Payment of the medical expenses to Holy Spirit Hospital and Orthopaedic Institute ofP A totaling $1,627.93 is approved. 3, Petitioners are authorized to sign a general Release or other appropriate Release with the East Pennsboro Township. 4. The remaining funds, totaling $9,940,77, are authorized to be placed with assistance of counsel, in a federally-insured financial institution or savings bank in the name of the Minor, with the provision that no withdrawals can be made from such account until the Minor reaches his majority. Proof of the deposit shall promptly be filed with the Court. BY THE Judge !'J Chl' dopher mellYS &JILU~ j Ihr~'&~ Cro ~L . "''''''''J ","," ,,.,,',- 'is :5 [1'1 82 JJO SGllZ "1\'1."\"".',..; """ 1""11":10 Nj\;c..Ll.-';~\_.<I:\;::'~(J =-11 3Ji:.<!'-O:nij IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA TREVOR HARNTER, A Minor by JEFFREY HARNER, Parent and Natural: Guardian NO. 05-6225 Civil Term Petitioner, CIVIL ACTION - LAW v. EAST PENNSBORO TOWNSHIP Respondent. PRAECIPE TO SETTLE/WITHDRAW AND DISCONTINUE TO THE PROTHONOTARY: Please withdraw the above-captioned action and mark as settled, discontinued and ended and/or dismissed. MENGES, MCLAUGHLIN, CUNNINGHAM & KALASNIK, P.C. ~/ ~ _-'7~( Shawn p, McLaughlin, Esquire Sup. Ct. LD. No. 62737 145 East Market Street York, PA 17401 (717) 843-8046 Attorney for Plaintiff ~ , , , - IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA TREVOR HARNTER, A Minor by JEFFREY HARNER, Parent and Natural: Guardian NO. 05-6225 Civil Term Petitioner, CIVIL ACTION - LAW v. EAST PENNSBORO TOWNSHIP Respondent. AFFIDAVIT OF DEPOSIT Before me, a Notary Public, in and for said County and Commonwealth, personally appeared Shawn P. McLaughlin, Esquire, who being duly sworn according to law deposes and says that in accordance with the December 28,2005 Court Order, the amount of the minor settlement has been deposited in a federally-insured til1ancial institution or saving bank in the name of the minor, as shown by the Deposit Receipt hereto attached. MENGES, MCLAUGHLIN, CUNNINGHAM & KALASNIK, P,C. '/ '1f It Date: '1 - d-I ,[i i -:<7~~- Shawn-P:-MCLaughlin, Esquire Sup. Crt. LD. No. 62737 Attorney for Petitioner SWORN iln~UBSCRIBED to before me this .fJJ..3!1 day of August, 2002 \ c w v Notarial S$el Diana K. DoWdell, Notary Public City of York, Yor1< County My Commission Exp....s Sept. 11, 2007 Member, Pennsylvania Association of Notariea WACHOVIA TIME DEPOSIT AUTOMATICALLY RENEWABLE PERSONAL CD 12 UP TO 18 MONTHS Opening Date Account Number Taxpayer 10 Number APRIL 20, 2006 247402052579909 206741350 This Receipt Acknowledges That The Depositor Named Below Has Deposited With This Bank The Sum Of $ ***"'*****10,000.00**;'** Depositor Name And Address TREVOR A HARNER 612 STRITES ROAD HARRISBURG PA 17111 Term Maturity Date JUNE 20, 2007 Interest Rate Per Annum 04,74% Annual Percentage Yield Interest Payment Frequency/Period 14 MONTHS 04,85% 1 MONTH(S) Interest Payment Disposition CAPITALIZE Account to Credit PROD-TYPE: 205 PROMO CD: CP00116 Issued by WACHOVIA BANK, N.A. NE CNTRL PA / UNION DEPOSIT PA C f/vfv~.J~ Authorized Signature X Date 4 ~ ~c'-c (~ Member FDIC NOT TRANSFERABLE CUSTOMER RECEIPT 566591 (Rev 04 Page 1 of 3) " ,) --\ ':.> L.;.