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Home My WebLink About06-6107 Ot:i'r'~ f ~L . ' , ",'J I I ~- " ,J 'I., " IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CNIL ACTION - LAW Michael Burnett and Cathy Burnett, Parents and Legal Guardians of Cody G. Burnett, a Minor 205 East Keller Street Mechanicsburg, Pa 17055 Petitioners v. No: Ci.- -l..lC1 c3ulLI€1w1 Gene E. Rusatsky and Robin J. Rusatsky 2470 Cocklin Court Mechanicsburg, Pa 17055 Respondents PETITION FOR LEAVE ALLOWING SETTLEMENT AND COMPROMISE AND FOR DISTRIBUTION Pursuant to Pa.R.C.P. 2039, Petitioners Michael Burnett and Cathy Burnett, Parents and Natural Guardians of Cody G. Burnett, respectfully represents the following: 1. Petitioners are Michael Burnett and Cathy Burnett, adult individuals residing at 205 East Keller Street, Mechanicsburg, Pennsylvania. 2. The minor, Cody G. Burnett, is nine (9) years of age, having been born on December 12, 1996, and is the son of Petitioners Michael Burnett and Cathy Burnett. 3. Respondents are Gene E. Rusatsky and Robin 1. Rusatsky, adult individuals, residing at 2470 Cocklin Court, Mechanicsburg, Pennsylvania and insured by Donegal Mutual Insurance Company. 4. On or about July 1, 2005, Petitioner Cody G. Burnett sustained personal injuries when Respondents' son threw a toy magnetic "dart", striking Petitioner Cody G. Burnett's mouth. 5. As a result ofthe incident, Petitioner Cody G. Burnett sustained an injury to his anterior tooth #7, in the nature of a "chip". 6. As a result of said injury, Petitioner Cody G. Burnett was treated by Timothy D. Futato, D.M.D., of Endodontics Associates. 7. In August of 2005, Dr. Futato performed root canal treatment to the minor child's anterior tooth #7. Dr. Fatuto subsequently applied a protective resin to the tooth's surface in the fall of 2005. 8. Petitioners have represented that Petitioner Cody G. Burnett will require future dental work; specifically, the protective resin may require additional application and a crown has been recommended for anterior tooth #7 when Petitioner Cody G. Burnett reaches fifteen (15) years of age. 9. Respondents, through their insurance company, Donegal Mutual Insurance Company, have offered to compromise the claim for injuries and damages sustained by Petitioner Cody G. Burnett for the sum of Five Thousand Dollars ($5,000.00), as full settlement of the present action. 10. In the opinion of Petitioners, the settlement offer concerning Petitioner Cody G. Burnett is fair and reasonable and would serve the best interest of the minor child. 11. Petitioners submit that there are no attorney's fees and/or costs for the minor child with regard to the instant action. 12. Petitioners propose and request this Court to approve a settlement of the claims of Petitioner Cody G. Burnett with the following payments: a. The sum of Five Thousand Dollars ($5,000.00), shall be made payable to Petitioner Cody G. Burnett, be paid to Petitioners herein which will be placed in a federally insured account or certificate of deposit in a bank or savings and loan institution. b. Petitioners Michael Burnett and Cathy Burnett shall be permitted to withdraw funds, as necessary, to pay for the minor child's additional dental work with regard to the instant action. The minor child, Cody G. Burnett, shall have full and exclusive control over the remaining funds. WHEREFORE, Petitioners Michael Burnett and Cathy Burnett, Parents and Natural Guardians of Cody G. Burnett, a minor, respectfully pray your Honorable Court to enter an Order approving the proposed compromise settlement and distribution of the proceeds of settlement. Respectfully submitted, 4;1L/- 10' Date: / I 'Z / Dc lchael Burnett, Parent and Natural rim of Cody G. Burnett, a minor l~ &LNe)f Cathy Burnett, Parent and Natural Guardian of Cody G. Burnett, a minor CERTIFICATE OF SERVICE We, Michael Burnett and Cathy Burnett, Parents and Natural Guardians of Cody G. Burnett, a minor, hereby state that the within documents have been served upon the following on the date set forth: Nadine C. Bell, Esquire Nikolaus & Hohenade1, LLP 212 North Queen Street Lancaster, PA 17603 ~ i / ' ~/~ Mic el Burnett, Parent and Natural G~5\.rdU% of Cody G. Burnett, a minor . r ,~~1f a y Burnet, Parent and Natural Guardian of Cody G. Burnett, a minor 'u/ Date: / 12/ ~ , - 4 ~ ., , RL~ r', AL O'/U.' ,Ji Nadine C. Bell, Esquire Attorney I.D. No. 89388 NIKOLAUS & HOHENADEL, LLP 212 North Queen Street Lancaster, P A 17603 (717) 299-3726 FAX (717) 299-1811 E-mail: nbell(cV.n-hlaw.com Attorneys for Respondents IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLV ANlA CNIL ACTION - LAW Michael Burnett and Cathy Burnett, Parents and Legal Guardians of Cody G. Burnett, a Minor 205 East Keller Street Mechanicsburg, Pa 17055 Petitioners No: v. Gene E. Rusatsky and Robin J. Rusatsky 2470 Cocklin Court Mechanicsburg, Pa 17055 Respondents ACCEPT ANCE OF SERVICE AND NOW on this I v day of ((l(j-o k;dA... , 2006, I, Nadine C. Bell, Esquire, attorney for Respondents Gene E. Rusatsky and Robin J. Rusatsky, hereby accept service ofthe Petition for Leave Allowing Settlement and Compromise and For Distribution by Petitioners Michael Burnett and Cathy Burnett, Parents and Natural Guardians of Cody G. Burnett, a minor, in reference to the above matter. NIKOLAUS & HOHENADEL, LLP BY: 'll/.hP cf'~ Nadine C. Bell, Esquire Attorney for Respondents , ,~ 1 'Kt A) lI1 #- .fI't Q ""-> ~ c::., ~ C'.::;) ~ Q-\ CI) "TJ Q7 C 5! ........ COP, L) mE? -'", l j ~ tv "",:.,:"_. .~,"/-; --I ~ ~?2.:- "" .r ~ co :IJ? 0 ~ ~._-jO -I': ~ :r:: -r; ~~ (~"'. :It' C)f,' .z: " ~ i'fi W -:( , ~ J..' c.-: S> C...J '2: =r;! ::.2 Ul ~ .'V -< .....--.... ... O,OI~ r" c' ), & nll:i'U,/il.. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CNIL ACTION - LAW Michael Burnett and Cathy Burnett, Parents and Legal Guardians of Cody G. Burnett, a Minor 205 East Keller Street Mechanicsburg, Pa 17055 Petitioners v. No: D~ -~1O'7 (3c..>~L/~ Gene E. Rusatsky and Robin J. Rusatsky 2470 Cocklin Court Mechanicsburg, Pa 17055 Respondents SCHEDULING ORDER IT IS HEREBY ORDERED that a hearing will be held on tJ ~ ~1 ,2006 at a~.~(J o'clock ~ in Courtroom Number::s, on Petitioner's Petition for Leave Allowing Settlement and Compromise and for Distribution. f)c..ftJ.Ju A5J~tJ.10 J. ,\) ~ \ 't . -':'~i/~llJ L 0 :8 HV 92 1JO SOOl AW'''J') ("\,., .'" l,r\, , , -'u I :10 u \ ......\..)iV"Jtll.\.)(:.:'J ,:jru.. :Dl:!::!o-o::m:l .. ." . Or.~..~. "j All[. 11iU"ft / IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW Michael Burnett and Cathy Burnett, Parents and Legal Guardians of Cody G. Burnett, a Minor 205 East Keller Street Mechanicsburg, Pa 17055 ,- ("- I.", i 2 4 Z006 /f)V Petitioners v. No: O~-l.lo7 C.tu~l'-r~ Gene E. Rusatsky and Robin 1. Rusatsky 2470 Cocklin Court Mechanicsburg, Pa 17055 Respondents ORDER OF COURT ANDNOW,thisJ7~daYOf tJ~ , 2006, upon consideration of the Petition allowing settlement and compromise and for distribution, it is hereby ORDERED and DECREED that the said Petition is APPROVED and distributed is directed as follows: 1. The Parties to the action are hereby authorized to compromise the above claim upon the terms set forth in the attached Petition. 2. The Payment of Five Thousand Dollars ($5,000.00) to be made by Donegal Mutual Insurance Company shall be in full settlement of the liabilities of Gene E. Rusatski and Robin J. Rusatski for all causes of action of Petitioners Michael Burnett and Cathy Burnett, Parents and Natural Guardians of Cody G. Burnett, a minor, regarding a personal injury action that occurred on or about July 1, 2005. 3. This Court approves a settlement of the claim of Petitioners with the following Payments: .,' a. To Michael Burnett and Cathy Burnett, Parents and Natural Guardians of Cody G. Burnett, is to be deposited in a federally insured account or certificate of deposit in a bank or savings and loan institution in the name of the minor, until the minor child Cody G. Burnett obtains the age of eighteen (18), Five Thousand Dollars ($5,000.00). b. Petitioners Michael Burnett and Cathy Burnett shall be permitted to withdraw funds, as necessary, to pay for Cody G. Burnett's additional dental work as related to the instant action. The minor, Cody G. Burnett, shall have full and exclusive control over the remaining funds. 4. That the above captioned matter is marked settled, discontinued and ended. Petitioners shall file of record proof of the deposit of the funds into a restricted account within thirty (30) days of this Order. J. Attest: v()~ C. &>>. ~~ ~.-+IflkA.~ ~l- i\JJ\~t..: , ( ~ :/\~ :-\ ::) 0'" . ," U J ..; t... ;.(, '~"ifJ L2 9DOl .... ... Joseph G. Muzic, Jr., Esquire NIKOLAUS & HOHENADEL, LLP 212 North Queen Street Lancaster, P A 17603 (717) 299-3726 (717) 299-1811 fax jmuzic@n-hlaw.com Attorney J.D. No. 55919 Attorney for Respondents MICHAEL BURNETT and CATHY BURNETT, Parents and Legal Guardians Of CODY G. BURNETT, a Minor, Petitioners IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNA. CNIL ACTION - LAW vs. NO. 06-6107 Civil Term GENE E. RUSATSKY and ROBIN J.RUSATSKY Respondents PROOF OF DEPOSIT TO THE PROTHONOTARY: Please file the attached Proof of Deposit in the above referenced matter. Date: d1.r~3-0 7 By: . Muzic, Jr., Esquire for Respondents r .. ::.-~ .h..4 l~:,~ 'ffi. t,-~ ;~ t~ !t~ t_ a"~ r.~ d,.~ 1.;'~ l~ ~h"" r~r~ '~ h:.j !~i ~~, ;~r.t , '} I..~.":""'" ~.,':;' ;p""l! ! ~'~<j <<.. .j\ Jf.iHJ t~~ ~~ T', r~ 74t~ :~;~ !~ ~::\ '..... , I'''. ~~ 1 ~"( t~t ~~'j :.~'Y" l... t.... lrij ;'-;1 TIME CERTIFICATE OF DEPOSIT it' NONTRANSFERABLE AND NONNEGOTIABLE ;~5! MICHAEL R BURNETT I 0000000001012989 '.... ~\3.,., =-....~.OO.:;,O,; ~ e (ffu~~lf.~ity INTEGRITY BANK CAMP HILL BRANCH, 3345 Market Street, Cam Hill, PA 17011 No. 06-6107 TIME CERTIFICATE OF DEPOSIT NONTRANSFERABLE AND NONNEGOTIABLE Account Title Account Type 6 - 11 MONTH CD Taxpayer 10 Number MICHAEL R BURNETT 267-33-4100 Account Number Amount Term 6 Months I Automatic Renewal Interest Payment Frequency Monthly 0000000001012989 $ 5,000.00 Februa 12, Interest Rate Per Annum 4.89 % with an annual percentage yield of 5.00 %. rity Date t 12, 2007 Interest Payment Disposition Interest will be capitalized to this certificate. TIME CERTIFICATE OF DEPOSIT Agreement. This Time Certificate of Deposit is a part of, an(J''''l)verne!1..bV, our Time Deposit Agreement. Among other things, this means that all terms defined in that agreement have the same mea~g$j!\~,/ You have received a copy of that agreement, the Truth in Savings disclosures (if applicable), and the fee schedule, You have rea~Jhemanda9ree to them, . . Early Withdrawal Penalty. We do not have to permit eaflY~l:l~a'NaI.$Jrom the account. On each one we do permit, we can charge a penalty. calcu~ted as follows: If the term is.cUf1!1.er 3.0 . day....... ;!t\t....'...'..~..t.w~l.be waived if the accout is cia sed before maturity. If the term is between 30 ~s and under one year a penalty of;ol1e motMh,~re$t will'be assessed. If the term is one year and over, a penalty of three monts Interest will be assessed. If there is enough accrueOint,'Q!I~ttQieover the penalty, we deduct the penally from it. If not, we deduct the remainder of the penalty from principal. If the account is;,f;vafUlblef8teaccount, we will calculate the penalty using the interest rate being applied at the time of withdrawal, If the account is an IndiYidi:JafRetirement Account, the early withdrawal penalty will be in addition to any penalty imposed under the Individual Retirement Account (IRA) Disclosure Statement. The minimum earty withdrawal penally is seven days' simple interest on any amount withdrawn (a) within the first six days after the account is opened, or (b) within six days after a previous early withdrawal. Nontransferable. This Time Certificate ot:Pepo$it i~,!)onn~otiable and nontr~nsferable. All purported holders or assignees of it agree that our right of setoff will have priority over any of their claims. INTEGRITY BA~~ By (Y't I \ J--~-~ ~J{j. j t~7 Date t 2 00001100/20061440 Printed 2/1012007 11:45 AM @ 2006 Kirchman Corporation r ,.... No. 06-6107 CERTIFICATE OF SERVICE I hereby certify that a true and correct copy ofthe foregoing Proof of Deposit was sent by first-class mail, postage prepaid on the date set forth to the following: Michael and Cathy Burnett 205 East Keller Street Mechanicsburg, P A 17055 NIKOLAUS & HOHENADEL, ~~p Date: C)..r~3-Dl By: Jose Att G uzic, Jr., Esquire y for Respondents 3 (") c: ~,? -oCT rT1 ,; -;" .-. (0 --".., ~:'- .......,.., .-,--. .f:.:,.. t 5~:'= '-'? .r...'-~i ~ r-..:> = = ......J .." r'l'1 co N -.I ~ ~-n rnF ""l'..,ITl ~;JY qC) .,,~~ -'l.~ ~; -('1 c5C -b;'" ~ ",~ " 25,t1l ~.-t -r.:- ~ -0 :J?: <.f? o CO - Joseph G. Muzic, Jr., Esquire NIKOLAUS & HOHENADEL, LLP 212 North Queen Street Lancaster, P A 17603 (717) 299-3726 (717) 299-1811 fax jmuzic@n-hlaw.com Attorney I.D. No. 55919 Attorney for Respondents MICHAEL BURNETT and CATHY BURNETT, Parents and Legal Guardians Of CODY G. BURNETT, a Minor, Petitioners vs. GENE E. RUSA TSKY and ROBIN J.RUSATSKY Respondents n.D,r.fNAL IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNA. CIVIL ACTION - LAW NO. 06-6107 Civil Term PRAECIPE TO DISCONTINUE AND END TO THE PROTHONOTARY: Please mark the above-captioned action settled, discontinued, ended and costs paid. Date: 3-;LJ~o7 ,LLP Jose h G. uzic, Jr., Esquire Attorney for Respondents DISCONTINUANCE CERTIFICATE AND NOW, this ...<2.u c...Lday of fYI'::J/Jr"-. , 2007, suit has been marked as above directed. 1~"''''~ ~ (") C ? .....'- -un,:: ~~:; (f) -( ~ ~- ~2 -7 ~ "" = = --.J ::it :;ta.. ;;0 1',) N -0 :::E: o -n :r:o m, -urn ";::JCi bl. -,{O .....,-..T4 ;~.- ::D ",)C' 7' .- Om .-\ SJ =< w 00