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COURTNEY RYAN WHITE, : IN THE COURT OF COMMON PLEAS
a Minor, by MARY RAE WHITE,: OF CUMBERLAND COUNTY, P A.
her Guardian
: CML ACl'lON - LAW
v.
STATE FARM MUTUAL
AUTOMOBILE INSURANCE
COMPANY
,
; NO, 1994 - LI-"3'1.3 e:"..;1. ~
ORDER
AND NOW, this ~/.. day of August,.1994, hearinkon the within
petition is scheduled for ...:.~o oJ" A, r . ('Nf'--" ,J-. / .1994,
at It: 8-0 /I,M., in Courtioom No. ..!..- of' the Cumberland County
Courthouse, Carlls(e; Pennsylvania,
By the Court,
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COURTNEY RYAN WHITE, : IN THE COURT OF COMMON PLEAS
a Minor, by MARY RAE WHITE,: OF CUMBERLAND COUNTY, PA,
her Guardian :
: aVIL ACI10N . LAW
V.
STATE FARM MUTUAL ; NO,I994- ~ 3'1.3 e.:.,.;.e .:r~~
AUTOMOBILE INSURANCE
COMPANY
ORDER
.' rr -ib r--
AND NOW, this I > day of . \ 'fJ l .-5 } . 1994, after
hearing on the within petition, the minor's settlement Is approved and
distribution directed as follows:
William S. Daniels, Esquire, attorney's fee
Mary Rae White, Guardian of Courtney
Ryan White, $4,760.00 to purchase
a computer for the said minor
$
400,00
4,760.00
The remaining $15,240.00 to be placed In a
federally-Insured savings account or
certificate of deposit, marked, "Not to be
withdrawn until age 18 or further
Order of a Court"
$
15,240.00
20,400.00
By the Court,
fk&~./ F
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AUG 15 IZ ilS fK '9'1
<,r~'HICE
Of ~i",' ,:..THON:!~r.y
CUllh;:,cl,HO C~;:'HY
FPltP.}"I'1 V.l'i~!..
.
COURTNEY RYAN WHITE, : IN THE COURT OF COMMON PLBAS
a Minor, by MARY RAB WHITE,: OF CUMBBRLAND COUNTY, PA.
her Guardian
: CIVIL ACTION - LAW
V,
.
STATBFARMMUTUAL : NO,I994.4~l)3 C,.ov;( .:r~....,
AUTOMOBILB INSURANCB
COMPANY
PETITION FOR APPROVAL OF MINOR'S SB'ITLEMBlS't
AND PROPOSED DISTRIBUTION
1. The minor plaintiff, Courtney Ryan White, age 12, born January 1,
1982, resides with her mother and guardian, Mary Rae White, at 15 Brian Drive,
Carlisle, Cumberland County, Pennsylvania,
2. The defendant, State Farm Mutual Automobile Insurance
Company, Is an Illinois corporation having a place of business at 115 Limekiln
Road, New Cumberland, York County, Pennsylvania.
3. On November 7, 1992, Mary Rae White carried her uninsured
motorist coverage with the defendant, State Farm Mutual Automobile Insurance
Company, hereinafter called "State Farm."
4. At or about 8 P,M. on the aforesaid date, the said minor plaintiff got
out of a vehicle, which her mother had Just parked In a parking place at the Wal-
Mart store in Silver Spring Township, Cumberland County, Pennsylvania.
5. The said minor plaintiff walked to the rear of her mother's car,
where she was struck by an eastbound vehicle, which left the scene of the
accident.
6. The said minor plaintiff was thrown against another parked car,
7. In this pedestrian-automobile col1lsion, the minor plaintiff
sustained a closed head Injury,
8. Attached hereto, marked Exhibit "A", 15 the report from Dr, Robert
B, Page, a neurosurgeon on the staff of the Hershey Medical Center, In which he
gave a good prognosis, and stated that there was no disability.
9. Attached hereto, marked Bxhiblt "B", Is a report from Dr, Todd F,
Barron, a pediatric neurologist at the Hershey Medical Center, In which he said
that the change in the minor plaintiff's I.Q. was most likely relnted to the motor
vehicle accident, but he was not sure whether her prior seizures represent a form
of primary generalized epilepsy, or are related to the motor vehicle accident,
10, Attached hereto, marked Exhibit "C", is an earlier report from the
said Dr, Barron, dated Apr1l27, 1993, in which he sets forth:
"Family history is significant in that the material grand-
mother and mother both have seizure disorders, but are
both seizure free now and are off medication. Interestingly,
mother has had episodes which are consistent with petit
mal seizures. There is also a history of Raynaud's disease
in the mother,"
11. As the minor plaintiff was the victim of a hit-and-run driver, which
driver has never been discovered, the minor plaintiff is entitled to an uninsured
motorist claim against State Farm on her mother's policy,
12. The parties have worked out a settlement of $20,400.00, which your
petitioner believes to be in the best interests of the minor plaintiff to accept,
13. The requested attorney's fee in the case is $400.00.
14. It is further requested that since the minor plaintiff now has a
memory problem and school work, that the guardian be authorized to spend the
sum of $4,760.00 to buy a computer for the said minor, along with the necessary
equipment and software, in order to have the computer function properly. A
detailed list prepared by the said minor is attached hereto, marked Exhibit "0".
15. It is further requested that the remaining $15,240.00 be placed in a
federally-insured savings account or certificate of deposit, marked not to be
withdrawn until age 18 or further Order of a Court.
WHEREFORE, it is prayed that the settlement and distribution be
approved.
HUMER & DANIELS
Byc::;~:,,,,,/M~ ,~
William S. Daniels
COMMONWEALTH OF PENNSYLVANIA )
: 55.
COUNTY OF CUMBERLAND )
~o. ~ Q{). 0 Lu-h..::.h
Mary Rae ~te
Mary Rae White, being duly sworn according to law, deposes and says
that the averments in the within petition are true and correct, to the best of
signer's knowledge, information, and belief,
Sworn and subscribed to before me
this ;2.qtL daYOf~1994'
\}. dUX- )/1. YfdAj/"'
otary
NOIARIAl SEAL
JANEl II. lAY NOIARY PUBLIC
CARLISLE BORO, CUMBERLANO COUNTY
MY COMMISSION EXPIRES JUNE 26. 1995
. ,.......
F?ENNSTATE
~
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College of Medicine : University Hospital
The Milton S. Hershey Medical Center
JVN 23 1993
RECEIVCD
Department 01 Surge".
Division 01 Neurosurgery
P ,0. Box 8S0
Hershey, Pennsylvania 17033
(717) m,g807
"
June 17,1993
Mr. Matthew J. Greer
Senior Claims Representative
State Farm Insurance Companies
Harrisburg Service Center
115 Limekiln Road
P.O. Box 257
New Cumberland, P A 17070-0257
. .
Dear Mr. Greer,
In response to your letter of April 29th concerning Courtney White ( Claim # 38-
6537-265) initial diagnosis was closed head injury. Her current diagnosis is closed head
injury. The patient was injured in an automobile accident in which she sustained a brief
loss of consciousness and transient cortical blindness, Her condition improved. ACT
scan was performed and was normal. The patient has been discharged from the hospital
(admitted 11108 through 11110/92). There was no disability, Her prognosis is good. The
patient is now under the care of Dr. Craig Jurgensen in Carlisle, PA.
Sincerely,
~~'P"'T-
Robert B. Page, M,D.
Professor of Neurosurgery and
Anatomy
RBPlbb
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. 'PENNSTATE
"
College of Medicine
University Hospital' Children's Hospital
The Milton S. Hershey Medical Center
MAY 2 6 1!:l!:l4
.
Depanment or Pedi..,I.s
Division or Neurology
RECEIVED
P.o, Bo. 850
Her.<hey, Pennsylvania 17033
(717)531,8790
May 2, 1994
Fo,e. ~ .P-. ~
Q.{ OJ ~ -#==- 38- fDfi3 7 -~ ~ t;;
Dr. Robert Page
Division of Neurosurgery
The Milton S. Hershey Medical Center
Hershey, PA 17033
Re: Courtney White
MSHMC #333294
Dear Dr. Page:
I had the pleasure or" seeing Courtney White for neurologic re-
evaluation on May.2. 1994. As you know, she is a 12 4/12 year old
girl who experienced head trauma approximately 18 months ago
whom I follow for possible absence-type seizures. Over the past six
months since her last visit, she has remained seizure-free on
Depakote 500 mg twice daily, At her last visit there was concern
raised by her mother about her school performance, and to date, she
continues in a gifted program but has significant problems and is
struggling to maintain a B-C average. She was retested as was
recommended, and. clearly there has been a signfficant drop in her
. IQ, primarily in the verbal sphere, Pre-accident her verbal IQ was
127, and presently it's Ill. . Performance was 132 and presently is
127, with a full scale change of 133 down to 121. On her
achievement test there is significant scatter, and most of her
problems seem to be manifest in verbal skills, Her exam remains
largely normal.
-.
After some discussion with her mother, clearly the change in IQ
is most likely related to the MV A, especially with the associated
scatter, With respect to her seizures, at the present time it's not
entirely certain whether her seizures represent a form of primary'
generalized epilepsy or are truly related to her MV A. Her EEG was
An [qll~1 OJ1pnnunll"l"ni'l.'r~lh
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/::'1))/1);' /:)
Dr. Robert Page
Page 2
May 2, 1994
normal and there was no evidence of a generalized spike-wave.
which is what one would expect with primary generalized epilepsy,
The very fact that the seizures began after the MV A is somewhat
supportive, although circumstantial of the seizures somehow being
related to the accident, At this time 1 recommended that she
continue on the Depakote for at least one more year, and if she is twO
years seizure-free we will consider discontinuing it: With respect to
her education. we did hold a lengthy discussion about her school
placement, and at this time 1 have recommended that she should uy
to continue in the gifted program as this is her wish, but with some
support from the school in the way of learning support. How this
will impact on her future academic performance and therefore
employment potential is uncertain, but certainly will put her at a
disadvantage compared to other children her age. In the meantime,
thank you for allowing me to share in her care. 1 will see her in six
months.
TFB:kb
cc: Medical Records
Office File
Sincerely yours,
Todd F. Barron, M,D.
Assistant Professor
Division of Pediatric Neurology
. :.:.--..------ _.--:...~ --.
PENNSTATE
~~
'If
College of Medicine . University Hospital
The Milton S. Hershey Medical Center
.'
Dcpallm,nl or p.diatrlc.
Dlyl.ion or N.urololY
P,O. Bo, 8S0
Hmh.y. r.nns)'lvania 17033
(717) S31.879O
April 27, 1993
'.
Dr. Roben Page
Division of Neurosurgery
Hershey Medical Center
Hershey, PA 17033
Re: Counney White
MSHMC #333294
Dear Dr. Page:
I had the pleasure of seeing Counney in my Pediatric Neurology outpatient clinic on
April 23, 1993, As you well know, Courtney is an 11 year old, white female who suffered
a closed head injury following a motor vehicle accident in November of 1992 with loss of
consciousness and transient vision loss, Her initial head CT demonstrated no lesions. Her
initial ophthalmologic examination showed no papilledema and her vision was 20120
bilaterally, A follow-up ophthalmologic examination in December of 1992 showed her
examination to be within nonnallimits. She had no visual complaints at this time. She
was also seen in January of 1993 by Dorris Tinker for behavior problems which were
found to be related to probable postconcussion syndrome, In tenns of behavior she has
had remarkable improvement and is currently seeing a pastor for counsellin? Her main
complaint at this time is that she has been noted to have drop attacks, approxunately 4
episodes since March of 1993 with associated brief loss of consciousness. A probable
postictal state is described with her being sleepy. She denies having any myoclonic jerks.
In school, she also has been noted to have periods of inattentiveness and has been
desClibed as daydreaming or spaced out at times. At home, she also has been noted to have
brief staring episodes. Mother also noted two episodes of new onset enuresis, twice within
the last month, Courtney denies increased fluid ir.take after the accident as compared to
prior to the accident, She complains of no headaches, blurring of vision, double vision or
encopresis. She has also been noted to have bite marks in the insides of her mouth upon
awakening in the morning.
Family history is significant in that the maternal grandmother and mother both have
seizure disorders, but are both seizure free now and are off medication. Interestingly,
mother has had episodes which arc consistent with petit mal seizures. There is also a
history of Raynaud's disease in the mother,
Gourmey has no allergies. Immunizations are up to date. Her past medical history
is essentially unremarkable. She lives with mother and a 6 year old brother. Mother is
divorced and the biological father is not actively involved in the children's care.
All Eqll:ll '''I''r('lflllnll~ Uni\('"il~
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Re: Courtney WhJle
MSHMC #333294
JUL 3 0 I,Qo.~
RECE:I\ _
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On examination, weight was 54 kg (90th percentile); height was 155,3 cm (91st
percentile); head circumference was 54 cm (75th percentile). Her neurologic examination
was essentially unremarl!:able and non-focal. Her pupils were both equal and reactive to
light, Visual fields were intact. BOlh fundi were well visualized with good venous
pulsations, EOM's were intact. No facial asymmelly was noted Gag was present,
Uvula and tongue were midline with no lingual fasciculations. MOlor fuhction was 515 in
all extremities, Sensory function was grossly nonnal. Reflexes were brisk, Toes were
downgoing with no clonus noted. Gait was nonnal. Coordination was nonnal, Position
sense was nonnal. The remainder of her examination was essentially unremarakble. No
ireegular heart rhythm was nOled
/.. My impression is that the drop allacks and staring episodes are strongly suggestive)
I of a p'robable seizure disorder. In the face of a strong family history of seizures, it is /
~' pOSSible that this ~ould be new onset juvenile myoclonic epilepsy. Howe\l.er,Jhe. _.' _...'.
possibility that this may be related 10 a post-traumatic state is possible.~ Despite a'ilorinaJ
ardiovascular examination, prolonged Q.T syndrome should also be considered. r
recommend atlhis pointlhat Courtney obtain a sleep'deprived EEG as well as an EKG next
Tuesday, April 27. 1993. Phannacotherapy will be considered based on review of the
EEG as well as her EKG.
Thank you for allowing me 10 share in Ihe care of this patient. Should you have
any questions, please do not hesitate 10 call. ,
Sincerely,
..-/~NU.
Todd F. Barron, M.D.
Assislant Professor
Division of Pediatric Neurology
Dictated by Maria Molina, M.D,. Resident, Dept. of Pediatrics
MM:mw
cc: Medical Records; Office Flle
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COURTNEY RYAN WHITE, : IN THE COURT OF COMMON PLEAS OF
a Minor, by MARY RAE WHITE, CUMBERLAND COUNTY, PENNSYLVANIA
her Guardian
V.
STATE FARM MUTUAL CIVIL ACTION - LAW
AUTOMOBILE INSURANCE COMPANY: NO. 94-4393 CIVIL TERM
IN RE: MINOR'S SETTLEMENT
ORDER OF COURT
AND NOW, this 15th day of August, 1994, I am
satisfied that Mary White, Courtney's mother, has been properly
advised as to the significance of the Court approving this
settlement, and, therefore, at the request of Mary White and
with the concurrence of her counsel, I will sign the order
accordingly.
By the Court,
/./
tIer, ,,-I f~ . );:~{/:~~
Harold E. Sheely, P.J. '
William S. Daniels, Esquire
For the Petitioners
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Cumberlud CollDly, Pemuyh'Ulia.
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BRANCH DESKlNAfION
NON.NEGOTIABLE I NON TRANSFERABLE
.J1.L
TIME CERTIFICATE OF DEPOSIT
FARMERS~
TRUST"
104889
DEPOSITOR(S)
M. Rae White custodian
Courtney R. White
15 Brian Dr
Carlisle, PA 17013
for
ADDRESS
~
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MI"'IlA 'OIC
209-40-6042
411-51-5183 .. ONE WEST HIGH STREET. P.O, BOX 220
CARLISLE, PENNSYLVANIA 17013
"Not to '1i8'''wltR'drawn until 717,241.3212
age 18 or further Order of I
a court. S 15,240.00."
-FARMl:II$_u -t I::: 2ItOdo1'sOOC.{'S
l"RIJSl COMPl\fJY.L i./. '+ ~ ..
HAS DEPOSITED IN THIS BANK
PAVABLE TO SAID DEPOSITOR S, SUBJECT TO THE CON~1TI0NS PRINTED ON THE REVERSE SIDE OF CERTIFICATE.
ISSUE TERM OF MATURITY '."'("1'01""1. INTEREST PAYABLE rJ MAIL CHECK
OAT T FI T AT UNH . _THLY 0 SEM.ANNUAllY llXCOMPOUNDIND
o AHNUAU v
8/18/94 20 months 4/18/96 5.00' nOUAR'....Y DATMAlUlITY 0 CREDIT ACCT. NO.
fik~~~\~~fNALTIU OF PEA.lUAV I CfATlf., THAT THE "'IOVI NUMIlR II MY CORRICT TAaPA'f'l" IDENtifICATION KJ: IIHall ""YUllln, CI",jflCAflIIJlM , ON IAC_,
IV\,~Dfn P[HAl.lIfSOf PIR.lUflY Icuntl'( THAT lAM HOT SUBJECT lOBAClI.UIIWllHtQ.DIHClllTHEAIECAUSE I HAVE 0 ..'0..""'" ',N,W.'" C""'''.'' ,.11I. ON ..e., ,
~'BEEN NOTIFIED tI",,"AMIU8Jf.Cr T08ACtl.UPWlTHHQlDIHGASAA(SU!. T OF Af-"URI! TOArPORt ALL "lENS' _
OR OIVlOENOS. OR 'HE INTlRNAL RlVlHUE SffMCl HAS NOlfIED... TH." I AM NO LONGER IUBJECT TO BACKUP
WITHIIQlOlHQ ~ ~.
DEPOSITOR'S '-y.,_ . J .L.. AUTHORIZED
SIGNATURE I I" 1 . ~ L ~ H'h 7r:C ' SIGNATURE
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RADIO SHACK OI-ZOIO
CAMP HILL-CAPITAL LIT.
3592 CAPITAL CllY MALL
CAMP HILL, PH 17011
(717) 7111-8323
RAE WHITE
Hi BRIAN OR
CARLISLE, PA 17013
(717) 258-08211
238-08211
Stock No. Description Dty. Price Amount
-------------------------------------------------------------------------------------
2110-29110 JPIOOO INKJET PRT 1 349.99 349.99
2110-29111 PK2 REFILL JPIOOO 1 10.99 10.99
2110-2962 REPL. PRINT HEAD 1 39.99 39.99
260-2963 COLOR KIT JPI000 1 69.99 69.99
2110-29114 COLOR PRTHEAD JPl 1 49.99 49.99
2110-0363 POWER SWITCH UNIT 1 . 79.99 79.99
2110-0384 DELUXE JOYSTICK 1 49.99 49.99
279-03511 25' 4COND MOD-MOD , 1 6.19 6.19
250-3130 CARMEN IN WORLD 1 49.99 49.99
250-4296 PLY LANG SPAN MPC 1 19.99 19.99
250-4250 PLYING W FRNH MPC . . 1 '1 19.99 19.99
250-3134 PRINT SHOP DLUXE 1 49.99 49.99
250-1911 THE FAR SIDE WIN 1 29.99 29.99
250-6137 TELL-TALE HRT VIS 1 19.99 19.99
250-11204 TIME ALMC VIS\MPC 1 39.99 39.99
250-4284 CURTIN CALL MPC 1 39.99 39.99
250-4282 GRT CITIES II MPC 1 29.99 29.99
2110-03112 SYSTM/PRINTR CRTS i 99.99 99.99
2110-0358 GLASS MONITOR FLT 1 , 39.99 39.99
2110-0329 WRIST REST 1 J 12.99 12.99
~bO-0330 TOP SHELF TRRY 1 12.99 12.99
2bO-03'3b COPY HOLDER 1 4.99 4.99
260-0342 MlmI'TOR COVER 1 9.99 9.99
260-0343 KEYBOARD COVER 1 4.!i9 4.99
260-0356 PRINTER COVER SML 1 11.99 6.99
260-0353 DELUXE MOUSE PRO 1 9.99 9.99
2110-0275 MOUSE HANGER 1 2.49 2.49
2bO-03115 MOUSE CORD CLIP 1 1.99 1.99
260-0431 10-3.5" HD DISKS 1 10.99 10.99
2bO-0244 PK100 3.5 DSK LBL 1 2.99 2.99
~60-0140 3.5" DISK BOX-35 1 8.99 8.99
420-0223 CD STORAGE RACK42 1 9.99 9.99
420-0227 CD LEN CLEAN DISC 1 9.99 9.99
420-02211 CD CLN KIT W/CVR 1 9.99 9.99
260-0295 3.5/5.25 CLNk KIT 1 7.99 7.99
640-4325 DUST REMOVR SPRAY 1 7.99 7.99
640-4344 CLOTH WIPE PACK 1 3.49 3.49
Z1I0-0134 1M 9.5Xll 20. BOW 1 11.99 11.99
2110-1328 PKl000 I-WIDE LBL 1 11.29 6.29
SYSTEM 1 2499.00 2499.00
Page 1 ot 2
i
I
Sto~k No. D..~rlptlon
( ~ "!l7f'{
RADIO SHACK 01-2010
CAMP HILL-CAPITAL CITY
3~9~ CAPITAL CITY MALL
CAMP HILL, PA 17011
(717) 7bl-8323
Ilty.
Prl~.
Amount
-------------------------------------------------------------------------------------
;;:50-"095 VGM500 15" .28 EM 1 599.99
~50-0"0" AST ADVTG ADVNTR 1 1999.00
bO MONTH COMPUTER CARRY IN TSP FOR
2bO-29bO JPIOOO PRINTER INKJE 1 89.00 89.00
bO MONTH COMPUTER CARRY IN TSP FOR
2bO-03b3 POWER SWITCH UNIT 1 .00 .00
bO MONTH COMPUTER CARRY IN TSP FOR
250-0404 AST 48bDX2 bbMHZ 420 1 129.00 129.00
SUBTOTAL 3972. 11
TAX 238.33
, TOTAL 4210.44
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THANKS FOR SHOPPING YOUR KnART
IF YOU FINO A LO~ER PRICE ELSE~HERE ~E
WILL MATCH IT
t'~~~13lijB~a ,~~a \:~% N
1 g2IHJ.JJ ,,"'UMn~ll~ L..~a
4
34707036710 nEnOREX
6 034707036611 nEnOREX
7 034707017726 nEnOREX
8 034707017726 nEnOREX
9 VOID LINE. 5
034707036611 nEnOREX
SUST A
TAX
TOTAL
CHECK TENDERED
CHANGE
35.44
2.03
37.47
37.47
.00 .
8881-8881 024 07 8/19/94 9208 3107P
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6 OB95SSi4S367
LE1TSR-SIZE CLIP <SALE>
. TICKET 2,04
7 020755363649 '
~AG~ETIC S"X4" M <SRLE>
TICKET 2.99
B 01B421004~26
ROUND P~NCIL SHA <SALE,
T!C~~T 0.93
9 019'2j~C'026
ROU~:' ~.: 01: l~ SHR <S~L~)
TlC~C 0.93
SU~ TOTQl
6,0:7. O;l(
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0.93
1.79 ." '
0.69
0.69
9.34
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CARLISLE PLAZA
CARLISLE, ~A !?C:3
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WA~MART
W ESE l l
FOR l E S S
STORE t 1886
HECHANICS 55
6 OPt 00000070 TEt 01 TRt 06 7
00\161407896 107.00 J
SUBTOTAL 107.00
SALES TAX I 6,4~
TOTAL \13 .42
u VOIDED EIlTRY ..
t IR 001161407896 107.00'
CH R 00\\61407896 97.00
SUBTOTAL 97,00
SALES TAX 1 5.82
l 1 2.
HANGING FilE 007 1 . J
STOR CRATE 007203812701 2.50 J
TARTAN ElEC 005400749656 0.67 J
.. SUBTOTAL 104.09
SALES TAX 1 6.24
. ., TOTAL 110,33
. ' .', CHECK TEND 110.33
.~~.. CHANGE DUE 0.00
TCt 60611866628042108
THANK YOU FOR CHOOSINO UAL-HARTtI8861
08/27/94 22:54:24
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010561 DAY DREANIN ~AUY
913596 MONOPOLY
995004 SNART START
SU9 TOTAL
6.00070 TAX
TOTAL
CHECK
nUt~K u'CP uuU~t~
.10."''' i'i1 u il I'i",,,,i\
021304120 1:3569~
9.91
14,99
19.99
44.91
2.10
m.61
41.67
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(lOrn ptL'tCr 9 o..VYl e ~
RED HOT UALUES ON REO SLASHED ITENS~
CUSTOMER COPY
IPU LN 0622159
THANK YOU FOR SHOPPING AT KAY-9EE
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18:53 286-1941016-022 AIR
DR>IVEP. . Ll CENSE NUI1B~R
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.,. .,... ":.i." ',,' '.. },STOCKTl:lKE IUTH 'DRTE ~D...DlV19/94
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rint Shop Deluxe 1.2
Merchandise
Sales Tax (! 6%
Total
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SUBTOTAL 2~'~ :j
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