HomeMy WebLinkAbout96-00262
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STATE FARM INSURANCE COMPANIES
HARRISBURG
fEB 2 lj 1993
RECEIVED
STANDARD SETTLEMENT AGREEMENT
THIS AGREEMENT entered into this 21TH day of JANUARY , 1993 ,
by and between State Farm Insurance Company(hereinafter the carrier) and
KIM WETZLER (hereinafter the uninsured).
1. In forebearance of the filing of a suit against him, the unins~red
agrees to pay the carrier the sum of $ 1~005.48 , payable as follows:
the sum of $ 25.00 by the 15TH aay of FEBRUARY , 1993 , and a
like sum of $25.00 by the 15TH of each and every month thereafter,
IIntil the whole of said slim shall he pald.
2.
1 above,
injuries
Upon the payment of all monies due according to the terms of Paragraph
the carrier shall release and discharge the uninsured in full for all
and for all damages sustained, to the e~tent of payment by the carrier.
3. The carrier agrees not to institute any suit to recover this sum,
or any part thereof, as long as the uninsured is not in default of this
Agreement.
4. Waiver of any default shall not affect the carrier's right upon any
later default.
5. I hereby authorize and empower the Prothonotary or Clerk or any
attorney of any court of record in Pennsylvania to appear for and to enter
Judgement against me in the sum of $1,005.48 , with costs of suit, release
of errors, without stay of execution and w1th 10 per cent added for collection
fees, and I hereby waive and release all relief from any all appraisement,
stay or exemption laws of any state, now enforced, or hereafter to be passed.
IN WITNESS WHEREOF, uninsured hereby sets his hand and seal the day and
year first above written, with intention of being legally bound thereby.
WITNESS:
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(DATE)
INSURED: DAVID BITNER
STATE FARM FIRE & CASUALTY COMPANY
XXXXSTATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
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PEAATOR'S
B'l:DAVE BUCHER
CLAIM
(DATE OF BIRTH)
38-6538-034
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Home Office: Bloomington, Illinois 61710-0001
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State Farm Insurance Companies
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January 15, 1996
H."ltbu,g "Mo. C.nt.,
115 Urnokiln ".od
P.O. "x ZS1
Now Cumbortend, P. 17010-0257
ottice ot the prothonotary
CUmberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
RF.: Claim Number:
Date of. Loss:
Our Insured:
Claimant Name:
File Number:
38-6538-034
December 17, 1992
David Bitner
Kim M. Wetzler
Dear Sir:
Enclosed please tind the oriqinal judqement note which we have
trom a debtor tor a 12-17-92 auto accident. The debtor has
tailed to continue payments. The balance owed at this time is
$655.48. We ask that you enter a judqement aqainst Kim Wetzler
at thJ.s time. Your cooperation is appreciated. I have enclosed
the neccessary tee. Thank you.
Sincerely,
,Xt'tul,,- j;c-e-(
Linda L. Koch
Claim Specialist
(717) 774-9010
State Farm Mutual Automobile Insurance company
HOME OFFICES, BLOOMINGTON. ILLINOIS 51710.0001