COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTYJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)FIRST JUDICIAL DISTRICT:CIVIL TRIAL DIVISION::TERM, 20::No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ORDER APPROVING SETTLEMENTANDORDER FOR DISTRIBUTIONTHE PEOPLE OF THE STATE OF NEW YORK TOAND NOW, this day of , 20, upon consideration of the Petition For Leave to Compromise A Minor's Action, filed it is hereby ORDERED and DECREEDthatPetitionerisauthorized toenterintoasettlementwith Defendant(s) in the gross sum of ($) Dollars. Defendant(s) shall forward all settlement drafts or checks to Petitioners' counsel for proper distribution.IT IS FURTHER ORDERED and DECREED that the settlement proceeds be allocated as follows:GREETINGS:1.To: Minor Plaintiff(s)NAMEDATE OF BIRTHSOCIAL SECURITY #WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,$ located at County of$ o'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room2.To: Adult Plaintiff(s)$Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.$IT IS FURTHER ORDERED and DECREED that the settlement proceeds be distributed as follows:1.Minor Plaintiff*, one of the Justices of theNAMEDATE OF BIRTHSOCIAL SECURITY #Court in Witness, Honorableday of, 20 County,$ $ (Attorney must sign above and type name below)a.To: , Esquire$Reimbursement of Costs b.Attorney(s) forTo: $ Costs c.To: , Esquire$Counsel Fees d.Office and P.O. AddressThe balance, the sum of $, payable to , a minor, shall be distributed as follows+:* The share of each minor Plaintiff shall be separately distributed. + In the event a portion of the settlement is payable through the purchase of an annuity, set forth the credit rating of the entity whichTelephone No.: Facsimile No.: E-Mail Address:assumes responsibility for future payments, the present cost of the annuity, as well as the periodic and lump sum payments.Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)OPTION 1To: , Guardian of the Estate of , a minor; provided, however, that no payment shall be made to the guardian until the guardian has posted additional security as required by the Orphans' Court Division of County pursuant to 20 Pa.C.S. ยง5121, et seq. An appropriate Petition shall be filed with the Orphans' Court within thirty (30) days.OPTION 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Counsel is hereby authorized to execute all documentation necessary to purchase saving certificate(s), from federally insured banks or savings institutions having an office in Philadelphia County, in the sum of $, each not to exceed the insured amount, with the funds payable to the minor upon majority. The certificate shall be titled and restricted as follows:THE PEOPLE OF THE STATE OF NEW YORK TO, a minor, not to be redeemed except for renewal in its entirety, not to be withdrawn, assigned, negotiated, or, otherwise alienated before the minor attains majority, except upon prior Order of Court.Counsel shall open a savings account in the sum of $ in the name of the minor. The savings account shall be titled and restricted as follows:GREETINGS:, a minor, not to be withdrawn before the minor attains majority, except for the payment of city, state, and federal income taxes on the interest earned by the savings certificate and savings account, or upon prior Order of Court.WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofo'clock in the day ofnoon, and at any recessed in room, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of the2. Adult Plaintiff* The portion of the settlement payable to , an Adult Plaintiff named in the Complaint, shall be distributed as follows:To: , Esquire $Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.Reimbursement for CostsTo: $Costs, one of the Justices of theCourt in Witness, Honorableday of, 20 County,To: , Esquire $Counsel FeesTo: $(Attorney must sign above and type name below)PlaintiffPursuant to Phila. Civ. R.2039.1(I), counsel shall file with the office of Civil Administration within sixty (60)days from the date of this final Order, proof of the establishment of the accounts as required herein, by Affidavit from counsel certifying compliance with this Order. Counsel shall attach to the Affidavit a copy of the Certificate of Deposit and/or bank account containing the required restrictions.Attorney(s) forBY THE COURT:Office and P.O. AddressJ.ORPHANS' COURT DIVISIONTelephone No.: Facsimile No.: E-Mail Address:*The share of each adult plaintiff shall be separately distributed.Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com
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