FJD - ORDER APPROVING SETTLEMENT AND ORDER FOR DISTRIBUTION

IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY
FIRST JUDICIAL DISTRICT

	:	CIVIL TRIAL DIVISION
	:
	:	TERM, 19
	:
	:	NO:

ORDER APPROVING SETTLEMENT
AND
ORDER FOR DISTRIBUTION

AND NOW, thisday of, 19 , upon consideration of the Petition For Leave to Compromise A Minor's Action, filed ____________________ it is hereby ORDERED and DECREED that Petitioner is authorized to enter into a settlement with
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:

1. To: Minor Plaintiff(s)

NAME	DATE OF BIRTH	SOC. SEC. #
________________	________________	________________	$_____________
________________	________________	________________	$_____________

2. To: Adult Plaintiff(s)

_____________________________________ $_____________

IT IS FURTHER ORDERED and DECREED that the settlement proceeds be distributed as follows:

1. Minor Plaintiff*

NAME DATE OF BIRTH SOC. SEC. #

_______________ _______________ _______________ $_____________

a.	To:_____________________, Esquire	$_____________ Reimbursement of Costs
b.	To:_____________________	$_____________ Costs
c.	To:_____________________, Esquire	$_____________ Counsel Fees
d.	The balance, the sum of $___________ payable to ____________________________, a minor, shall be distributed as follows⁺:

OPTION 1

To:_____________________, 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. §5121, 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

___________________________________

*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 which assumes responsibility for future payments, the present cost of the annuity, as well as the periodic and lump sum payments.

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:

_____________________, 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:

_____________________, 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.

2. Adult Plaintiff*

The portion of the settlement payable to _____________________, an Adult Plaintiff named in the Complaint, shall be distributed as follows:

To:_____________________, Esquire	$_____________ Reimbursement of Costs
To:_____________________	$_____________ Costs

*The share of each adult plaintiff shall be separately distributed.

To:_____________________, Esquire $_____________
Counsel Fees

To:_____________________ $_____________
Plaintiff

Pursuant 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.

BY THE COURT:
_________________________________
J.
ORPHANS' COURT DIVISION