York Cnty. C.P. Local Rules of Orphans' Court Procedure Rule 5.6.2

(a) No action to which a minor is a party shall be compromised, settled, or discontinued,

except with court approval, pursuant to a petition, presented by the guardian of the minor

and a hearing before the court.

(1) The petition shall contain the following:

(i) The initials of the minor’s name and reference to the Confidential

Information Form (CIF);

(ii) The names and addresses of both of the minor’s parents. If one or both of

the minor’s parents are not identifiable, the Petition shall set forth the reasons

for their absence and attach as an exhibit any related documentation;

(iii) Written approval of the minor if the minor is over the age of 14 years;

(iv) A statement as to whether or not a guardian has been appointed for the

minor by the Orphans’ Court of this, or any other, jurisdiction;

(v) The mailing address of the Respondent(s) entering into the settlement

agreement, for both the Insured Party and the Insurance Company entering

the settlement agreement on behalf of the Insured;

(vi) A summary of the facts of the case;

(vii) An affidavit of the parents and/or guardians, certifying the physical

condition of the minor and reasons why the parents and/or guardians

approve of the settlement, and whether the parents and/or guardians sought

independent legal counsel on behalf of the minor prior to accepting the terms

of the settlement;

(viii) A specific list of costs sought to be reimbursed from the gross

settlement;

(ix) A report from a physician, or other documentation, clearly stating the

physical and/or mental condition of the minor, whether further treatment is

necessary, and the prognosis of the minor’s recovery;

(x) A statement of the reasonableness of counsel fees, which must be based

upon the settlement amount, presuming 25% of the settlement amount to be

reasonable, which presumption is rebuttable at the hearing. Counsel fees

shall be reduced by fees received, if any, if counsel also represented the

Respondent(s) in a subrogated claim;

(xi) A statement of whether any additional counsel fees were paid or will be

paid as a result of representing the Respondent(s) and subrogation claims;

(xii) In the event of a deceased minor, sufficient reasons and legal authority

shall be listed for any request that funds be allocated to the parents of

deceased minor or any request to allocate settlement proceeds among

children of a deceased minor, if applicable;

(xiii) A statement of any actual or potential lien of the Department of Human

Services and how such liens have been resolved; and

(xiv) Any special request for early distribution, alternative deposit of funds, or

other deviation from the order as set forth in York R.O.C.P. 5.6.2 shall be

stated in the Petition with supporting justification for the special request.

Counsel shall be prepared to address the necessity for the special request at

the time of the hearing.

(b) At the time of the hearing, counsel for Petitioner shall present a proposed Order

substantially in the form set forth hereinbelow.

(c) Within 14 days of receipt of settlement proceeds, counsel for Petitioner shall cause the

funds belonging to the minor to be deposited as directed by the court’s order approving the

compromise and settlement and directing distribution.

(d) Within 14 days of depositing the funds belonging to the minor, counsel for petitioner

shall file proof of deposit by way of an affidavit substantially in the form set forth

hereinbelow.

Form: Order Scheduling Hearing.

IN THE COURT OF COMMON PLEAS OF YORK COUNTY, PENNSYLVANIA

ORPHANS’ COURT DIVISION

In re: Estate of _______________, a Minor: No. 67-

(Initials only, use CIF for full name):

ORDER SCHEDULING A HEARING

ON THE COMPROMISE OR SETTLEMENT OF

AN ACTION IN WHICH A MINOR IS A PARTY

AND NOW, this ____ day of __________________ 20__, a hearing on the Petition

is hereby scheduled before the undersigned Judge on the ___ day of________, 20____,

beginning at ___________ __. m. In Courtroom No. ___, on the___th Floor, York County

Judicial Center, 45 North George Street, York, PA 17401.

The Petition does/does not comply with the requirements of York R.O.C.P.

5.6.2, and, if not, then, the Petitioner shall establish those requirements at the hearing.

At the time of the hearing, counsel for the Petitioner shall present a proposed

Order approving settlement substantially in the form as set forth in York R.O.C.P. 5.6.2.

Notice of the entry of this Order shall be provided to all parties by the Clerk of the

Orphans’ Court in accordance with Pa. R.O.C.P. Rule 4.6.

BY THE COURT,

_________________________

Judge

Form: Order Approving Compromise

IN THE COURT OF COMMON PLEAS OF YORK COUNTY, PENNSYLVANIA ORPHANS’

COURT DIVISION

In re: Estate of _______________, a Minor: No. 67-

(Initials only, use CIF for full name):

ORDER APPROVING

COMPROMISE, SETTLEMENT AND DISTRIBUTION

AND NOW, this _________ day of __________________ 20__, upon consideration of the

Petition For Leave To Compromise/Settle An Action Involving A Minor, it is hereby

ORDERED that the Petition is GRANTED and

1. Petitioner is authorized to enter into a settlement with the Respondent in a

gross amount of $_________________________ on behalf of the minor.

2. Respondent shall forward all settlement drafts or checks to Petitioner’s

counsel for proper distribution.

3. The settlement proceeds shall be allocated as follows:

a. To: _____________, (Minor’s Initials), a Minor $____________

b. To: _____________, (Minor's Initials), a Minor $____________

4. IT IS FURTHER ORDERED that the settlement proceeds be distributed as

follows:

a. To: ____________________, Esquire (Name of Counsel)

Costs $_________________

Counsel Fees $_________________

b. The balance of the settlement proceeds, the sum of $___________ as

follows:

1. _________________________________________

2. _________________________________________

and any interest thereon, payable to the minor, or minors in a pro-rata share as

set forth above.

5. Within 14 days of receipt of the settlement proceeds, COUNSEL, and not the

parent(s) or guardian(s) of the minor, is hereby authorized and specifically

DIRECTED to execute all documentation necessary to deposit the funds

belonging to the minor into an interest-bearing savings account or savings

certificate in a federally insured financial institution having an office in York

County, IN THE NAME OF THE MINOR ONLY. The savings account or

certificate shall be marked as hereinafter directed.

6. The savings account shall be titled and restricted as follows:

(Minor’s Name), a minor, not to be withdrawn before minor attains majority or

upon prior Order of Court.

7. The savings certificate shall be titled and restricted as follows:

(Minor’s Name), a minor, not to be redeemed except for renewal in its

entirety, nor to be withdrawn, assigned, negotiated, or otherwise alienated

before the minor attains majority, except upon prior Order of Court.

8. If no withdrawals are made from the investments authorized by this Order,

the depository may pay over the balance on deposit when the minor attains

majority, as defined with reference to 20 Pa.C.S.A. § 102, upon the order of the

late minor, without further Order of this Court.

9. Counsel shall file with the Clerk of the Orphans Court of York County,

Pennsylvania, within 14 days from the date of deposit of the funds, proof of the

establishment of the accounts as required herein, by Affidavit from counsel

certifying compliance with this Order.

a. Counsel shall attach to the Affidavit a copy of this Order as well as a

copy of the Certificate of Deposit or bank account showing the amount

deposited and containing the required restrictions.

b. The Affidavit shall further contain a specific averment by counsel that

counsel, and not the parent(s) and/or guardian(s) of the minor,

established the account(s) and deposited the funds therein as directed

above and that counsel has provided to the financial institution a certified

copy of this Order.

c. The Affidavit shall be substantially in the form as set forth in

hereinbelow.

10. Notice of the entry of this Order shall be provided to all parties by the

Clerk of the Orphans’ Court in accordance with Pa. R.O.C.P. Rule 4.6.

BY THE COURT,

_________________________

Judge

Form: Affidavit of Deposit

IN THE COURT OF COMMON PLEAS OF YORK COUNTY, PENNSYLVANIA

ORPHANS’ COURT DIVISION

Estate of:

______________________, a minor: No. 67

(Initials only, use CIF form):

AFFIDAVIT OF DEPOSIT OF MINOR’S FUNDS

COMMONWEALTH OF PENNSYLVANIA:

: SS

COUNTY OF YORK:

I, ___________________________, being duly sworn according to law, depose and say:

1. I am counsel for petitioner in the above captioned matter.

2. I am authorized to make this affidavit on behalf of

______________________________.

3. On ___________________, 202_, the sum of $____________________ was

deposited into an insured, interest-bearing Savings Account / Certificate of Deposit,

No._______ (last 4 digits only, use CIF Form) with _______________________________

(Name of Financial Institution) pursuant to the Court Order entered on

_____________________, 202_.

4. Account / Certificate No. ____ (last 4 digits only, Use CIF Form) is entitled,

_____________ (initials only), a Minor.

5. The express prohibition of withdrawals of income or principal prior to

__________________ without FURTHER ORDER OF COURT has been noted on the

depository’s records and on the passbook/certificate.

6. A certified copy of the above referenced Court Order was provided to the

above-named financial institution.

Name (printed): ____________________

Signature: ____________________

Sworn to and subscribed before me

this ____ day of ________, 202_.

_______________________________

Notary Public