Form 22.0 - Application To Settle A Minor'S Claim - Ohio
Download a blank fillable Form 22.0 - Application To Settle A Minor'S Claim - Ohio in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 22.0 - Application To Settle A Minor'S Claim - Ohio with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2PROBATE COURT OF ___________________ COUNTY, OHIO
IN THE MATTER OF ________________________________________________________
CASE NO. ___________________
APPLICATION TO SETTLE A MINOR'S CLAIM
[R.C. 2111.05, R.C. 2111.18, SUP. R. 67 AND 68]
[Check applicable boxes, complete applicable blanks, strike inapplicable language, and attach supporting
documentation.]
The applicant states that:
_________________________________________, is an unemancipated minor, born _________________, ______,
residing at ______________________________________________ in this county who on or about
____________________________, ______, suffered personal injury (and damage to this minor's property) by
wrongful act, neglect, or default that entitles this minor to maintain an action to recover damages. A copy of the birth
certificate is attached.
Attached is a narrative statement in support of the proffered settlement setting forth a description of the occurrence,
the injury or damage, the treatment progress and current prognosis by the treating physicians, and other proposed or
actual settlements resulting from the same occurrence being paid to persons other than this minor. Counsel will advise
at the hearing as to liability and collectability.
There is no legal guardian of the estate, and the Court may authorize the settlement without the
appointment of a guardian.
_________________________________ is the legal guardian of the estate. Case No. ______________
_________________________________ is (are) the parent__ and natural guardian__.
_________________________________ is the person by whom the minor is maintained.
There is a (full) (partial) settlement offer of $ ________________________ without suit being filed.
There is a (full) (partial) settlement offer of $ _________________________ after suit was filed; the
style of the case, court, and case number being ___________________________________________.
The proffered settlement should be approved.
Unreimbursed medical and other expenses of $ ________________________ have been incurred.
Attached is a list of such expenses and proposed payees.
A reasonable attorney fee for the attorney's services is $ _________________________ and
reimbursement to the attorney for suit expenses is $ _________________________. A copy of the
attorney's fee contract that has (has not) received prior approval of this Court, subject to
modification, and an itemization of suit expenses are attached.
FORM 22.0 - APPLICATION TO SETTLE A MINOR'S CLAIM AND ENTRY SETTING HEARING
10/1/98
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal