Fill and Sign the Cason V Western Heritage Insurance Company Et Al No 3 Form

IN THE CIRCUIT COURT OF ______________ COUNTY, ALABAMA ____________________________________,* * PLAINTIFF,* *vs. * CASE NO. ______________ *___________________________________,* * DEFENDANT* ORDER FOR PRO-AMI SETTLEMENT This cause coming on to be heard upon the Petition for Pro-Ami Settlement heretofore filed by _______________________________, individually, and as ___________ and next friend of _________________, a minor, and __________________________________, and the Court having appointed Hon. _________________________ as Guardian ad Litem to protect the interest of said minor child and the Court having heard testimony and received evidence in open court, with all parties being present and represented by counsel, concerning the nature and circumstances of the incident and the settlement which is the basis of this proceeding, the Court hereby finds as follows: 1. That _______________________ is a minor child who is properly represented by her ________ and next friend, _________________________, and that the minor has resided in the custody of her _______________ since birth.2. That _________________________ has agreed to pay the sum of $____________ to settle the claims of the Plaintiffs in this matter and that to accept this settlement would be in the best interest of the minor,_______________________________3. That _____________________________ entered into a fair and reasonable attorney fee arrangement with Hon. _____________________ to pay __________ (____) of any amount recovered in excess of $______________ and, thus, said attorney is entitled to $_______________ as his/her attorney fee for the representation of the Plaintiffs in this cause.4. That ______________________________, individually, is entitled to $______________ and _____________________________, as ___________ and next friend of _____________________________, shall be entitled to $______________.5.That $___________ is authorized to be paid to ________________________ in settlement of its subrogation claim for medical expenses paid.6. That __________________________ (along with _____________________) has custody of ___________________________ and his/her ___________ resides with him/her and he/she is an honest and suitable person to disburse the funds for said child.7.That there has been no guardian or conservator appointed for the minor and no action is pending for appointment of conservator or guardian over the minor’s estate.8.That the factual allegations set forth in the Petition are determined by the Court to be true and correct. It is therefore, ORDERED, ADJURED and DECREED that the Pro-Ami Settlement be approved and that judgment be and is hereby entered in favor of_________________________, individually, and as __________ and next friend of ____________________________, a minor, in the amount of $_____________ and that this judgment shall be a conclusive and final determination of all issues raised by the Petition and other pleadings heretofore filed, and the satisfaction of the judgment entered hereby shall discharge all parties from further liability in this cause.It is further ORDERED, ADJUDGED and DECREED that the $____________ judgment due to ___________________, individually, and as __________ and next friend of ____________________, shall be paid into the Circuit Court of ______________ County, Alabama, and the Clerk of said Court is hereby directed to pay the proceeds of the settlement as follows: 1.The sum of $_____________ to be paid to _______________________, as attorney for the Plaintiffs. 2.The sum of $_____________ to _______________________ for his/her individual claim in this case. 3.The sum of $______________ to _________________________________. 4.The sum of $______________ to be paid by the Circuit Court of __________ County, Alabama, to _________________________ as ____________ and next friend of __________________________ for the benefit of ___________________________, a minor as follows: A.$_______ on ____________ ____, _______.B.$_______ on ____________ ____, _______.C.$_______ on ____________ ____, _______.D.$_______ on ____________ ____, _______.E.$_______ on____________ ____, _______, plus accrued interest, up to a total of $______.F.Remaining accrued interest on ___________ ____, ______. Any remaining monies on hand shall be paid on the same day of each successive year, with each payment not to exceed $_______.G.Any payments due hereunder may be paid directly to ____________________ upon application and proof by her of reaching the age of majority. 5.That pending the payment of these sums, the Circuit Clerk of __________ County, Alabama, is hereby directed to deposit the balance of any monies on hand from these settlement proceeds in an interest bearing account at a banking institution in ________________, Alabama.6. That upon receipt of any of said monies, ________________________ is hereby ORDERED to deposit any of said sums received in a separate account in his/her name on behalf of ____________________________ in a financial institution for the use and benefit of _____________________________. 7.That a Guardian ad Litem fee of $_________ is awarded to Hon. __________________ for his/her representation of the minor child, to be taxed as cost in this matter.8. That costs in this matter are assessed against the Defendant, to include the sum $__________ which shall be reimbursed to attorney for the plaintiff.Done this _______ day of ________________________ ________. _______________________________________Circuit Judge