Name, Address and Telephone No. of Attorney(s) Space Below for Use of Court Clerk Only Attorney(s) for SUPERIOR COURT OF CALIFORNIA, COUNTY OF KERN 1415 TRUXTUN AVENUE, BAKERSFIELD, CALIFORNIA-93301 Plaintiff(s): No ENTERED Defendant (s): ORDER APPROVING COMPROMISE OF MINOR'S CLAIM (Abbreviated Title) This proceeding was heard on ............................................... by the Honorable , Department Good cause appearing, IT IS ORDERED that: 1. On payment of $ ................................in the manner provided below, the compromise of the above minor's claim against ( Defendant): herein called "payor", is approved and the paver shall be fully and forever released and discharged from all claims, charges, and demands of such minor arising from the accident set forth in the petition 2. Payor or his insurer shall disburse the full amount of the settlement by check or draft payable to (Name of petitioner and name and address of financial institution): The bank or other financial institution shall deposit the check or draft of the payor or his insurer as follows: To the account of (Petitioner): As trustee for (Minor): Not to be withdrawn without an order of court 4. The bank or other financial institution shall thereafter honor the following disbursement(s) made by the petitioner from such account by separate checks or drafts payable as follows: (a) (b) (c) (d) Attorney's fees to (Name) Reimbursement of medical and other costs to (Name(s)) Medical, hospital, ambulance, nursing and other expenses to (Names) Other (specify) Total allowances for fees and expenses 5. $ $ $ $ $ 3. No other disbursements or withdrawals shall be made from such account without an order of court, provided that such bank or other financial institution shall, without an order of court, release all funds to the minor on the date when the minor will attain the age of 18 years, namely, on (Date) KC Clerk CI 28 (See reverse side) (1M-R.12-74) ORDER APPROVING COMPROMISE OF MINOR'S CLAIM 2000 (C) American LegalNet, Inc. 6. Petitioner shall promptly: (1) Deliver the payor's or his insurer's check or draft, together with a certified or endorsed copy of this order, to the manager of such financial institution, and (2) File with the county clerk a written receipt of such financial institution acknowledging receipt and deposit of money as provided in this order, together with petition er's declaration or affidavit of compliance with the terms of this order and the dates thereof. On receipt of the full amount of the settlement, petitioner shall execute and deliver to payor a complete release or disc charge from this claim and a dismissal of this action with prejudice. 7. Date: Judge KC Clerk Cl 28 (1M - R.12-74)(back) 2000 (C) American LegalNet, Inc.