Form 22.0 "Application to Settle a Minor's Claim and Entry Setting Hearing" - Ohio

What Is Form 22.0?

This is a legal form that was released by the Ohio Judicial System - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 1998;
  • The latest edition provided by the Ohio Judicial System;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 22.0 by clicking the link below or browse more documents and templates provided by the Ohio Judicial System.

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Download Form 22.0 "Application to Settle a Minor's Claim and Entry Setting Hearing" - Ohio

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PROBATE 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
PROBATE 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
(Reverse of Form 22.0)
The parent_ , ________________________________, claim $ _________________ for damages on
account of loss of service of this minor and that claim is included in this settlement offer.
This is a structured settlement. All necessary documents, including a statement of the present value
of the settlement, are filed herewith.
The applicant requests that:
The Court authorize the applicant to execute a release which shall be effective upon payment of the
settlement.
The Court order payment of the above expenses and order that the net amount of
$ ________________________ for the benefit of the minor be:
Deposited
in
the
name
of
the
minor
with
__________________________
____________________________________________, a financial institution, and not to
be released until the minor attains the age of majority or upon further order of this Court.
Delivered to the legal guardian.
Delivered to ___________________________________________, parent __ and
natural guardian__.
Delivered to ________________________________________________, the person by
whom the minor is maintained.
Structured as set forth in the attached documents.
Supplemental forms required by local rule of Court are attached.
__________________________________
___________________________________
Attorney for Applicant
Applicant
__________________________________
___________________________________
Typed or Printed Name
Typed or Printed Name
__________________________________
___________________________________
__________________________________
___________________________________
Address
Address
__________________________________
___________________________________
Phone Number (include area code)
Phone Number (include area code)
Attorney Registration No. ____________
ENTRY SETTING HEARING AND ORDERING NOTICE
The Court sets _____________________________, at __________ o'clock __.m. as the date and time
for hearing the above application and orders notice to be given by the applicant, as provided in the Rules
of Civil Procedure, to the parents who have not waived notice and (further orders that the minor and
parent_ attend the hearing.)
___________________________________
Probate Judge
Print Form
FORM 22.0 - APPLICATION TO SETTLE A MINOR'S CLAIM AND ENTRY SETTING HEARING
10/1/98
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