MINOR SETTLEMENT CHECKLIST
Filing Fee
Court Costs: $119.00 without appointment of guardian.
- If the net settlement amount is $25,000.00 or less, you do not need a guardianship, otherwise a separate guardianship for a minor must be established.
Requirements
If the net settlement funds exceed $25,000 then a Guardianship is required with this settlement. The Guardianship action must be filed prior to or in conjunction with this minor settlement paperwork.
Note:
- All paperwork must be typed or written neatly in blue ink.
- All filings must be single-sided. We will not accept double-sided originals.
- Please do not staple original paperwork. We cannot accept filings with staples.
Initial Filing
- Self-Representation Acknowledgment (FC Form 75.1) If applicable
- This form must be filed if applicant is not represented by an attorney.
- Contact Information Form (FC Form 75.3-A)
- Application to Settle a Minor’s Claim (Form 22.0)
The following must be included with the Application:
- Narrative statement of the incident and injuries to the minor
- Copy of the signed fee agreement between parties and attorney (Local Rule 71.5)
- Photocopy of minor’s birth certificate
- Copy of structured settlement agreement If applicable (See Local Rule 68.2)
- If structured settlement is funded by an annuity: An affidavit or other similar proof must be attached, which verifies that the insurer issuing the annuity funding the structured settlement meets the qualifications listed in Local Rule 68.2(C)
- List of itemized case expenses claimed for reimbursement
- List of medical expenses claimed for reimbursement
- Waiver and Consent signed by both parents (Form 22.1)
- If a parent will not sign Waiver and Consent, then the applicant must serve the parent with Notice of this settlement.
- If a parent is deceased, you must provide a copy of the death certificate.
- Proposed Entry Approving Settlement of Minor’s Claim (Form 22.2)
- Proposed Verification of Receipt and Deposit (Form 22.3), if net proceeds less than $25,000.00
- Proposed Report of Distribution of Minor’s Claim (Form 22.4)
- Application for Approval of Attorney Fee Agreement (FC Form 71.5-A) If applicable
- Entry Approving Attorney Fee Agreement (FC Form 71.5-B) If applicable
- A signed statement from an independent certified public accountant, actuary, certified financial planner or equivalently qualified professional specifying the present value of the structured settlement and the calculations used to arrive at the present value determination. If applicable