__[Attorney name]__
__[Address]__
__[Telephone number]__

Attorney for Plaintiff, __[name]__


            _ _ _ _ _ _ Court, County of _ _ _ _ _ _
                   __[_ _ _ _ _ _ District]__

_ _ _ _ _ _ _ _ _ _ _ _ _  )   No. _ _ _ _ _ _
                  Plaintiff)
By __[name]__,               ) ORDER APPROVING COMPROMISE OF
__[his/her]__ guardian     )   __[MINOR/INCOMPETENT]__'S
ad litem                                 )CLAIM  
vs.                                                        )
                                                                          )
_ _ _ _ _ _ _ _ _ _ _ _ _  )
                               Defendant(s))
_________________________  )

     The petition of __[name]__, as guardian ad litem for
plaintiff, __[name]__, __[a minor/an incompetent person]__, for
an order approving the proposed compromise of plaintiff's claim
against defendant, __[name]__, was heard at the above date and
time. Appearing as attorneys were: __[List names of attorneys and
parties represented by each]__.
     Satisfactory proof having been made, and good cause
appearing,
     IT IS ORDERED that:
     1.   The compromise be approved.
     2.   On payment of $_ _ _ _ _ _ in the manner provided
below, defendant be fully released and discharged from all claims
of plaintiff arising from the facts set forth in the petition.
     3.   The proceeds of the settlement be disbursed as follows:
               a.__[Itemize payments authorized to be made from
settlement proceeds, e.g., to Allen & Black, Attorneys-at-Law,
for legal services rendered, $_ _ _ _ _ _, and for costs
advanced, $_ _ _ _ _ _; to Dr. John Smith, for medical services
rendered, $_ _ _ _ _ _]__.
               b.The balance of $_ _ _ _ _ _ is to be __[state
disposition, e.g., deposited in the Union Central Bank, Main
Street Branch, in the name of petitioner as trustee for
plaintiff, together with a certified copy of this order, and is
not to be withdrawn without first obtaining a court order. Bond
is hereby waived]__.
     4.   On receipt of the full amount of the settlement,
petitioner be authorized and directed to execute and deliver to
defendant:
               a.A complete final release and discharge of all
claims of plaintiff arising from the facts set forth in the
petition.
               b.A properly executed dismissal of this action with
prejudice.
     5.   __[State any additional orders]__.

Date: _ _ _ _ _ _                        ___________________________
                                                                                                                                                                                    Judge
      


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Legal Forms : Set Two