DASTI, MURPHY,McGUCKIN,ULAKY,

KOUTSOURIS & CONNORS

A Professional Corporation Fed Id #22-3450668
JERRY J. DASTI COUNSELLORS AT LAW
GEORGE F. MURPHY,JR. ~' 0 THE CLOCK TOWER BUILDING TELEPHONE NUMBERS
GREGORY P. McGUCK1N 620 WEST LACEY ROAD (609)971-1010
ROBERT E. ULAKY $ > POST OFFICE BOX 1057 (609)693-4100
CHRISTOPHER J. CONNORS FORKED RIVER,NEW JERSEY 08731 (732)349-2446
CHRISTOPHER K. KOUTSOURIS 400 WEBSITE: www.dmmlawfirm.com (732)295-3000
CHRISTOPHER J. DASTI E-MAIL: FORKEDRIVER@DMMLAWFIRM.COM (609)918-1292
TIMOTHY J. McNICHOLS >
MARTIN J. BUCKLEY

OfCounsel WRITER'S E-MAIL:tmcnichols@dmmlawfirm.com

ELIZABETH MACKOLIN DASTI >

FACSIMILE NUMBERS
'~ CERTIFIED CIVIL TRIAL ATTY (609)971-7093
0o CERTIFIED MUNICIPAL COURT (732)349-1590
LAW ATTORNEY
March 14, 2018 Real Estate:(609)971-6176
$ MEMBER, NATIONAL ACADEMY OF
ELDER LAW ATTORNEYS,INC
0 MEMBER NJ AND FLA BAR
> MEMBER NJ AND PA BAR
D MEMBER NJ AND NY BAR
PLEASE REFER TO:
Our File No.: GL-22095

Sent Via Email &Regular Mail

Brian Hunkins, DAG
Office of the Attorney General
R. J. Hughes Justice Complex :_
25 Market Street ----~
PO Box 080 '~`'
Trenton, NJ 08625-0080 ~
~1 •--- ,
__
1'

Re: Tara Murphy,an Incapacitated Person, John F. and Margaret A. Murphy,gf al v:~~
State of New Jersey, Ancora Psychiatric Hospital, et al
Case No.: 15-8410(FLW-TJB)

Dear Mr. Hunkins:

This letter shall confirm that the above-captioned matter has settled for $50,000.00. To that end,
enclosed please find a notarized Release executed by my clients, together with a signed Stipulation of
Dismissal with prejudice. I am also enclosing two "clear" Child Support Judgment Searches indicating
there are no outstanding judgments, as well as this firm's W-9 form.

Kindly have the settlement check made payable to "Dasti, Murphy, McGuckin, P.C., and John F.
Murphy and Margaret A. Murphy."

Should you have any questions, please do not hesitate to contact my office.

Very tr y yours,

~~~
TIMOTH J. McNICHOLS
TJM:cIa
Enclosures
MARGARET A. MURPHY, UNITED STATES DISTRICT COURT
Administratrix of the Estate of DISTRICT OF NEW JERSEY
TAR.A MURPHY TRENTON VICINAGE
Civil Action No.
Plaintiff, 3:15-CV-8410-FLW-TJB

v.
CIVIL ACTION
STATE OF NEW JERSEY, ANGORA
PSYCHIATRIC HOSPITAL, PHYLIS
DAVIS individually and in her UNCONDITIONAL RELEASE
Official Capacity, NATASHA ALMON
individually and in her Official
Capacity, 'ASHLEY DOE'
individually and in her Official
Capacity, ELIZABETH STILL
individually and in her Official
Capacity, DAVID PRICE
individually and in his Official
Capacity, JOHN DOE (S) I-X,
fictitious persons and/or
fictitious entities individually
and in Official Capacity, JOHN
DOE(S) XI-XX, fictitious persons
and/or fictitious entities
individually and in Official
Capacity, JOHN DOE(S) XXI-XXX,
fictitious persons and/or
fictitious entities individually
and in Official Capacity,

Defendants,

1. Releasor and Releasees: This UNCONDITIONAL RELEASE (the

"Release"), is given by the releasor(s). The Releasor(s) are
John F. Murphy and Margaret A. Murphy, individually and as
Administratrix of the Estate of Tara Murphy, referred to as "I"
or "Me". If more than one person signs the Release "I" sha11
mean each person who signs this Release. The Releasees,
hereinafter referred to as "You", are all defendants, State of
New Jersey, Ancora Psychiatric Hospital, Phylis Davis, Natasha
Almon, Elizabeth Still and David Price, individually and in
their official capacity.

2. Release. I release and give up any and all claims and

rights which I may have against you. This releases all claims,
demands, damages, causes of action, or suits which have been or
 UNCONDITIONAL RELEASE
DOCKET N0. 3:15-CV-8410-FLW-TJB

could have been brought related to the events that gave rise to
the Complaint, including claims for attorney's fees and costs,
any claims of which I am not aware, and any claims not mentioned
in this Release. This Release applies to claims resulting from
anything which has happened up to now and which may happen in
the future, and specifically, as full payment and satisfaction
for any and all claims resulting from:

a. Property damage and personal injuries and damages

sustained, including but not limited to (if
applicable), medical expenses, pain and suffering,
income loss, loss of services and/or loss of
consortium arising out of incidents which occurred at
Ancora Psychiatirc Hospital which were the subject of
a suit captioned Murphy v. Ancora Psychiatric Hospital
et al., venued in the United States District Court,
Docket No. 3:15-CV-8410-FLW-TJB and in any other
litigation arising out of the same occurrences.

b. Any and all claims and/or liens, past current

and/or future arising out of this litigation or
asserted against the proceeds of the settlement and
agree that such claims and/or liens are to be
satisfied by me, including but not limited to any
Medicare or Medicaid claims and/or liens, Worker's
Compensation claims and/or liens, Social Security
claims and/or liens, hospital/healthcare insurer
claims and/or liens, physician or attorney claims and/
liens, or any of the statutory, equitable, common law
or judgment claims and/or liens. As set forth in
Paragraphs 3 and "1"1 herein, any indebtedness to the
State of New Jersey has been waived.

c. All claims for wrongful death.

3. Terms: In consideration of my releasing the claims

enumerated in this Unconditional Release, You have agreed to pay
me, in full satisfaction of all of my claims, including my
claims for costs and attorneys' fees, a total of $50,000 (FIFTY
THOUSAND DOLLARS and 0 cents). In addition, you have waived any
indebtedness to the State.

The $50,000 is being paid to John F. Murphy and Margaret A.

Murphy also in return for the dismissal of their individual
claims.

2
 UNCONDITIONAL RELEASE
DOCKET N0. 3:15-CV-8410-FLW-TJB

The indebtedness to the State is being waived in return for the

dismissal of the claims of the Estate of Tara Murphy.

The check shall be made payable to: Dasti, Murphy, McGuckin,

John F. Murphy and Margaret A. Murphy. I acknowledge that this
is consideration to which I am not otherwise entitled. This sum
represents full payment, including all attorney fees, costs, and
expenses. I agree that I shall not seek anything further from
you. Payment shall not be made unless counsel for Releasees has
received this Release signed by Me and notarized, a Child
Support Certification, a State of New Jersey W9 executed by my
counsel, and a signed Stipulation of Dismissal with Prejudice.
The signed Stipulation of Dismissal with Prejudice will be held
until my attorney receives the payment. I understand that while
the Release makes no guarantee, payment may be made within
twelve weeks after counsel for Releasees receives this Release
signed by Me and notarized, a State of New Jersey W9 executed by
my counsel, and a signed Stipulation of Dismissal with
Prejudice.

4. Taxes: I shall be solely responsible for the payment of

appropriate taxes on this settlement, if any, and I agree and
understand that the Releasees have not made any representation
to Releasor regarding the tax treatment of the sums paid
pursuant to this agreement. In the event a claim for such taxes,
and/or penalties and interest, is assessed by any taxing
authority, I agree to, and do hereby hold the Releasees harmless
and indemnify Releasees against any and all tax liability,
interest and/or penalties as due thereon from Me.

5. Liens: I Shall be solely responsible for the payment of any

claims or liens that may be asserted against the proceeds of
this settlement. In the event a claim for such payment is
asserted by anyone, including Medicare and/or Medicaid, I agree
to make those payments and do hereby hold the Releasees harmless
and indemnify Releasees against any and all liability for same.
As set forth in Paragraph 3 and 11 herein, any indebtedness to
the State of New Jersey has been waived.

6. Attorneys' Fees: This Release includes all claims for

attorneys' fees and costs.

7. No Admission of Liability. Releasees expressly deny the

validity of my disputed claims and nothing contained herein may
be used or viewed as an admission of liability by Releasees.

3
 UNCONDITIONAL RELEASE
DOCKET N0. 3:15-CV-8410-FLW-TJB

8. Dismissal of Lawsuit: I hereby authorize and instruct my

legal counsel of record to sign a Stipulation of Dismissal with
Prejudice and Without Costs as to all claims and all defendants
named in the matter docketed as Murphy v. Ancora Psychiatric
Hospital et al. in the United States District Court, Docket No.
3:15-CV-8410-FLW-TJB and to provide same to counsel for
Releasees at the time of execution of this Release. The
Stipulation of Dismissal shall be filed by counsel for Releasees
upon tender of the settlement check to Releasor.

9. Non-Assignment: I acknowledge that none of the proceeds

given herein have been assigned.

10. Child Support Certification: I hereby acknowledge and

understand my obligation to comply with the legal requirements
of N.J.S.A. 2A:17-56.23b, including, but not limited to, the
requirement to perform a certified child support judgment lien
search and to provide Releasees with said documentation prior to
the Releasees' disbursement of the Payment. I agree that I shall
direct my attorneys to perform the judgment search required by
N.J.S.A. 2A:17-56.23b, and deliver a copy of the certification
to Releasees' counsel. I further understand and acknowledge
that, (a~ no settlement funds due to me under this Release shall
be released prior to the receipt of the judgment search
certification, and (b) any fees incurred, and payments made, by
Releasees in connection with N.J.S.A. 2A:17-56.23b shall be
deducted from the payment prior to its disbursement to me.

11. State liens: Any indebtedness to the State of New Jersey

has been waived in consideration for the dismissal of the claims
of the Estate of Tara Murphy and the individual claims of the
Releasors.

12. Who is Bound. I am bound by this Release. Anyone who

succeeds to my rights and responsibilities, such as my heirs or
the executor of my estate, is also bound. This Release is made
for your benefit and all who succeed to your rights and
responsibilities, such as your heirs or the executor of your
estate.

13. Signatures. I understand and agree to the terms of this

Release, have had sufficient opportunity to review it with
counsel of my choice, and sign it knowingly and voluntarily.
 UNCONDITIONAL RELEASE
DOCKET N0. 3:15-CV-8410-FLW-TJB

THE UNDERSIGNED FURTHER STATES THAT HE/SHE HAS CAREFULLY READ

THE FOREGOING AGREEMENT AND KNOWS THE CONTENTS THEREOF AND SIGNS
THE SAME AS HIS/HER OW REE ACT.

arg ret A. Murphy, indivi~divall~and as

Administratrix of the Estate of Tara Murphy

i
John F. Murphy

Swo n and subscribed to me on this

~~ day of ~,~;-`Cr..~r
; 2018.
~,
~~ ~~
Notary Public ~t
iS to of New Jersey
1
Print Name: C~<.~c`~~ ; ~~.Z-Z-~ „~o„~ ..,►.,.,,,
M~7 C OTTlTCl1 S S1O Tl Expires : A Nat9ry Pt ~hiir of Nt~w .lor~eav
My Commission ExAires Decemt~r 18.2020
GURBIR S. GREWAL
ATTORNEY GENERAL OF NEW JERSEY
R.J. Hughes Justice Complex
PO Box 116
Trenton, New Jersey 08625
Attorney for Defendants,
State of New Jersey, Ancora Psychiatric
Hospital, Natasha Almon, Elizabeth Still
and David Price

By: Brian Hun~ins (017931982)

Deputy Attorney General
609-292-6095
Brian.Hunkins@law.njoag.gov
DOL# 16-04273

MARGARET A. MURPHY, UNITED STATES DISTRICT COURT

Administratrix of the Estate of DISTRICT OF NEW JERSEY
TARA MURPHY TRENTON VICINAGE
Civil Action No. 3:15-CV-8410-
Plaintiff, FLW-TJB

v.
CIVIL ACTION
STATE OF NEW JERSEY, ANGORA
PSYCHIATRIC HOSPITAL, PHYLIS
DAMS individually and in her STIPULATION OF DISMISSAL WITH
Official Capacity, NATASHA ALMON PREJUDICE AGAINST ALL PARTIES
individually and in her Official
Capacity, 'ASHLEY DOE'
individually and in her Official
Capacity, ELIZABETH STILL
individually and in her Official
Capacity, DAVID PRICE
individually and in his Official
Capacity, JOHN DOE (S) I-X,
fictitious persons and/or
fictitious entities individually
and in Official Capacity, JOHN
DOE (S) XI-XX, fictitious persons
and/or fictitious entities
individually and in Official
Capacity, JOHN DOE (S) XXI-XXX,
fictitious persons and/or
fictitious entities individually
and in Official Capacity,
 Murphy v. Ancora Psychiatric Hospital et al.
3:15-CV-8410-FLW-TJB

Defendants,

This matter having been amicably adjusted by and between

the parties, it is hereby stipulated and agreed that Plaintiff's

complaint is voluntarily dismissed against Defendants State of

New Jersey, Ancora Psychiatric Hospital, Natasha Almon,

Elizabeth Still and David Price and Phylis Davis, with prejudice

and without costs.

GURBIR S. GREWAL
ATTORNEY GENERAL OF NEW JERSEY

._
%'vt By:
Timot J. McNichols, Esq. Brian Hunkins
Attorney for Plaintiffs Deputy Attorney General

DATED: ~3 l~
 Murphy v. Ancora Psychiatric Hospital et al.
3:15-CV-8410-FLW-TJB

Anthony Vinhal, Esq.

Defendant Davis
 * * * CHILD SUPPORT JUDGMENT SEARCH
NEW JERSEY SUPERIOR COURT
Q4~.J~.~p, G~N1A~/'
F_stahlished 1911

341-1090-20 RE: MURPHY

CERTIFIED T0:

LAFAYETTE GENERAL TITLE

TITLE AGENCY INC
614 MAIN ST
TOMS RIVER NJ 08753-7456

SIuNATURE INFGRP~IATION SOLLTTivNS LLC HEREBY CERTIFIES THAT IT HAS SEARCHED

THE INDEX OF THE CIVIL JUDGMENT .AND ORDER DOCKET OF THE SUPERIOR COURT OF
NEW JERSEY AND DOES NOT FIND REMAINING UNSATISFIED OF RECORD THEREIN A
JUDGMENT FOR CHILD SUPPORT PURSUANT TO N.J.S.A. 2A:17-56.23(B) EXCEPT AS
SET FORTH BELOW AGAINST:

FROM TO

MARGARET A. MURPHY 09-01-1992 03-09-2018

SSN: XXX-XX-2546
*** Name is CLEAR ***

JOHN F. MURPHY 09-01-1992 03-09-2018

SSN: XXX-XX-4804
*** Name is CLEAR ***

DATED 03-09-2018
TIME 08:45 AM

CHARLES JONES SEARCH

PROVIDED BY
SIGNATURE INFORMATION SOLUTIONS
P.O. BOX 8488
CJ18-072-02240 072 0656072 Ol TRENTON, NJ 08650
Form ~'9 Request for Taxpayer Give Fflrm to the
(Rev. December 2014) requester. Do not
Department of the Treasury Identification Number and Certification send to the IRS.
Internal Revenue Service
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
Dasti, Murphy & McGuckin, P.C.
2 Business name/disregarded entity name, if different from above
N
N
(b —
a 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to
o certain entities, not individuals; see
y ❑Individual/sole proprietor or ❑ C Corporation ~✓ S Corporation ❑ Partnership ❑ TrusVastate instructions on page 3):
d e single-member LLC Exempt payee code (if any)
~~~ ~ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership)►
Exemption from FATCA reporting
`p ~ Note. For asingle-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for
~ y the tax classification of the single-member owner. code (if any)
•~ c (Applies fo ecwunts maintained outside the U.S.J
a V ❑Other (see instructions) ~
5 Address(number, street, and apt. or suite no.) Requester's name and address (optional)
v
a 620 West Lacey Road
~ 6 City, State, and ZIP code
~ Forked River, NJ 08731
7 List account numbers) here (optional)

~~ Taxpayer Identification Number (TINj

Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number _~
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other - -
entities, it is your employer identification number (EIN). If you do not have a number, see Haw to get a ~ ~
TIN on page 3. or
Employer identification number
Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for
guidelines on whose number to enter. ~~~~

Certification --
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because:(a) 1 am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below); and

4. The FATCA codes} entered on this form (if any} indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage
interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TiN. See the
instructions on page 3.
Sign I Signature of .2~i~~~'
.G~
~
Here U.S. person ► Date ► ~ /

General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. Information about developments affecting Form W-9 (such
as legislation enacted after we release it) is at www.rrs.gov//w9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an information
return with the IRS must obtain your correct taxpayer identification number (TIN)
which may be your social security number (SSN), individual taxpayer identification
number (ITIN), adoption taxpayer identification number (ATIN), or employer
identification number (EIN}, to report on an information return the amount paid to
you, or other amount reportable on an information return. Examples of information
returns include, but are not limited to, the following:
• Form 1098 (home mortgage interest). 1098-E (student loan interest), 1098-T
(tuition)
• Form 1099-C (canceled debt}
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN.
t/ you do not return Form W-9 to the requester with a TIN, you might be subject
to backup withholding. See Whaf is backup withholding? on page 2.
By signing the filled-out form, you:
1. Certify that the TIN you are giving is correct (or you are waiting for a number
to be issued),
2. Certify that you are not subject to backup withholding, or

• Form 1099-INT (interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutual funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
• Form 1099-B (stock or mutual fund sales and certain other transactions by
brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
3. Claim exemption from backup withholding if you are a U.S. exempt payee. If
applicable, you are also certitying that as a U.S. person, your allocable share of
any partnership income from a U.S. trade or business is not subject to the
withholding tax on foreign partners' share of effectively connected income, and
4. Certify that FATCA codes) entered on this form (if any) indicating that you are
exempt from the FATCA reporting, is correct. See Whaf is FATCA reporting? on
page 2 for further information.

Form W-9 (Rev. 12-2014)

Cat. No. 10231X