FILED: ONONDAGA COUNTY CLERK 08/19/2019 03:37 PM INDEX NO.

2015EF4455
NYSCEF DOC. NO. 58 RECEIVED NYSCEF: 08/19/2019

EXHIBIT B
FILED: ONONDAGA COUNTY CLERK 08/19/2019 03:37 PM INDEX NO. 2015EF4455
NYSCEF DOC. NO. 58 RECEIVED NYSCEF: 08/19/2019

CLOSING STATEMENT

July 1, 2019

Rebeka Kwiatkowski, as
Administratrix for the Estate
of Chanel Lakatosz
VENTO
URVAD POCZTOWY
TARNOGAJSKA 11-13
PO BOX 67017

WROCLAW, POLSKA
50-580

Gross Settlement: $440,000.00

Less Disbursements: Medical Records, Copies & Binders $880.61

Filing Fees $885.00

Service Fees $137.80

Expert Review: Forensic Pathologist $1,000.00

Expert Review: Nursing Expert $987.50

Mediation $2,763.13

Stenographer Fees $519.20

Postage/FaxlOvernight Delivery $162.85

Mileage and Lodging $1,738.59

Research $420.00

Total Disbursements: $9,494.68

Net After $430,505.30

Disbursements:

Less Fee: I 30% of $0.00 to $250,000.00 $75,000.00

Attorney
25% of the balance of $180,505.30 $45,126.33 $120,126.30

I I

Net After Attorney

Fee: $310,379.00

Less Lien(s): None | $0.00

Net Recovery: | $310,379.00

Reviewed & Approved By: Dated: