Roberts v. Kaiser Foundation Hospital, et. al.

Filing 49

ORDER signed by Magistrate Judge Carolyn K. Delaney on 3/2/2015. No later than 3/13/2015, plaintiff may submit a Declaration, signed under penalty of perjury, setting forth following information: A) Plaintiff's monthly gross pay or wages. B) Oth er income in the past 12 months received from the following sources (for each category describe each source of money and state the amount received and amount expected to be received in the future): i. business, profession, or other self-employment; i i. rent payments, interest or dividends; iii. pension, annuity, or life insurance payments; iv. disability, or worker's compensation payments; v. gifts, or inheritances; vi. any other sources. C) Amount of money in checking, savings, and retirem ent accounts. D) Items of value owned by plaintiff, including automobiles, real estate, stocks, bonds, securities, trusts, jewelry, art work, or other financial instruments. E) Housing, transportation, utilities, loan payments or other regular month. expenses. F) Names of all persons dependent on plaintiff for support, relationship, and amount of contribution for support. G) Any debts or other financial obligations. H) All limited liability partnerships, corporations or other businesses owned by plaintiff or in which plaintiff is a corporate officer. (Marciel, M)

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UNITED STATES DISTRICT COURT

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FOR THE EASTERN DISTRICT OF CALIFORNIA

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ELSA ROBERTS,

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Plaintiff,

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No. 2:12-cv-2506 CKD

v.

ORDER

KAISER FOUNDATION HOSPITAL, et
al.,
Defendants.

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Defendants have submitted a bill of costs, to which plaintiff objects. Plaintiff argues, in

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part, that costs should not be awarded because she cannot afford to pay the costs. Plaintiff

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contends she receives only $1,200 per month in federal disability benefits. Plaintiff has made an

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inadequate showing of indigency. The court will grant an opportunity to submit further evidence

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in support of plaintiff’s claim she cannot afford costs. Should plaintiff choose not to submit the

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detailed information set forth below, the matter will stand submitted on the present evidentiary

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record.
Accordingly, IT IS HEREBY ORDERED that no later than March 13, 2015, plaintiff may

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submit a declaration, signed under penalty of perjury, setting forth the following information:
a. Plaintiff’s monthly gross pay or wages.

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b. Other income in the past 12 months received from the following

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sources (for each category describe each source of money and state the amount received and the

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amount expected to be received in the future):

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i. business, profession, or other self-employment

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ii. rent payments, interest or dividends

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iii. pension, annuity, or life insurance payments

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iv. disability, or worker’s compensation payments

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v. gifts, or inheritances

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vi. any other sources

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c. Amount of money in checking, savings, and retirement accounts.

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d. Items of value owned by plaintiff, including automobiles, real estate, stocks,

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bonds, securities, trusts, jewelry, art work, or other financial instruments.

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e. Housing, transportation, utilities, loan payments or other regular monthly
expenses.

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f. Names of all persons dependent on plaintiff for support, relationship, and
amount of contribution for support.

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g. Any debts or other financial obligations.

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h. All limited liability partnerships, corporations or other businesses owned by

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plaintiff or in which plaintiff is a corporate officer.

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Dated: March 2, 2015

_____________________________________
CAROLYN K. DELANEY
UNITED STATES MAGISTRATE JUDGE

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