Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_12-cv-02506/USCOURTS-caed-2_12-cv-02506-9/pdf.json

Nature of Suit Code: 445
Nature of Suit: Americans with Disabilities Act - Employment
Cause of Action: 42:12101 Americans with Disabilities Act

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UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

ELSA ROBERTS,

Plaintiff,

v.

KAISER FOUNDATION HOSPITAL, et 

al.,

Defendants.

No. 2:12-cv-2506 CKD

ORDER

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

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

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

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

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

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

record.

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

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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Case 2:12-cv-02506-CKD Document 49 Filed 03/02/15 Page 1 of 2
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b. Other 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 the 

amount expected to be received in the future):

i. business, profession, or other self-employment

ii. 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 retirement 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 monthly 

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.

Dated: March 2, 2015

4 roberts.finaff

_____________________________________

CAROLYN K. DELANEY

UNITED STATES MAGISTRATE JUDGE

Case 2:12-cv-02506-CKD Document 49 Filed 03/02/15 Page 2 of 2