Document Lo4Y1prZJ5pBzqzyo7o0kp055

' IN FCHE2A-PAUPEL3 CIVIL DISTRICT COURT FOR THE PARISH OF ORLEANS STATE OF LOUISIANA NO. 540-012 DIVISION JCBpT UBT.TJ8 tgn DOCKET 4 VS. Ttmmm. GZPSXH, a AL CITATION *^75 TO: HAIIOKAL GXPSOi C0HF1B7, through their registered agent: C. S. CORFOBJSXOB SSSTEH 1300 ramtA BASS BtmSXBD BEN OSLSABSf L0CXSZA2U YOU ARE HERESY CITED to either comply with the demand contained in the peti tion of which certified copy accompanies this citation, or make an appearance, cither by fil ing a pleading or otherwise, in The Civil District Court ior the Parish of Orleans. State of the address of which is The Civil Courts Building, 421 Loyola Avenue, New Or leans, Louisiana within fifteen days after the service hereof under penalty of default., and you are further ordered to shov cause on the day of September , 1972, at 9*30 o'clock A.h., why the order peraitting tho berctiu named litigant to litigate, or to continue litigation, vithout the paynent of the accrued costs, all as prayed herein. Witness the ____ OLIVER P. CARRIERS, CLARENCE DOWLING, PAUL P. GAROFALO, S. SANTORD LEVY, RICHARD J. GARVEY, WALTER 7. MARCUS, JR., THOMAS A EARLY, JR^ GEORGE C. CONNOLLY, JIL, GERALD P. FEDOROFF end HENRY J. ROBERTS, JR* Judges of the said Court IN WITNESS WHEREOF I have hereunto set my hand and affixed the seal of The Civil District Court for the Parish of Orleans, State of Louisiana, this 7^4 day of September in the year of our Lord 19 72. THOMAS S. BUCKLEY. SR* Clerk of The Civil District Court for the Parish of Orleans, State of Louisiana by Clerk's Office, Room 402, Civil Courts Building 421 Loyola Avenue, New Orleans, Louisiana _____________ Deputy Clerk. SHERIFF'S RETURN: Deputy Sheriff IN FORMA PAUPERIS CIVIL DISTRICT COURT FOR THE PARISH OF ORLEANS no. 5^5-012 STATE OF LOUISIANA DIVISION DOCKET if JERRY WELLS VS. NATIONAL GYPSUM, ET AL PILED: Septeaber 6, 1972 R. O'ERIE: DEPUTY CLERK PETITION IN WORKMEN'S COMPENSATION PROCEEDING FOR BENEFITS AND PENALTIES The petition of JERRY WELLS, of full age and a resident of the Parish of Orleans, State of Louisiana, with respect, represents that: 1. As herelnbelow set forth, the following named defendants are liable Jointly and In solid, to your petitioner for fire hundred (500) weeks of compensation at the rate of FORTY-NINE ($49*00) DOLLARS per week, beginning September 5, 1972, with interest on each weekly payaent at the legal rate froa due date until paid, subject to a credit for payments previously made; for medical expenses in the full sum of TEN THOUSAND ($10,000.00) DOLLARS, together with Interest thereon at the legal rate from date of Judicial demand until paid: A) NATIONAL GYPSUM COMPANY, a foreign corporation which is and was, at all times pertinent hereto, qualified to do and doing business In the city of New Orleans, State of Louisiana. 3) XYZ INSURANCE COMPANY, whose proper name will be later'sub stituted, and which company is, on information and belief, a foreign Insurance company qualified to do and doing business In the Parish of Orleans, State of Louisiana, and which in surance company, on information and belief and at all times pertinent hereto, had in full force and effect a policy or policies of Workmen's Compensation or other Insurance covering the entire liability of the said NATIONAL GYPSUM COMPANY, to petitioner herein and additionally providing .for medical pay ment up to the full sum of $10,000.00. Prom Septeaber 19$7 until September 1971 petitioner was employed by NATIONAL' GYPSUM COMSXNY at its pliant location In New Orleans, Louisiana In the shipping which employaent Is haxardous within the scope of and covered by the Workman's Compensation Laws of Louisiana. ' - Page 2 - ^ During the aforesaid period* petitioner, while performing his dut7 K as an employee at the plant in New Orleans contracted a severe and diaahling lung disease or diseases* which disease or diseases have rendered hia totally and peraantly disabled froa doing work of any reasonable character. 4. As a result of the above shown illnesses* petitioner was treated by Dr. Morris Klinger, Dr. Shea Balls* and at the Charity Hospital, in which hospital petitioner was confined for five weeks* and at which hospital petitioner is under continuing treatment as an out patient. 5. As a further result of the above shown illnesses* petitioner has needed and will continue to need medical treatment for the rest of his life. 6. As a result of extensive tests administered at Charity Hospital in January* 1972* petitioner's condition and its connection with him employ ment was then first speelfleally diagnosed and discovered. 7. In hla efforts to secure medical treatment and evaluation of his disability, petitioner has kept every medical appointment which has ever been made for him, has undergone all treatments prescribed* and has submitted to every examination requested; and petitioner is and will remain unable to do work of any reasonable character. 8. Because of his poverty and want of means, petitioner is not able to P7 the costs of this suit in advance or as they accrue or to give bend for eosts and further shows that he i3 a citlsen of the Stats of Louisiana and is entitled to prosecute this acticn under the provisions of the Louisiana Cede of Civil Procedure, Articles 5131-5189. ?tge 3 - WHEREFORE, petitioner JERRI WELLS respectfully prays that he pe allowed to file this petition without prior payment of costa, that defendants RATIONAL GTPSUM COMPANY and the 372 INSURANCE COMPANY be served a eopy of this petition, and duly cited to answer the sane, and that, after due proceedings had, there be Judgment herein In favor of petitioner and against said defendants. Jointly and in solldo, as follows: Compensation at the rate of FORTY-HIKE (**9-00) DOLLARS per week for five hundred (500) weeks, beginning with all accrued amounts to be paid In a lump sum, together with Interest thereon at the legal rate from due date until paid, subject to a credit for payments previously made; Medical expenses in the amount of TEN THOUSAND (310,000.00) DOLLARS, subject to a credit for sueh expenses as have been paid by defendants, together with Interest thereon at the legal rate from date of Judicial demand until paid; And/or such other amounts or relief as may be provided In the Workmen's Compensation Aet or Acts or as ordered by this Honorable Court; For all general and equitable relief and all costs of these proceedings. (SGD) CARL 0. BROWN, JR. PLEASE SERVE: CARL O. BROWN, JR Attorney for Petitioner 505 S. Carrollton Avenue Hew Orleans, Louisiana 70118 866-7469 National Oypsum Company Through Its registered agent for service C T Corp. System 1300 Hibernia Bldg, New Orleans, Louisiana 70112 XY2 Insurance Company (Proper name to be furnished at a later date) The allegations of the foregoing petition and the supporting Affidavits being considered: IT IS ORDERED that petitioner be permitted to litigate this action without the payment of the costs of Court In advance, or aa they accrue, or to furnish security therefor, IT IS FURTHER ORDERED *hat the ad petitioner, and the defendant* in the within proceedings, show cause, if any they have, on September 25th 1972 at _9fJ0------ a.tt., why the hereinabove Order permitting the herein ' named litigants to litigate, or to continue litigation, without paying the accrued costs aa they accrue, or furnishing security thereror, should not be rescinded and all accrued costs paid, falling in which the said litigation shall be-stayed. NEW ORLEANS, LOUISIANA -- Qp^ September 6, N19Sf^O^ (SGD) f.iLTZrt ? MAfiCUS, Jfc, ^ Y c 6 odSJhrc^ , c&* ___ T7:V-'''-~-rC*0*SS judge t AFFIDAVIT STATE OF LOUISIANA PARISH OP ORLEANS BEFORE ME, the undersigned authority, personally appeared KATTIS SCOTT . who being sworn, deposed: That she knows JERRY B. WELLS, the plaintiff in the above and foregoing petition, and knows his financial condition and she firmly believes that the said JERRY B. WELLS is una tie either to pay the costs of the cause in-advance or as they acerue, or to give bond for the payment of these costs. AFFIDAVIT STATE OF LOUISIANA PARISH OP ORLEANS BEFORE ME PERSONALLY came and appeared JERRY 8'. WELLS, who being duly sworn, deposed: That he is a citizen and Is presently domiciled in the State of Louisiana; that he is unable, because of his poverty and want of means, to make prior payment of the costs of these proceed ings or as they accrue, or to furnish security therefor; and, further, that he is the plaintiff in these proceedings and has read the above and foregoing petition and that it is true and correct to the best of his knowledge, information, and belief. Sworn to and subscribed before ae this .J^gjday Wr- NOTARY *'b JERRY 8. WELLS i