On September 21, 2021 a
Miscellaneous
was filed
involving a dispute between
Leblanc, James,
and
Massachusetts Parole Board,
for Civil Actions with Incarcerated Party
in the District Court of Suffolk County.
Preview
DOCKET NUMBER Trial Court of Massachusetts
CIVIL ACTION COVER SHEET
2184cv
o2sh
woete The Superior Court Ww)
PLAINTIFF(S): James LeBlanc eounry Suffolk
ADDRESS: W38597 - Box 43
Norfolk, MA 02056 DEFENDANT(S): Massachusetts Parole Board
ATTORNEY: Pro Se
ADDRESS: ‘ADDRESS: 12 Mercer Road
Natick,’ MA 01760
BBO:
TYPE OF ACTION AND TRACK DESIGNATION (see reverse side)
‘CODE NO. TYPE OF ACTION (specify) TRACK HAS A JURY CLAIM BEEN MADE?
ertiorari EF Cyves fk]No
*If "Other" please describe:
-- = > zB
STATEMENT OF DAMAGES PURSUANT TO G.L. c. 212, § 3A
2
The following is a full, itemized and detailed statement of the facts on which the undersigned plaintiff or plaintiff counsel geen y damages. For
this form, disregard double or treble damage claims; indicate single damages only. So
r
‘ORT Cl Q*
NG
(attach additional sheets as necessary) 2B flBS
pr
|A. Documented medical expenses to date: wo
See
1. Total hospital expenses
2. Total doctor expenses =D
IQ 50
3. Total chiropractic expenses et eo
4. Total physical therapy expenses ‘S aS
5. Total other expenses (describe below) Fe,
jubtotal (A)
IB, Documented lost wages and compensation ta date
|C. Documented property damages to dated
ID. Reasonably anticipated future medical and hospital expenses
E. Reasonably anticipated lost wages..
F. Other documented items of damages (describe below)
'G, Briefly describe plaintiff's injury, including the nature and extent of injury:
TOTAL (A-F):$
(attach additional sheets as necessary)
Provide a detailed description of claims(s)
ibe
TOTAL: $
Signature of Attorney/Pro Se Plaintiff; Date: 8/4/21
RELATED ACTIONS: Please “T 7 ouroy ose rfame, and county of any related actions pending in the Superior Court.
CERTIFICATION PURSUANT TO SJC RULE 1:18
| hereby certify that | have complied with requirements of Rule 5 of the Supreme Judicial Court Uniform Rules on Dispute Resolution (SJC
Rule 1:18) requiring that | provide my clients with information about court-connected dispute resolution services and discuss with them the
advantages and disadvantages of the various methods of dispute resolution.
Signature of Attorney of Record: X Date:
.
Document Filed Date
September 21, 2021
Case Filing Date
September 21, 2021
Category
Civil Actions with Incarcerated Party
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DOCKET NUMBER Trial Court of Massachusetts CIVIL ACTION COVER SHEET 2184cv o2sh woete The Superior Court Ww) PLAINTIFF(S): James LeBlanc eounry Suffolk ADDRESS: W38597 - Box 43 Norfolk, MA 02056 DEFENDANT(S): Massachusetts Parole Board ATTORNEY: Pro Se ADDRESS: ‘ADDRESS: 12 Mercer Road Natick,’ MA 01760 BBO: TYPE OF ACTION AND TRACK DESIGNATION (see reverse side) ‘CODE NO. TYPE OF ACTION (specify) TRACK HAS A JURY CLAIM BEEN MADE? ertiorari EF Cyves fk]No *If "Other" please describe: -- = > zB STATEMENT OF DAMAGES PURSUANT TO G.L. c. 212, § 3A 2 The following is a full, itemized and detailed statement of the facts on which the undersigned plaintiff or plaintiff counsel geen y damages. For this form, disregard double or treble damage claims; indicate single damages only. So r ‘ORT Cl Q* NG (attach additional sheets as necessary) 2B flBS pr |A. Documented medical expenses to date: wo See 1. Total hospital expenses 2. Total doctor expenses =D IQ 50 3. Total chiropractic expenses et eo 4. Total physical therapy expenses ‘S aS 5. Total other expenses (describe below) Fe, jubtotal (A) IB, Documented lost wages and compensation ta date |C. Documented property damages to dated ID. Reasonably anticipated future medical and hospital expenses E. Reasonably anticipated lost wages.. F. Other documented items of damages (describe below) 'G, Briefly describe plaintiff's injury, including the nature and extent of injury: TOTAL (A-F):$ (attach additional sheets as necessary) Provide a detailed description of claims(s) ibe TOTAL: $ Signature of Attorney/Pro Se Plaintiff; Date: 8/4/21 RELATED ACTIONS: Please “T 7 ouroy ose rfame, and county of any related actions pending in the Superior Court. CERTIFICATION PURSUANT TO SJC RULE 1:18 | hereby certify that | have complied with requirements of Rule 5 of the Supreme Judicial Court Uniform Rules on Dispute Resolution (SJC Rule 1:18) requiring that | provide my clients with information about court-connected dispute resolution services and discuss with them the advantages and disadvantages of the various methods of dispute resolution. Signature of Attorney of Record: X Date: .