Case 1:19-cv-00597 Document 12-3 Filed 12/20/19 Page 1 of 2 PageID 177 DNSWOBN DECLARATION OF DAVID B. POLK In the matter of: Graham et al. v. Justice Energy. Inc.. et al. 1, David B. Polk, of PO Box 10, McCraws, WV 25875, pursuant to 28 U.S.C. 1476 do hereby solemnly declare the followingwas formerly employed by Double-Bonus Coal Co., with my last day of credited service on or about February 28, 2007. On or about that date I retired. During my years of. service, Double-Bonus Coal Co. was bound by a series of collective bargaining agreements with the United Mine Workers of America. Those collective bargaining agreements included promises by Double-Bonus Coal Co. to provide pension, healthcare, and prescription drug bene?ts to quali?ed retirees. Under those collective bargaining agreements, and as a result of my credited service at Double-Bonus Coal Co., I quali?ed for pension, healthcare, and prescription drug bene?ts. My wife and I are entitled to those bene?ts during our retirement. Double-Bonus Coal Co. has failed to provide the level of healthcare and prescription drug bene?ts to which my wife and I are entitled. Double-Bonus Coal Co. has periodically cutoff my medical and prescription drug coverage without warning or explanation. Not knowing if or when I will have medical and prescription drug coverage is a constant concern. I need treatment and medication for an abnormal heartbeat and my wife has high cholesterol. We have not kept appointments for medical treatment because we do not have consistent coverage and do not know if the bills will be paid. I know that waiting Case Document 12-3 Filed 12/20/19 Page 2 of 2 PageID 178 on medical treatment can do irreparable harm to my health, but I cannot afford to pay the bills. I declare under penalty of perjury that the foregoing is true and correct. Executed on: 961/? Date @W/a 20% Bavid B. Polk (Signature)