Preview
FILED: NEW YORK COUNTY CLERK 10/30/2019 04:44 PM INDEX NO. 450207/2018
NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 10/30/2019
Sªg'g°
REQUEST FOR JUDICIAL INTERVENTION (re
New York Supreme COURT, COUNTY OF New York
Index No: 450207/2018 Date Index Issued: 02105!2018 For Court Use Only:
IAS EntryDate
COMMISSIONERS OF THE STATE INSURANCE FUND
Judge Assigned
-against- Plaintiff(s)/Petitioner(s)
PREMlER ENTERPRISE CO INC.
RJIFiled Date
Defendant(s)/Respondent(s)
COMMERCIAL MATRIMONIAL
O Contested
O BusinessEntity (includes corporations, a=•+aarWps, LLCs,LLPs,etc.)
NOTE: If there are children under the age of 18, complete and attach the
Contract MATR1MONDALRJRAddendum (UCS-84OM).
O Insurance(where insurance company is a party, except arbitration) . .
For UncontestedMatamamal actions, use the UncontestedDivorce RJ1(UD-13).
O UCC(includes sales and negotiable instruments)
O Other Commercial(specify):
TORTS
NOTE: For CommercialDivision assignment requests pursuant to 22 NYCRR202.70(d),
complete and attach the COMMERCRALDEV151ON
RJRADDENDUM (UCS-84OC). O Asbestos
O Child Victims Act
REAL PROPERTY: Specify how many properties the app!!cet!en includes: .
Environmental (specify):
O
O Condemnation O Medical,Dental, or Podiatric Malpractice
O O nacidential
Mortgage Foreclosure(specify): O Commercie! O Motor Vehicle
Property Address: O Products Liability (specify):
O Other Negligence(specify):
NOTE: For Mortgage Foreclosureactions involving a one to four-family, owner-
occupied residential property or owner-occupiedcondominium, complete and
O Other ProfessionalMalpractice (specify):
attach the FORECLOSURERJRADDENDUM (UCS-84OF). Other Tort (specify):
O
O Tax Certiorari - Section: Block: Lot:
Tax Foreclosure SPECIAL PROCEEDINGS
O
Other Real Property (specify): O CPLRArticle 75 (Arbitration)
[see NOTE in COMMERCIALsection]
O
O CPLRArticle 78 (Body or Officer)
OTHER MATTERS
O Election Law
O Certificate of Incorporatior./D|sso:üt|or.
[see NOTE in COMMERCIALsection] O Extreme Risk ProtectionOrder
O Emergency MedicalTreatment O MHLArticle 9.60 (Kendra's Law)
O HabeasCorpus O MHLArticle 10 (Sex Offender Confinement-initial)
O LocalCourt Appeal O MHLArticle 10 (Sex Offender Confinement-Review)
O Mechanic'sLien O MHLArticle 81 (Guardianship)
O NameChange O Other Mental Hygiene (specify):
O Pistol Permit Revocat!enHearing O Other Special Proceeding(specify):
O Saleor Financeof Religious/Not-for-ProfitProperty
O Other (specify):
STATUS OF ACTION OR PROCEEDING: AnswerYESor NOfor every question and enter additional information where indicated.
YES NO
Hasa summons and complaint or summonswith notice been filed? O 02/02/2018
If yes, date filed:
Hasa summons and complaint or summonswith notice been served? O u2i2õ/2u15
If yes, date served:
Is this action/proceeding being filed pe&judgment? O 05/24/2018
If yes, judgment date:
NATURE OF JUDICIAL INTERVENTION: Checkone box only and enter additional infomet!en where indicated.
O Infant's Compromise
O Extreme Risk ProtectionOrder Application
O Note of Issc^.fCe•+ificateof Readiness
O Date Issuejoined:
Notice of Medical, Dental, or Podiatric Malpractice
Notice of Motion Leaveto File
Relief iiequested: Return Date:11/21/2019
Notice of Petition Relief Requested: Return Date:
O
Order to ShowCause Relief Requested: Return Date:
O
Other Ex ParteApplication Relief Requested:
O
O PoorPersonApplication
O Requestfor Preliminary Conference
O a.c:!dent!a!Mortgage ForeclosureSettlement Conference
O Writ of HabeasCorpus
O Other (specify):
1 of 2
FILED: NEW YORK COUNTY CLERK 10/30/2019 04:44 PM INDEX NO. 450207/2018
RELATED CASES: actions.
List any related For Matrimonial
cases, list any
relatedcriminalor Family
Court cases.If none,
leaveblank.If additional
space
NYSCEF DOC. NO. 24is required,
complete and attachtheRJI Addendum (UCS-840A). RECEIVED NYSCEF: 10/30/2019
Case Title Index/Case Number Court Judge (ifassigned) Relationship to instantcase
For parties
withoutan attorney,
check the "Un-Rep"box and entertheparty's phone number and email in the
space
PARTIES: address,
provided.If additional
spaceis required,
complete and attach
the RJI Addendum (UCS-840A).
Un- Parties Attorneys and/or Unrepresented Litigants Issue Joined Insurance Carriers
Rep For represented parties, provide attorney's name, firm name, address, phone
List parties in same order as listed in the For each defendant,
For each defendant,
caption and indicate roles (e.g., plaintiff,
and email. For unrepresented parties, provide party's address, phone and
indicate if issue has
indicate insurance
defendant; 3rdparty plaintiff, etC.) email. beenjoined. carrier, if applicable.
Name: COMMISSIONERSOFTHESTATE MICHAELTOTARO,NEWYORKSTATEINSURANCE FUND,199 CHURCHST ,
INSURANCEFUND NEWYORK,NY 10007, mtotaro@nysif.com O YES 2 NO
Role(s):Plaintiff/Petitioner
Name: PREMIER
ENTERPRISECOINC· 52-35 74th St., Elmhurst, NY 11373
O YES O NO
Role(s):Defendant/Respondent
Name:
O YES O NO
Role(s):
Name:
0 YES 0 NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
0 YES 0 NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
0 YES 0 NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
0 YES 0 NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED ACTIONS OR
PROCEEDINGS, EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FORJUDICIAL INTERVENTION BEEN PREVIOUSLY FILED INTHIS
ACTION OR PROCEEDING.
Dated: 10/30/2019 MICHAEL D. TOTARO
Signature
5036421 MICHAEL D. TOTARO
Attorney Registration Number PrintName
This form was generated by NYSCEF
2 of 2
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FILED: NEW YORK COUNTY CLERK 10/30/2019 04:44 PM INDEX NO. 450207/2018 NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 10/30/2019 Sªg'g° REQUEST FOR JUDICIAL INTERVENTION (re New York Supreme COURT, COUNTY OF New York Index No: 450207/2018 Date Index Issued: 02105!2018 For Court Use Only: IAS EntryDate COMMISSIONERS OF THE STATE INSURANCE FUND Judge Assigned -against- Plaintiff(s)/Petitioner(s) PREMlER ENTERPRISE CO INC. RJIFiled Date Defendant(s)/Respondent(s) COMMERCIAL MATRIMONIAL O Contested O BusinessEntity (includes corporations, a=•+aarWps, LLCs,LLPs,etc.) NOTE: If there are children under the age of 18, complete and attach the Contract MATR1MONDALRJRAddendum (UCS-84OM). O Insurance(where insurance company is a party, except arbitration) . . For UncontestedMatamamal actions, use the UncontestedDivorce RJ1(UD-13). O UCC(includes sales and negotiable instruments) O Other Commercial(specify): TORTS NOTE: For CommercialDivision assignment requests pursuant to 22 NYCRR202.70(d), complete and attach the COMMERCRALDEV151ON RJRADDENDUM (UCS-84OC). O Asbestos O Child Victims Act REAL PROPERTY: Specify how many properties the app!!cet!en includes: . Environmental (specify): O O Condemnation O Medical,Dental, or Podiatric Malpractice O O nacidential Mortgage Foreclosure(specify): O Commercie! O Motor Vehicle Property Address: O Products Liability (specify): O Other Negligence(specify): NOTE: For Mortgage Foreclosureactions involving a one to four-family, owner- occupied residential property or owner-occupiedcondominium, complete and O Other ProfessionalMalpractice (specify): attach the FORECLOSURERJRADDENDUM (UCS-84OF). Other Tort (specify): O O Tax Certiorari - Section: Block: Lot: Tax Foreclosure SPECIAL PROCEEDINGS O Other Real Property (specify): O CPLRArticle 75 (Arbitration) [see NOTE in COMMERCIALsection] O O CPLRArticle 78 (Body or Officer) OTHER MATTERS O Election Law O Certificate of Incorporatior./D|sso:üt|or. [see NOTE in COMMERCIALsection] O Extreme Risk ProtectionOrder O Emergency MedicalTreatment O MHLArticle 9.60 (Kendra's Law) O HabeasCorpus O MHLArticle 10 (Sex Offender Confinement-initial) O LocalCourt Appeal O MHLArticle 10 (Sex Offender Confinement-Review) O Mechanic'sLien O MHLArticle 81 (Guardianship) O NameChange O Other Mental Hygiene (specify): O Pistol Permit Revocat!enHearing O Other Special Proceeding(specify): O Saleor Financeof Religious/Not-for-ProfitProperty O Other (specify): STATUS OF ACTION OR PROCEEDING: AnswerYESor NOfor every question and enter additional information where indicated. YES NO Hasa summons and complaint or summonswith notice been filed? O 02/02/2018 If yes, date filed: Hasa summons and complaint or summonswith notice been served? O u2i2õ/2u15 If yes, date served: Is this action/proceeding being filed pe&judgment? O 05/24/2018 If yes, judgment date: NATURE OF JUDICIAL INTERVENTION: Checkone box only and enter additional infomet!en where indicated. O Infant's Compromise O Extreme Risk ProtectionOrder Application O Note of Issc^.fCe•+ificateof Readiness O Date Issuejoined: Notice of Medical, Dental, or Podiatric Malpractice Notice of Motion Leaveto File Relief iiequested: Return Date:11/21/2019 Notice of Petition Relief Requested: Return Date: O Order to ShowCause Relief Requested: Return Date: O Other Ex ParteApplication Relief Requested: O O PoorPersonApplication O Requestfor Preliminary Conference O a.c:!dent!a!Mortgage ForeclosureSettlement Conference O Writ of HabeasCorpus O Other (specify): 1 of 2 FILED: NEW YORK COUNTY CLERK 10/30/2019 04:44 PM INDEX NO. 450207/2018 RELATED CASES: actions. List any related For Matrimonial cases, list any relatedcriminalor Family Court cases.If none, leaveblank.If additional space NYSCEF DOC. NO. 24is required, complete and attachtheRJI Addendum (UCS-840A). RECEIVED NYSCEF: 10/30/2019 Case Title Index/Case Number Court Judge (ifassigned) Relationship to instantcase For parties withoutan attorney, check the "Un-Rep"box and entertheparty's phone number and email in the space PARTIES: address, provided.If additional spaceis required, complete and attach the RJI Addendum (UCS-840A). Un- Parties Attorneys and/or Unrepresented Litigants Issue Joined Insurance Carriers Rep For represented parties, provide attorney's name, firm name, address, phone List parties in same order as listed in the For each defendant, For each defendant, caption and indicate roles (e.g., plaintiff, and email. For unrepresented parties, provide party's address, phone and indicate if issue has indicate insurance defendant; 3rdparty plaintiff, etC.) email. beenjoined. carrier, if applicable. Name: COMMISSIONERSOFTHESTATE MICHAELTOTARO,NEWYORKSTATEINSURANCE FUND,199 CHURCHST , INSURANCEFUND NEWYORK,NY 10007, mtotaro@nysif.com O YES 2 NO Role(s):Plaintiff/Petitioner Name: PREMIER ENTERPRISECOINC· 52-35 74th St., Elmhurst, NY 11373 O YES O NO Role(s):Defendant/Respondent Name: O YES O NO Role(s): Name: 0 YES 0 NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: 0 YES 0 NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: 0 YES 0 NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: 0 YES 0 NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED ACTIONS OR PROCEEDINGS, EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FORJUDICIAL INTERVENTION BEEN PREVIOUSLY FILED INTHIS ACTION OR PROCEEDING. Dated: 10/30/2019 MICHAEL D. TOTARO Signature 5036421 MICHAEL D. TOTARO Attorney Registration Number PrintName This form was generated by NYSCEF 2 of 2