On December 16, 2021 a
Exhibit,Appendix
was filed
involving a dispute between
People Of The State Of New York By
Attorney Gerneral Of The State Of New York,
and
5 Corners Pet Inc,
Gerard O'Sulllivan,
Marc Jacobs Both Indvidually And As Owners Of
Shake-A-Paw,
Risk Enterprises Inc Dba Shake-A-Paw,
for Special Proceedings - Other (Pursuant to Exec Law 6312)
in the District Court of Nassau County.
Preview
FILED: NASSAU COUNTY CLERK 06/13/2022 12:37 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 402 RECEIVED NYSCEF: 06/13/2022
W6LCo
L6nt oFMd o ) Date O 7nn
Owner (Last Name First): ½
Address:
City: State: ) Z p:
E-mail JR
Home Phone: ( ) Cell Phone:
Co-Owner/Spouse (Last Name First):
p E-mail Address: Phone: (
Emergency Contact Name: Phone: ( )
How did you learn about our practice? 30 k CL
Number of pets (pleasespecify by type)
Primary reason for visit: 06 d d .b(Imo 0ho#- , b0d ACi
Pet ormatton
Pet's Name: 60 N Jog O Cat O Other
Sex: F M O F Age: eds Birthdate: 10 2 3 Breed:
Color: ,b\qd Q & Neutered/Spayed: O Yes At what age?
What age was pet obtained? S
From: O Friend O Breeder Ót Shop O Humane Society O Other Ñ
Reason for obtaining pet (check allthat apply) O Companion O Protection O Breeding
O Show O Other
Describe your pet's diet:______
Listyour pet'scurrent medication:
Please check symptoms or problems you ve noticed with your pet:
any
O Appetite Loss O Gagging deezing O Behavioral Changes
O Gums Bleedine O Thirst Q Breathing Problems O Limping
Urination Increase Q Loss of Balance O Vomiting
ghing
Depression O 3 Weakness O Diarrhea
Scooting
3 O Eye Disorders: O Shaking Head O Other:
Scratching
Pet's History (check allthat pet has received)
O Distemper O Feline Leukemia Test O Prior Surgery:
Q Parvovirus (Dog) Q FVRCP (Infectious Disease-Cat) O Prior Illness:
O Rabies O Dental 3 Other:
(Dog/Cat)
uthorleation
prescribe for, or treat the above described pet. I assume
I hereby authorize the veterinarian to examine,
the animal. I also understand that ALL PROFESSIONAL
responsibility for all chames incurred in the care of
FEES ARE 0TlE AT THE TIME SERVICL ARE R NDE
clientresponsible for pet(sk 11 L Date 1 3C22
Signature of
#35144-© 2005MedicalArts Press®1-800-328-2179
. (Vers.V2SSS05)
FILED: NASSAU COUNTY CLERK 06/13/2022 12:37 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 402 RECEIVED NYSCEF: 06/13/2022
TREATMENT RECORD
Owner's Name:
Animals Name:
D.O.B.: SEX: BREED: \
() I.D.#
REFERRED BY (DEAL):
Phone #: ._
Cell#: ._
Date Jreatment Charge Paid Balance
Mo. Day Yr.
4Sr
p
a6n\hrs-der Dr.
Green - Male Feline
FILED: NASSAU COUNTY CLERK 06/13/2022 12:37 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 402 RECEIVED NYSCEF: 06/13/2022
Date Treatment Charge Paid Balance
Mo. Day Yr.
RVvaccine,KV
awLEPTO5RRAA-
CAMCOE
!
FILED: NASSAU COUNTY CLERK 06/13/2022 12:37 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 402 RECEIVED NYSCEF: 06/13/2022
.,- MesufaeParer Lot a Expires Date Given
memcal Other Dewclaw Removal 10/11/2021
MedicalProcedure Dock Tail 10/11/2021
Medication Pyrantel Merck 19917 I1/01/2022 10/22/2021
Medication Pyrantel Merck 19917 11/01/2022 11/05/2021
Vaccination Intra-Trac3 Nobivac 00541448B 01/12/2023 11/05/2021
Vaccination NeoPar NeoTech 7290 04/23/2024 11/05/2021
Vaccination Vanguard Plus 5 Zoetis 498470B 08/23/2022 11/12/2021
Medication Pyrantel Merck 19917 11/01/2022 11/19/2021
Vaccination NeoPar NeoTech 7290 08/23/2024 11/19/2021
Medication Ivomec Merial E39N 04/01/2023 11/19/2021
Medication Ivomec Merial E39N 04/01/2023 11/26/2021
Medication Pyrethrin
Dip Virbac 180214E426 12/01/2022 I1/26/2021
Medication Safeguard X 5 days Pfizer F067A01 01/01/2023 11/28/2021
Medication Albon x 5 Days Pfizer 464311 07/01/2023 11/28/2021
Vaccination Vanguard Plus 5 Zoetis 432144A I1/09/2022 12/08/2021
Vaccination Neo Par Neotech 7278 08/28/2023 12/11/2021
..
DRONTAL , j ,
VAN%sUAKD PLUb b B L/ L-
Document Filed Date
June 13, 2022
Case Filing Date
December 16, 2021
Category
Special Proceedings - Other (Pursuant to Exec Law 6312)
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Preview
FILED: NASSAU COUNTY CLERK 06/13/2022 12:37 PM INDEX NO. 615766/2021 NYSCEF DOC. NO. 402 RECEIVED NYSCEF: 06/13/2022 W6LCo L6nt oFMd o ) Date O 7nn Owner (Last Name First): ½ Address: City: State: ) Z p: E-mail JR Home Phone: ( ) Cell Phone: Co-Owner/Spouse (Last Name First): p E-mail Address: Phone: ( Emergency Contact Name: Phone: ( ) How did you learn about our practice? 30 k CL Number of pets (pleasespecify by type) Primary reason for visit: 06 d d .b(Imo 0ho#- , b0d ACi Pet ormatton Pet's Name: 60 N Jog O Cat O Other Sex: F M O F Age: eds Birthdate: 10 2 3 Breed: Color: ,b\qd Q & Neutered/Spayed: O Yes At what age? What age was pet obtained? S From: O Friend O Breeder Ót Shop O Humane Society O Other Ñ Reason for obtaining pet (check allthat apply) O Companion O Protection O Breeding O Show O Other Describe your pet's diet:______ Listyour pet'scurrent medication: Please check symptoms or problems you ve noticed with your pet: any O Appetite Loss O Gagging deezing O Behavioral Changes O Gums Bleedine O Thirst Q Breathing Problems O Limping Urination Increase Q Loss of Balance O Vomiting ghing Depression O 3 Weakness O Diarrhea Scooting 3 O Eye Disorders: O Shaking Head O Other: Scratching Pet's History (check allthat pet has received) O Distemper O Feline Leukemia Test O Prior Surgery: Q Parvovirus (Dog) Q FVRCP (Infectious Disease-Cat) O Prior Illness: O Rabies O Dental 3 Other: (Dog/Cat) uthorleation prescribe for, or treat the above described pet. I assume I hereby authorize the veterinarian to examine, the animal. I also understand that ALL PROFESSIONAL responsibility for all chames incurred in the care of FEES ARE 0TlE AT THE TIME SERVICL ARE R NDE clientresponsible for pet(sk 11 L Date 1 3C22 Signature of #35144-© 2005MedicalArts Press®1-800-328-2179 . (Vers.V2SSS05) FILED: NASSAU COUNTY CLERK 06/13/2022 12:37 PM INDEX NO. 615766/2021 NYSCEF DOC. NO. 402 RECEIVED NYSCEF: 06/13/2022 TREATMENT RECORD Owner's Name: Animals Name: D.O.B.: SEX: BREED: \ () I.D.# REFERRED BY (DEAL): Phone #: ._ Cell#: ._ Date Jreatment Charge Paid Balance Mo. Day Yr. 4Sr p a6n\hrs-der Dr. Green - Male Feline FILED: NASSAU COUNTY CLERK 06/13/2022 12:37 PM INDEX NO. 615766/2021 NYSCEF DOC. NO. 402 RECEIVED NYSCEF: 06/13/2022 Date Treatment Charge Paid Balance Mo. Day Yr. RVvaccine,KV awLEPTO5RRAA- CAMCOE ! FILED: NASSAU COUNTY CLERK 06/13/2022 12:37 PM INDEX NO. 615766/2021 NYSCEF DOC. NO. 402 RECEIVED NYSCEF: 06/13/2022 .,- MesufaeParer Lot a Expires Date Given memcal Other Dewclaw Removal 10/11/2021 MedicalProcedure Dock Tail 10/11/2021 Medication Pyrantel Merck 19917 I1/01/2022 10/22/2021 Medication Pyrantel Merck 19917 11/01/2022 11/05/2021 Vaccination Intra-Trac3 Nobivac 00541448B 01/12/2023 11/05/2021 Vaccination NeoPar NeoTech 7290 04/23/2024 11/05/2021 Vaccination Vanguard Plus 5 Zoetis 498470B 08/23/2022 11/12/2021 Medication Pyrantel Merck 19917 11/01/2022 11/19/2021 Vaccination NeoPar NeoTech 7290 08/23/2024 11/19/2021 Medication Ivomec Merial E39N 04/01/2023 11/19/2021 Medication Ivomec Merial E39N 04/01/2023 11/26/2021 Medication Pyrethrin Dip Virbac 180214E426 12/01/2022 I1/26/2021 Medication Safeguard X 5 days Pfizer F067A01 01/01/2023 11/28/2021 Medication Albon x 5 Days Pfizer 464311 07/01/2023 11/28/2021 Vaccination Vanguard Plus 5 Zoetis 432144A I1/09/2022 12/08/2021 Vaccination Neo Par Neotech 7278 08/28/2023 12/11/2021 .. DRONTAL , j , VAN%sUAKD PLUb b B L/ L-