On October 30, 2018 a
Request for Judicial Intervention
was filed
involving a dispute between
Carla Tellez Hernandez,
Genesis Cuamatzi Tellez,
and
The New York City Department Of Education,
for Torts - Other Negligence (Negligent supervision)
in the District Court of Kings County.
Preview
FILED: KINGS COUNTY CLERK 02/06/2019 01:10 PM INDEX NO. 522048/2018
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 02/06/2019
REQUEST FOR JUDICIAL INTERVENTION For Court Clerk Use Only:
UCS-840 (7/2012) IAS kntry [.)ate
Supreme COURT, COU.NTY OF Kings
Judge Assigned
Index No: 522048/2018 Date Index Issued: 10/30/2018
CAPTION. Enter the complete case baptiori Do not use et al or et ano. Ifmore space is required RJI uate
attach a caption rider she'etfWAhirh
GENESIS CUAMATZI TELLEZ, an infant by her mother and natural guardian, CARLA TELLEZ
HERNANDEZ and CARLA TELLEZ HERNANDEZ, individually,
Plaintiff(s)/Petitioner(s)
-apainst-
fHE NEW YORK CITY DEPARTMENT OF EDUCATION,
Defendant(s)/Rer:±.. 's)
NATURE OF ACTION OR PROCEEDING: . Check ONE box only and specify where indicated. . .
MATRIMONIAL COMMERCIAL
Ö Contested O Business Entity (including corporations, partnerships, LLCs, etc.)
NOTE: For allMatrimonial actions where the parties have children under O Contract
the age of 18, complete and attach the MATRIMONIAL RJI AddeGdu-n-
O Insurance (where insurer is a party, except arbitration)
For Uncontested Matrimonial actions, use RJI form UD-13-
O UCC (including sales, negotiable instruments)
TORTS O Other Commercial:
(SP°
O Asbestos
O Breast Implant NOTE: For Commercial Division assignment requests [22 NYCRR §
O environmental: 202.70(d)], complete and attach the COMMERCIAL DIV RJI Addeadürs.
(SP"
REAL PROPERTY: How many properties does the applicationinclude?
O Medical, Dental, or Podiatric Malpractice O Condemnation
O Motor Vehicle O Mortgage Foreclosure (specify): O Residential O Commercial
O Products Liability: Property Address:
(specify) StreetAddress City State Zip
O Other Negligence: NOTE: For Mortgage Foreclosure actions involving a one- to four-family,
(specify) OWner-OCCupied, residential property, or an owner-occupied
O Other Professional Malpractice: condominium, complete and attach the FORECLOSURE RJi Addendum.
(specify)
O Tax Certiorari - Section: Block: Lot:
O Other Tort: O Tax Foreclosure
(specify)
Û Other Real Property:
(SP°°'Y)
OTHER MATTERS
Û Certificate of Incorporation/Dissolution [see NOTE under Commercial) SPECIAL PROCEEDINGS
O Emergency Medical Treatment O CPLR Article 75 (Arbitration) [see NOTE under Commercial]
O Habeas Corpus O CPLR Article 78 (Body or Officer)
O Local Court Appeal O election Law
O Mechanic's Lien O MHL Article 9.60 (Kendra's Law)
O Name Change O MHL Article 10 (Sex Offender Confinement-Initial)
O Pistol Permit Revocation Hearing Q MHL Article 10 (Sex Offender Confinement-Review)
O Sale or Finance of Religious/Not-for-Profit Property O MHL Article 81 (Guardianship)
O Other: O Other Mental Hygiene:
(specify) (specify)
O Other Special Proceeding:
(specify)
STATUS OF ACTION OR PROCEEDING: Answer YES or NO for EVERY question AND enter additional information where indicated.
YES | NO |
10/30/2018
Has a summons and complaint or summons w/notice been filed? Ifyes, date filed:
Has a summons and complaint or summons w/notice been served? If date served: 11/09/2018
yes.
Is thisaction/proceeding being filedpost-judgment? Ifyes. judgment date:
1 of 2
FILED: KINGS COUNTY CLERK 02/06/2019 01:10 PM INDEX NO. 522048/2018
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 02/06/2019
NATURE OF JUDICIAL INTERVENTION: Check ONE box only AND enter additional information where indicated.
Ó Infant's Compromise
O Note of Issue and/or Certificate of Readiness
O Notice of Medical, Dental, or Podiatric Malpractice Date Issue Joined:
O Notice of Motion Relief Sought: Return Date:
O Notice of Petition Relief Sought: Return Date:
O Order to Show Cause Relief Sought: Return Date:
O Other Ex Parte Application Relief Sought:
O Poor Person Application
O Request for Preliminary Conference
O Residential Mortgage Foreclosure Settlement Conference
O Writ of Habeas Corpus
O Other (specify):
CASES· List any related actions. For Matrimonial actions, include any related criminal and/or Family Court cases.
RELATED
Ifadditional space is required, complete and attach the RJI Addendum. Ifnone, leave blank.
Case Title Index/Case No. Court Judge (ifassigned) |Re!ationship to Instant Case
"Un-Rep"
MMS, For parties without an attomey, check box AND enter party address, phone number and e-mail address in space provided.
Ifadditional space is required, complete and attach the RJI Adde±
Parties: Attorneys and/or Unrepresented Litigants:
Issue
Un-
IListparties in caption order and Provide attorney name, firm name, business address, phone number and e-mail
Joined
Rep indicate role(s) (e.g.defendant; address of all attorneys that have appeared in the case. For unrepresented Carrier(s):
party
3rd-party plaintiff). litigants,provide address, phone number and e-mail address.
GENESIS CUAMATZl TELLEZ, an infant by _asprilla Jose M.
LastName Last Name FirstName
her mother and natural guardian, CARL/g falisman & Delorenz, P.C.
FirstName Firm Name
Primary Role:
362 Knickerbocker Avenue Brooklyn New York 11237
Plaintiff StreetAddress City State Zip
Role (if any): NO
Secondary
t1 (718)302-3330
Phone Fax e-mail
THE NEW YORK CITY DEPARTMENT OF EU
LastName Last Name FirstName
YES
ZACHARY W. CARTER Corporation Counsel
FirstName Firm Name
Primary Role:
100 Church Avenue New York New York 10004
Defendant StreetAddress City State Zip
Secondary Role (if any):
Phone Fax e-mail
Last Name Last Name FirstName
FirstName Firm Name
Primary Role:
StreetAddress City State Zip
Secondary Role (if any):
Phone Fax e-mail
Last Name Last Name FirstName
FirstName Firm Name
Primary Role:
StreetAddress City State Zip
secondary Role (if any):
Phone Fax e-mail
I AFFIRM UNDER THE PENALTY OF PERJURY THAT, TO MY KNOWLEDGE, OTHER THAN AS NOTED ABOVE, THERE ARE AND HAVE
BEEN NO RELATED ACTIONS OR PROCEEDINGS, NOR HAS A REQUEST FOR JUDICIAL INTERVENTION PREVIOUSLY BEEN FILED IN
THIS ACTION OR PROCEEDING.
Dated: 01/28/2019
SIGNATURE
5666664 Jose Lasprilla
ATTORNEY REGISTRATION NUMBER PRINT OR TYPE NAME
Print Form
2 of 2
Document Filed Date
February 06, 2019
Case Filing Date
October 30, 2018
Category
Torts - Other Negligence (Negligent supervision)
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Preview
FILED: KINGS COUNTY CLERK 02/06/2019 01:10 PM INDEX NO. 522048/2018 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 02/06/2019 REQUEST FOR JUDICIAL INTERVENTION For Court Clerk Use Only: UCS-840 (7/2012) IAS kntry [.)ate Supreme COURT, COU.NTY OF Kings Judge Assigned Index No: 522048/2018 Date Index Issued: 10/30/2018 CAPTION. Enter the complete case baptiori Do not use et al or et ano. Ifmore space is required RJI uate attach a caption rider she'etfWAhirh GENESIS CUAMATZI TELLEZ, an infant by her mother and natural guardian, CARLA TELLEZ HERNANDEZ and CARLA TELLEZ HERNANDEZ, individually, Plaintiff(s)/Petitioner(s) -apainst- fHE NEW YORK CITY DEPARTMENT OF EDUCATION, Defendant(s)/Rer:±.. 's) NATURE OF ACTION OR PROCEEDING: . Check ONE box only and specify where indicated. . . MATRIMONIAL COMMERCIAL Ö Contested O Business Entity (including corporations, partnerships, LLCs, etc.) NOTE: For allMatrimonial actions where the parties have children under O Contract the age of 18, complete and attach the MATRIMONIAL RJI AddeGdu-n- O Insurance (where insurer is a party, except arbitration) For Uncontested Matrimonial actions, use RJI form UD-13- O UCC (including sales, negotiable instruments) TORTS O Other Commercial: (SP° O Asbestos O Breast Implant NOTE: For Commercial Division assignment requests [22 NYCRR § O environmental: 202.70(d)], complete and attach the COMMERCIAL DIV RJI Addeadürs. (SP" REAL PROPERTY: How many properties does the applicationinclude? O Medical, Dental, or Podiatric Malpractice O Condemnation O Motor Vehicle O Mortgage Foreclosure (specify): O Residential O Commercial O Products Liability: Property Address: (specify) StreetAddress City State Zip O Other Negligence: NOTE: For Mortgage Foreclosure actions involving a one- to four-family, (specify) OWner-OCCupied, residential property, or an owner-occupied O Other Professional Malpractice: condominium, complete and attach the FORECLOSURE RJi Addendum. (specify) O Tax Certiorari - Section: Block: Lot: O Other Tort: O Tax Foreclosure (specify) Û Other Real Property: (SP°°'Y) OTHER MATTERS Û Certificate of Incorporation/Dissolution [see NOTE under Commercial) SPECIAL PROCEEDINGS O Emergency Medical Treatment O CPLR Article 75 (Arbitration) [see NOTE under Commercial] O Habeas Corpus O CPLR Article 78 (Body or Officer) O Local Court Appeal O election Law O Mechanic's Lien O MHL Article 9.60 (Kendra's Law) O Name Change O MHL Article 10 (Sex Offender Confinement-Initial) O Pistol Permit Revocation Hearing Q MHL Article 10 (Sex Offender Confinement-Review) O Sale or Finance of Religious/Not-for-Profit Property O MHL Article 81 (Guardianship) O Other: O Other Mental Hygiene: (specify) (specify) O Other Special Proceeding: (specify) STATUS OF ACTION OR PROCEEDING: Answer YES or NO for EVERY question AND enter additional information where indicated. YES | NO | 10/30/2018 Has a summons and complaint or summons w/notice been filed? Ifyes, date filed: Has a summons and complaint or summons w/notice been served? If date served: 11/09/2018 yes. Is thisaction/proceeding being filedpost-judgment? Ifyes. judgment date: 1 of 2 FILED: KINGS COUNTY CLERK 02/06/2019 01:10 PM INDEX NO. 522048/2018 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 02/06/2019 NATURE OF JUDICIAL INTERVENTION: Check ONE box only AND enter additional information where indicated. Ó Infant's Compromise O Note of Issue and/or Certificate of Readiness O Notice of Medical, Dental, or Podiatric Malpractice Date Issue Joined: O Notice of Motion Relief Sought: Return Date: O Notice of Petition Relief Sought: Return Date: O Order to Show Cause Relief Sought: Return Date: O Other Ex Parte Application Relief Sought: O Poor Person Application O Request for Preliminary Conference O Residential Mortgage Foreclosure Settlement Conference O Writ of Habeas Corpus O Other (specify): CASES· List any related actions. For Matrimonial actions, include any related criminal and/or Family Court cases. RELATED Ifadditional space is required, complete and attach the RJI Addendum. Ifnone, leave blank. Case Title Index/Case No. Court Judge (ifassigned) |Re!ationship to Instant Case "Un-Rep" MMS, For parties without an attomey, check box AND enter party address, phone number and e-mail address in space provided. Ifadditional space is required, complete and attach the RJI Adde± Parties: Attorneys and/or Unrepresented Litigants: Issue Un- IListparties in caption order and Provide attorney name, firm name, business address, phone number and e-mail Joined Rep indicate role(s) (e.g.defendant; address of all attorneys that have appeared in the case. For unrepresented Carrier(s): party 3rd-party plaintiff). litigants,provide address, phone number and e-mail address. GENESIS CUAMATZl TELLEZ, an infant by _asprilla Jose M. LastName Last Name FirstName her mother and natural guardian, CARL/g falisman & Delorenz, P.C. FirstName Firm Name Primary Role: 362 Knickerbocker Avenue Brooklyn New York 11237 Plaintiff StreetAddress City State Zip Role (if any): NO Secondary t1 (718)302-3330 Phone Fax e-mail THE NEW YORK CITY DEPARTMENT OF EU LastName Last Name FirstName YES ZACHARY W. CARTER Corporation Counsel FirstName Firm Name Primary Role: 100 Church Avenue New York New York 10004 Defendant StreetAddress City State Zip Secondary Role (if any): Phone Fax e-mail Last Name Last Name FirstName FirstName Firm Name Primary Role: StreetAddress City State Zip Secondary Role (if any): Phone Fax e-mail Last Name Last Name FirstName FirstName Firm Name Primary Role: StreetAddress City State Zip secondary Role (if any): Phone Fax e-mail I AFFIRM UNDER THE PENALTY OF PERJURY THAT, TO MY KNOWLEDGE, OTHER THAN AS NOTED ABOVE, THERE ARE AND HAVE BEEN NO RELATED ACTIONS OR PROCEEDINGS, NOR HAS A REQUEST FOR JUDICIAL INTERVENTION PREVIOUSLY BEEN FILED IN THIS ACTION OR PROCEEDING. Dated: 01/28/2019 SIGNATURE 5666664 Jose Lasprilla ATTORNEY REGISTRATION NUMBER PRINT OR TYPE NAME Print Form 2 of 2