Preview
FILED: KINGS COUNTY CLERK 01/09/2018 07:39 AM INDEX NO. 520642/2017
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 01/09/2018
REQUEST FOR JUDICIAL INTERVENTION For Court Clerk Use Only:
ucs-840(7/2012) IAS EntryDate
Kings Supreme COURT, COUNTY OF Kings
Judge Assigned
Index No: 520642/2017 Date Index Issued: 10/25/2017
Enter the complete case caption. Do not use et al or et ano. If more space is required, RJI Date
CAPTION: attach a caption rider sheet.
Brayan Terrazas
Plaintiff(s)/Petitioner(s)
-against-
-a ainst-
The Cityof New York, Arlene Hershberg
Defendant(s)/Respondent(s)
NATURE OF ACTION OR PROCEEDING: CheckONEbox o1ly and specify where indicated.
MATRIMONIAL COMMERCIAL
Contested BusinessEntity (including corporations, partnerships, LLCs,etc.)
Contract
NOTE: For all Matrimonial actions where the parties have children under the
age of 18, complete and attach the MATRIMONIAL RJIAddendum.
For
UncontestedMatrimonial actions, use RJIform UD-13. Insurance(where insurer is a party, except arbitration)
UCC(including sales, negotiable instruments)
TORTS
Other Commercial:
Asbestos
NOTE: For CommercialDivision assignment requests [22 NYCRR§ 202.70(D)],
Breast Implant complete and attach the COMMERCIALDIV RJIAddendum.
REAL PROPERTY: How many properties does the application include?
P Environmental:
Condemnation
Medical, Dental, or Podiatric Malpractice
Mortgage Foreclosure: U Residential Commercial
Motor Vehicle Property Address:
NOTE: For Mortgage Foreclosureactions involving a one- to four-family, owner-
P ProductsLiability:
occupied, residential property, or an owner-occupiedcondominium, complete and
attach the FORECLOSURERjI Addendum.
X Other Negligence: 205-e
Tax Certiorari - Section: Block: Lot:
Other ProfessionalMalpractice:
Tax Foreclosure
Other Tort: Other Real Property:
OTHER MATTERS SPECIAL PROCEEDINGS
Certificate of Incorporation/Dissolution
[see NOTE under Commercial] CPLRArticle 75 (Arbitration)
[see NOTE under Commercial]
Emergency MedicalTreatment CPLRArticle 78 (Body or Officer)
HabeasCorpus Election Law
LocalCourt Appeal MHLArticle 9.60 (Kendra's Law)
Mechanic'sLien MHLArticle 10 (Sex Offender Confinement-Initial)
NameChange MHLArticle 10 (Sex Offender Confinement-Review)
Pistol Permit Revocation Hearing MHLArticle 81 (Guardianship)
Sale or Financeof Religious/Not-for-ProfitProperty Other Mental Hygiene:
Other: Other SpecialProceeding:
STATUS OF ACTION OR PROCEEDING: AnswerYESor NOfor EVERYquestion AND enter additional information where indicated.
YES NO
Hasa summons and complaint or summonsw/notice been filed? X If yes, date filed:
10/25/2017
Hasa summons and complaint or summonsw/notice been served? X If yes, date served:
11/10/2017
Is this action/proceeding being filed post-judgment? X If yes, judgment date:
1 of 2
FILED: KINGS COUNTY CLERK 01/09/2018 07:39 AM INDEX NO. 520642/2017
NYSCEF
NATURE DOC.OF NO. 5
JUDICIAL INTERVENTION: RECEIVED NYSCEF:
CheckONEbox only ANDenter additional information where indicated. 01/09/2018
Infant's Compromise
Note of Issueand/or Certificate of Readiness
Notice of Medical, Dental, or Podiatric Malpractice
Date IssueJoined:
Notice of Motion Relief Sought: Return Date:
Notice of Petition Relief Sought: Return Date:
Order to ShowCause Relief Sought: Return Date:
Other Ex ParteApplication Relief Sought:
PoorPersonApplication
X Requestfor Preliminary Conference
ResidentialMortgage ForeclosureSettlement Conference
Writ of HabeasCorpus
Other:
RELATED CASES: List any
relatedactions.For Matrimonial include
actions, any relatedcriminal
and/or FamiyCourt cases.If
additional
space is required,
complete and attachthe RJl Addendum. If none,
leaveblank.
Case Title Index/Case No. Court Judge (ifassigned) Relationship to Instant Case
For parties
withoutan attorney,
check "Un-Rep" box AND enter phone number and e-mail
PARTIES: partyaddress,
address in space
provided.If additional
space is required,
complete and attachtheRJI Addendum.
Parties: Attorneysand/or Unrepresented
Litigants:
Un- ISSUe
Provide attorney name, firm name, business address, phone number and e-
List parties in caption order and indicate tef(s).
InsUfance Caff
mail address of all attorneys that have appeared in the case.
party role(s) (e.g., defendant; 3rd-party For Joined
Rep plaintiff). (y(N).
unrepresented litigants, provide address, phone number and e-mail address.
(Y/N):
Name: Terrazas, Brayan JOSEPH DECOLATOR, DECOLATOR, COHEN 8 DIPRISCO LLP, 1399
Franklin Avenue Suite 300, Garden City, NY
11530, 516-742-6575,
dcdlaw@yahoo.com
O Role(s): Plaintiff/Petitioner
YES
Name: The City of New York Stephen Bodiford, Zachary W. Carter, 100 Church Street, New York, NY
10007, 12123563235
O Role(s): Defendant/Respondent
YES
Name: Hershberg, Arlene ALEXA RISSOFF, Law Offices of Tobias 8 Kuhn, 100 William Street, Suite 920
, New York, NY
10038, 2125538790, Alexa.Rissoff@thehartford.com
O Role(s): Defendant/Respondent
YES
Name:
O Role(s):
Name:
O Role(s):
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: 01/09/2018 JOSEPH L DECOLATOR
SIGNATURE
2018414 JOSEPH L DECOLATOR
ATTORNEY REGISTRATION NUMBER PRINT OR TYPE NAME
This form was generated by NYSCEF
2 of 2
Preview
FILED: KINGS COUNTY CLERK 01/09/2018 07:39 AM INDEX NO. 520642/2017 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 01/09/2018 REQUEST FOR JUDICIAL INTERVENTION For Court Clerk Use Only: ucs-840(7/2012) IAS EntryDate Kings Supreme COURT, COUNTY OF Kings Judge Assigned Index No: 520642/2017 Date Index Issued: 10/25/2017 Enter the complete case caption. Do not use et al or et ano. If more space is required, RJI Date CAPTION: attach a caption rider sheet. Brayan Terrazas Plaintiff(s)/Petitioner(s) -against- -a ainst- The Cityof New York, Arlene Hershberg Defendant(s)/Respondent(s) NATURE OF ACTION OR PROCEEDING: CheckONEbox o1ly and specify where indicated. MATRIMONIAL COMMERCIAL Contested BusinessEntity (including corporations, partnerships, LLCs,etc.) Contract NOTE: For all Matrimonial actions where the parties have children under the age of 18, complete and attach the MATRIMONIAL RJIAddendum. For UncontestedMatrimonial actions, use RJIform UD-13. Insurance(where insurer is a party, except arbitration) UCC(including sales, negotiable instruments) TORTS Other Commercial: Asbestos NOTE: For CommercialDivision assignment requests [22 NYCRR§ 202.70(D)], Breast Implant complete and attach the COMMERCIALDIV RJIAddendum. REAL PROPERTY: How many properties does the application include? P Environmental: Condemnation Medical, Dental, or Podiatric Malpractice Mortgage Foreclosure: U Residential Commercial Motor Vehicle Property Address: NOTE: For Mortgage Foreclosureactions involving a one- to four-family, owner- P ProductsLiability: occupied, residential property, or an owner-occupiedcondominium, complete and attach the FORECLOSURERjI Addendum. X Other Negligence: 205-e Tax Certiorari - Section: Block: Lot: Other ProfessionalMalpractice: Tax Foreclosure Other Tort: Other Real Property: OTHER MATTERS SPECIAL PROCEEDINGS Certificate of Incorporation/Dissolution [see NOTE under Commercial] CPLRArticle 75 (Arbitration) [see NOTE under Commercial] Emergency MedicalTreatment CPLRArticle 78 (Body or Officer) HabeasCorpus Election Law LocalCourt Appeal MHLArticle 9.60 (Kendra's Law) Mechanic'sLien MHLArticle 10 (Sex Offender Confinement-Initial) NameChange MHLArticle 10 (Sex Offender Confinement-Review) Pistol Permit Revocation Hearing MHLArticle 81 (Guardianship) Sale or Financeof Religious/Not-for-ProfitProperty Other Mental Hygiene: Other: Other SpecialProceeding: STATUS OF ACTION OR PROCEEDING: AnswerYESor NOfor EVERYquestion AND enter additional information where indicated. YES NO Hasa summons and complaint or summonsw/notice been filed? X If yes, date filed: 10/25/2017 Hasa summons and complaint or summonsw/notice been served? X If yes, date served: 11/10/2017 Is this action/proceeding being filed post-judgment? X If yes, judgment date: 1 of 2 FILED: KINGS COUNTY CLERK 01/09/2018 07:39 AM INDEX NO. 520642/2017 NYSCEF NATURE DOC.OF NO. 5 JUDICIAL INTERVENTION: RECEIVED NYSCEF: CheckONEbox only ANDenter additional information where indicated. 01/09/2018 Infant's Compromise Note of Issueand/or Certificate of Readiness Notice of Medical, Dental, or Podiatric Malpractice Date IssueJoined: Notice of Motion Relief Sought: Return Date: Notice of Petition Relief Sought: Return Date: Order to ShowCause Relief Sought: Return Date: Other Ex ParteApplication Relief Sought: PoorPersonApplication X Requestfor Preliminary Conference ResidentialMortgage ForeclosureSettlement Conference Writ of HabeasCorpus Other: RELATED CASES: List any relatedactions.For Matrimonial include actions, any relatedcriminal and/or FamiyCourt cases.If additional space is required, complete and attachthe RJl Addendum. If none, leaveblank. Case Title Index/Case No. Court Judge (ifassigned) Relationship to Instant Case For parties withoutan attorney, check "Un-Rep" box AND enter phone number and e-mail PARTIES: partyaddress, address in space provided.If additional space is required, complete and attachtheRJI Addendum. Parties: Attorneysand/or Unrepresented Litigants: Un- ISSUe Provide attorney name, firm name, business address, phone number and e- List parties in caption order and indicate tef(s). InsUfance Caff mail address of all attorneys that have appeared in the case. party role(s) (e.g., defendant; 3rd-party For Joined Rep plaintiff). (y(N). unrepresented litigants, provide address, phone number and e-mail address. (Y/N): Name: Terrazas, Brayan JOSEPH DECOLATOR, DECOLATOR, COHEN 8 DIPRISCO LLP, 1399 Franklin Avenue Suite 300, Garden City, NY 11530, 516-742-6575, dcdlaw@yahoo.com O Role(s): Plaintiff/Petitioner YES Name: The City of New York Stephen Bodiford, Zachary W. Carter, 100 Church Street, New York, NY 10007, 12123563235 O Role(s): Defendant/Respondent YES Name: Hershberg, Arlene ALEXA RISSOFF, Law Offices of Tobias 8 Kuhn, 100 William Street, Suite 920 , New York, NY 10038, 2125538790, Alexa.Rissoff@thehartford.com O Role(s): Defendant/Respondent YES Name: O Role(s): Name: O Role(s): 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: 01/09/2018 JOSEPH L DECOLATOR SIGNATURE 2018414 JOSEPH L DECOLATOR ATTORNEY REGISTRATION NUMBER PRINT OR TYPE NAME This form was generated by NYSCEF 2 of 2