On May 05, 2022 a
Request for Judicial Intervention
was filed
involving a dispute between
Elements Financial Federal Credit Union,
and
Mary Tabolt,
for Other Matters - Consumer Credit (Non-Card) Transaction
in the District Court of Lewis County.
Preview
FILED: LEWIS COUNTY CLERK 01/27/2023 01:14 PM INDEX NO. EFCA2022-000134
NYSCEF DOC. NO. 9 RECEIVED NYSCEF: 01/27/2023
UCS-840
REQUEST FOR JUDICIAL INTERVENTION ver ovov2oza
SUPREME COURT, COUNTY OF LEWIS
Index No: EFCA2022-000134 Date Index Issued: 05/05/2022 For Court USe Or ly:
CAPTIOÑ Enter the complete case caption. Do not use et al or et ano. If more space is needed, attach a caption rider sheet. IAS Entry Date
ELEMENTS FINANCIAL FEDERAL CREDIT UNION
Plaintiff(s)/Petitioner(s; Judge Assigned
¬against-
MARY TABOLT RJIFiled Date
Defendant(s)/Respondent(s
-
NATURE OF ACTION OR PROCEEDING Check only one box and specify where i7dicated. ___C
COMMERICIAL MATRIMONIAL
Q Business Entity (includes corporations, partnerships, LLCs,LLPs,etc.) Q Contested
O Contract NOTE: If there are children under the age of 18, complete and attach the
Q Insurance (where insurance company is a party, except arbitration) MATRIMONIAL RJIADDENDUM (UCS-840M).
O UCC(includes sales and negotiable instruments) For Uncontested Matrimonial octions, use the Uncontested Divorce RJi(UD-13).
Q Other Commercial (specify): REALPROPERTY Specify how many properties the application includes:
NOTE: For Commercial Division assignment requests pursuant to 22 NYCRR202.70(d), Q Condemnation
complete and attach the COMMERCIALDIVISIONRJIADDENDUM (UCS-84OC). Q Mortgage Foreclosure (specify): Q Residential Q Commercial
TORTS Property Address:
Q Asbestos NOTE:For Mortgage Foreclosure octions involving a one to four-family,
O Child Victims Act owner-occupied residential property or owner-occupied condominium,
Q Environmental (specify): complete ond attach the FORECLOSURE
RJIADDENDUM (UCS-840F).
Q Medical, Dental or Podiatric Malpractice O Partition
Q Motor Vehicle NOTE: Complete ond ottach the PARTITIONRJIADDENDUM (UCS-840P).
O Products Liability (specify): Q Tax Certiorari (specify): Section: Block: Lot:
Q Other Negligence (specify): O Tax Foreclosure
O Other Professional Malpractice (specify): O Other Real Property (specify):
O Other Tort (specify): OTHERMATTERS
SPECIALPROCEEDINGS Q Certificate of Incorporation/Dissolution [see NOTEin COMMERCIALsection]
O Child-Parent Security Act (specify): QAssisted Reproduction OSurrogacy Agreement Q Emergency Medical Treatment
Q CPLRArticle 75 -Arbitration [see NOTEin COMMERCIALsection] Q HabeasCorpus
Q CPLRArticle 78 - Proceeding against a Body or Officer Q Local Court Appeal
Q Election Law Q Mechanic's Lien
O Extreme Risk Protection Order O Name Change/Sex Designation Change
O MHL Article 9.60-Kendra's Law O Pistol Permit Revocation Hearing
O MHL Article 10-Sex Offender Confinement (specify): Q Initial Q Review O Saleor rinance of Religious/Not-for-Profit Property
O MHL Article 81 (Guardianship) Other (specify): contract
O Other Mental Hygiene (specify):
O Other Special Proceeding (specify):
STATUS OF ACTION OR PROCEEDING Answer YESor NO forevery questior and enter additional information where indicated.
YES NO
Has a summons and complaint or summons with notice been filed? @ O If yes, date filed: 05/05/2022
Has a summons and complaint or summons with notice been served? If yes, date served:
Is this action/proceeding being filed post-judgment? If yes, judgment date:
NATURE OF JUDICIAL INTERVENTION Check one box only and enter additional information where indicated.
Q Infant's Compromise
Q Extreme RiskProtection Order Application
O Note of Issue/Certificate of Readiness
Q Notice of Medical, Dental or Podiatric Malpractice Date issue Joined:
@ Notice of Motion Relief Requested: ExtendTime for Service Return Date: 03/02/2023
Q Notice of Petition Relief Requested: Return Date:
Q Order to Show Cause Relief Requested: Return Date
Q Other Ex Parte Application Relief Requested:
Q Partition Settlement Conference
Q Poor Person Application
Request for Preliminary Conference
Residential Mortgage Foreclosure Settlement Conference
O writ of Habeas corpus
O Other (specify):
1 of 2
FILED: LEWIS COUNTY CLERK 01/27/2023 01:14 PM INDEX NO. EFCA2022-000134
NYSCEF DOC. NO. 9 RECEIVED NYSCEF: 01/27/2023
RELATED CASES List any related actions. For Matrimonial cases, list any related criminal or Family Court cases. If none, leave blank.
If additional space is required, complete and attach the RJi ADDENDUM (UCS-840A).
CaseTitle Index/CaseNumber Court Judge (if assigned) Relationship to instant case
"Un-Rep"
PARTIES For parties without at attorney, check the box and enter the party's address, phone number and email in the spacejrtM ifgl
If additional space is r3quked, c¼mplete and attachthe RJI ADDENDUM (UCS-840A). B
Un- Parties Attorneys and Unrepresentedlitigants Issue Joined Insurance Carriers
Rep List parties in same order as listed in the For represented parties, provide attorney's name, firm name, address, phone and For each defendant, For each defendant,
caption and indicate roles (e.g., plaintiff, email. For unrepresented parties, provide party's address, phone and email. indicate if issue has indicate insurance
defendant. 3rd party plaintiff, etC.) been Oined. carrier. if applicable.
Name: ELEMENTS FINANCIAL
FEDERAL CREDITUN.N Shelly Baldwin,
Esq- Goldstein
Relin. and Crane
L LP
O Role(s): 28EastMain
3254202
(585)
Suite1800.
Street,
baldwins@rgeattys
com
NewYork14614
Rocnester. OYES O NO
Name MARY TABOLT 6438 Linger Long Pond LoopRoad
Glenfield. New York 13343
CYES O NO
Defendant
Name:
Role(s): O YES O NO
Name:
O Role(s): O YES O NO
Name:
O Role(s): O YES O NO
Name:
¡ Role(s): O YES O NO
Name:
D Role(s): O YES O NO
Name:
O Role(s): OYES O NO
Name:
O Role(s): O YES O NO
Name:
¡ Role(s): O YES O NO
Name:
¡ Role(s): O YES O NO
Name:
O Role(s): OYES O NO
Name:
O Role(s): OYES O NO
Name:
O Role(s): O YES O NO
Name:
O Role(s): O YES O NO
I Al FIRM UNDER THE PENALTY OF PER.URY THAT, UPON INFORMATION AND BELIEF, THERE ARE O OT ItELATED ACTIONS 3R PROCEEDINGS,
EXCEPT AS OTED ABOVE, NOR H/.5 A REQUEST FOR JUDICIAL INTERVENTION BEEN PREVI SL ILED I THIS ACTION OR PROCEEDING.
Dated:
Signature
2984110 Shelly Baldwin, Esq
Attorney Registration Number Print Name
2 of 2
Document Filed Date
January 27, 2023
Case Filing Date
May 05, 2022
Category
Other Matters - Consumer Credit (Non-Card) Transaction
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Preview
FILED: LEWIS COUNTY CLERK 01/27/2023 01:14 PM INDEX NO. EFCA2022-000134 NYSCEF DOC. NO. 9 RECEIVED NYSCEF: 01/27/2023 UCS-840 REQUEST FOR JUDICIAL INTERVENTION ver ovov2oza SUPREME COURT, COUNTY OF LEWIS Index No: EFCA2022-000134 Date Index Issued: 05/05/2022 For Court USe Or ly: CAPTIOÑ Enter the complete case caption. Do not use et al or et ano. If more space is needed, attach a caption rider sheet. IAS Entry Date ELEMENTS FINANCIAL FEDERAL CREDIT UNION Plaintiff(s)/Petitioner(s; Judge Assigned ¬against- MARY TABOLT RJIFiled Date Defendant(s)/Respondent(s - NATURE OF ACTION OR PROCEEDING Check only one box and specify where i7dicated. ___C COMMERICIAL MATRIMONIAL Q Business Entity (includes corporations, partnerships, LLCs,LLPs,etc.) Q Contested O Contract NOTE: If there are children under the age of 18, complete and attach the Q Insurance (where insurance company is a party, except arbitration) MATRIMONIAL RJIADDENDUM (UCS-840M). O UCC(includes sales and negotiable instruments) For Uncontested Matrimonial octions, use the Uncontested Divorce RJi(UD-13). Q Other Commercial (specify): REALPROPERTY Specify how many properties the application includes: NOTE: For Commercial Division assignment requests pursuant to 22 NYCRR202.70(d), Q Condemnation complete and attach the COMMERCIALDIVISIONRJIADDENDUM (UCS-84OC). Q Mortgage Foreclosure (specify): Q Residential Q Commercial TORTS Property Address: Q Asbestos NOTE:For Mortgage Foreclosure octions involving a one to four-family, O Child Victims Act owner-occupied residential property or owner-occupied condominium, Q Environmental (specify): complete ond attach the FORECLOSURE RJIADDENDUM (UCS-840F). Q Medical, Dental or Podiatric Malpractice O Partition Q Motor Vehicle NOTE: Complete ond ottach the PARTITIONRJIADDENDUM (UCS-840P). O Products Liability (specify): Q Tax Certiorari (specify): Section: Block: Lot: Q Other Negligence (specify): O Tax Foreclosure O Other Professional Malpractice (specify): O Other Real Property (specify): O Other Tort (specify): OTHERMATTERS SPECIALPROCEEDINGS Q Certificate of Incorporation/Dissolution [see NOTEin COMMERCIALsection] O Child-Parent Security Act (specify): QAssisted Reproduction OSurrogacy Agreement Q Emergency Medical Treatment Q CPLRArticle 75 -Arbitration [see NOTEin COMMERCIALsection] Q HabeasCorpus Q CPLRArticle 78 - Proceeding against a Body or Officer Q Local Court Appeal Q Election Law Q Mechanic's Lien O Extreme Risk Protection Order O Name Change/Sex Designation Change O MHL Article 9.60-Kendra's Law O Pistol Permit Revocation Hearing O MHL Article 10-Sex Offender Confinement (specify): Q Initial Q Review O Saleor rinance of Religious/Not-for-Profit Property O MHL Article 81 (Guardianship) Other (specify): contract O Other Mental Hygiene (specify): O Other Special Proceeding (specify): STATUS OF ACTION OR PROCEEDING Answer YESor NO forevery questior and enter additional information where indicated. YES NO Has a summons and complaint or summons with notice been filed? @ O If yes, date filed: 05/05/2022 Has a summons and complaint or summons with notice been served? If yes, date served: Is this action/proceeding being filed post-judgment? If yes, judgment date: NATURE OF JUDICIAL INTERVENTION Check one box only and enter additional information where indicated. Q Infant's Compromise Q Extreme RiskProtection Order Application O Note of Issue/Certificate of Readiness Q Notice of Medical, Dental or Podiatric Malpractice Date issue Joined: @ Notice of Motion Relief Requested: ExtendTime for Service Return Date: 03/02/2023 Q Notice of Petition Relief Requested: Return Date: Q Order to Show Cause Relief Requested: Return Date Q Other Ex Parte Application Relief Requested: Q Partition Settlement Conference Q Poor Person Application Request for Preliminary Conference Residential Mortgage Foreclosure Settlement Conference O writ of Habeas corpus O Other (specify): 1 of 2 FILED: LEWIS COUNTY CLERK 01/27/2023 01:14 PM INDEX NO. EFCA2022-000134 NYSCEF DOC. NO. 9 RECEIVED NYSCEF: 01/27/2023 RELATED CASES List any related actions. For Matrimonial cases, list any related criminal or Family Court cases. If none, leave blank. If additional space is required, complete and attach the RJi ADDENDUM (UCS-840A). CaseTitle Index/CaseNumber Court Judge (if assigned) Relationship to instant case "Un-Rep" PARTIES For parties without at attorney, check the box and enter the party's address, phone number and email in the spacejrtM ifgl If additional space is r3quked, c¼mplete and attachthe RJI ADDENDUM (UCS-840A). B Un- Parties Attorneys and Unrepresentedlitigants Issue Joined Insurance Carriers Rep List parties in same order as listed in the For represented parties, provide attorney's name, firm name, address, phone and For each defendant, For each defendant, caption and indicate roles (e.g., plaintiff, email. For unrepresented parties, provide party's address, phone and email. indicate if issue has indicate insurance defendant. 3rd party plaintiff, etC.) been Oined. carrier. if applicable. Name: ELEMENTS FINANCIAL FEDERAL CREDITUN.N Shelly Baldwin, Esq- Goldstein Relin. and Crane L LP O Role(s): 28EastMain 3254202 (585) Suite1800. Street, baldwins@rgeattys com NewYork14614 Rocnester. OYES O NO Name MARY TABOLT 6438 Linger Long Pond LoopRoad Glenfield. New York 13343 CYES O NO Defendant Name: Role(s): O YES O NO Name: O Role(s): O YES O NO Name: O Role(s): O YES O NO Name: ¡ Role(s): O YES O NO Name: D Role(s): O YES O NO Name: O Role(s): OYES O NO Name: O Role(s): O YES O NO Name: ¡ Role(s): O YES O NO Name: ¡ Role(s): O YES O NO Name: O Role(s): OYES O NO Name: O Role(s): OYES O NO Name: O Role(s): O YES O NO Name: O Role(s): O YES O NO I Al FIRM UNDER THE PENALTY OF PER.URY THAT, UPON INFORMATION AND BELIEF, THERE ARE O OT ItELATED ACTIONS 3R PROCEEDINGS, EXCEPT AS OTED ABOVE, NOR H/.5 A REQUEST FOR JUDICIAL INTERVENTION BEEN PREVI SL ILED I THIS ACTION OR PROCEEDING. Dated: Signature 2984110 Shelly Baldwin, Esq Attorney Registration Number Print Name 2 of 2