On December 16, 2021 a
Party Statement
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 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
AFFIDAVIT OF RECORDS CUSTODIAN
CERTIFICATION OF VETERINARY RECORDS
tat bomHe , being duly sworn, deposes and states that:
1. My name is o n a kmborolo , I am of sound mind, capable of making this
affidavit. I am over the age of 18, and not a party to any related matter.
2. I am the Custodian of Records for 5
3. The records attached hereto and true and exact copies of the reports and records of
veterinary treatment rendered for patient P|m su, ech,4 hst , on
through
Date offirst visit Date of last visit
4. The records attached hereto were made by physicians and/or staff who had personal
knowledge of the facts recorded.
5. The records are of a type regularly kept and maintained by ts 5 qi .
6. Annexed hereto are true and accurate copies of the original records.
7. I hereby certify that pages accompany this Affidavit of Certification.
I AFFIRM UNDER PENALTIES OF PERJURY THAT THE FOREGOING
REPRESENTATIONS ARE TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE AND BELIEF.
Signed:
Records Custodian
NOTARYPUBLIC, STATEOF NEW YORK
NO. 018R6319141
QUALIFIEDIN NASSAU COUNTY
MY CONSS!0UXRRES FEB 9. 2010 General
NYS Attorney
Notary
MAR 0 8 9023
Nassau Regional Office
FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
1/1/2016 52368 9/21/2015
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12/28/201552336 10/18/2015
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12/28/201552333 10/5/2015
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Last_Name Name First First_Visit Client_ID DOB
FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
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1/1/2016 43327 1/1/2008
FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
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FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
2/16/2016 52856 11/6/2015
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FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
2/26/2016 52973 12/10/2015
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FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
3/10/2016 36780 3/10/2013
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3/8/2016 53110 10/30/2015
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FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
3/26/2016 22244 11/2/2015
3/26/2016 50424 3/1/2000
3/25/2016 53301 1/14/2016
3/25/2016 53299 12/4/2015
3/23/2016 53283 5/19/2016
3/23/2016 53278 1/13/2016
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3/22/2016 53266 1/9/2016
3/22/2016 47851 3/22/2004
3/22/2016 47851 3/22/2004
3/21/2016 51971 3/21/2013
3/20/2016 53243 1/7/2016
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3/18/2016 53221 11/13/2015
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3/13/201µ 53174 1/27/2016
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3/13/201µ 53166 10/16/2015
3/12/201E 53156 12/24/2015
3/12/201E 53150 12/4/2015
3/11/201µ 53146 1/8/2016
3/10/201E 53139 11/11/2015
3/10/201E 53135 10/16/2015
FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
4/8/2016 53462 1/24/2016
4/8/2016 53461 1/23/2016
4/8/2016 53459 1/9/2016
4/7/2016 52932 12/20/2015
NEW ACCT--USE 4/7/2016 40743 12/7/2015
4/6/2016 53436 12/5/2015
4/6/2016 51180 4/6/2013
4/6/2016 53434 12/11/2015
4/6/2016 53433 11/18/2015
4/4/2016 53426 1/1/2016
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4/4/2016 1/11/201610001077
4/3/2016 53412 1/18/2016
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FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
4/23/2016 53615 1/16/2016
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4/22/2016 47568 12/22/2015
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FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
5/3/2016 53757 2/28/2016
5/2/2016 45224 5/2/2012
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FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
5/18/2016 53914 2/19/2016
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5/17/2016 48972 5/16/2016
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5/10/2016 13148 5/10/1998
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5/7/2016 52415 12/24/2010
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FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
6/6/2016 54151 3/19/2016
6/6/2016 54146 3/11/2016
6/4/2016 54130 3/31/2016
6/3/2016 54026 2/4/2016
5/31/2016 31474 5/31/2012
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5/29/2016 51180 1/1/2000
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5/27/2016 33090 3/28/2016
5/26/2016 40444 5/26/2004
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5/26/2016 18462 3/4/2016
5/25/201E 53633 3/19/2016
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5/24/201E 53987 2/12/2016
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5/23/201E 53977 3/12/2016
5/22/201E 53970 1/26/2016
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5/20/201E 53930 2/5/2016
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5/19/201E 10003330 3/10/2016
5/19/201E 53919 1/25/2016
5/18/201E 53916 3/4/2016
FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
6/28/2016 48946 4/15/2016
6/27/2016 54390 4/13/2016
6/26/2016 17627 3/28/2016
6/25/2016 54372 3/6/2016
6/25/2016 48549 4/11/2016
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6/23/2016 54333 2/21/2016
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6/22/2016 54217 6/15/2015
6/21/2016 54312 4/13/2016
6/18/2016 54271 4/9/2016
6/17/2016 48368 12/1/2011
6/16/2016 54252 3/31/2016
6/16/2016 54247 3/24/2016
6/16/2016 54244 3/10/2016
6/14/2016 53983 6/15/2011
NEW 3LD
ACCT--USE 6/13/2016 40743 3/19/2016
6/13/2016 38772 12/12/2015
6/13/2016 54217 4/7/2016
6/12/2016 54214 3/28/2016
6/11/2016 52415 2/3/2016
6/10/2016 54185 1/27/2016
6/8/2016 54169 3/10/2016
6/8/2016 54166 9/17/2011
6/7/2016 39115 9/11/2015
6/7/2016 54162 1/28/2016
6/7/2016 54157 2/4/2016
6/7/2016 54157 1/28/2016
6/6/2016 54154 3/6/2016
6/6/2016 54153 10/16/2015
6/6/2016 54152 3/4/2016
FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
7/11/2016 54580 5/2/2016
7/10/2016 54154 7/10/2001
7/10/2016 45336 5/5/2016
7/9/2016 54540 4/15/2016
7/8/2016 66971 5/7/2016
7/8/2016 54534 3/25/2016
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7/8/2016 54528 1/15/2016
7/7/2016 40167 4/24/2016
7/7/2016 54515 5/2/2016
7/6/2016 54509 4/3/2016
7/6/2016 54502 3/12/2016
7/5/2016 54494 3/10/2016
7/5/2016 54493 4/29/2016
7/5/2016 54489 4/9/2016
7/5/2016 52212 4/11/2016
7/4/2016 54479 3/7/2016
7/4/2016 54476 4/4/2016
7/3/2016 28936 3/8/2016
7/3/2016 54455 3/15/2016
7/3/2016 54445 3/17/2016
7/2/2016 54442 4/9/2016
7/2/2016 54437 4/22/2016
7/2/2016 54437 4/22/2016
7/1/2016 54428 5/1/2016
7/1/2016 45865 4/5/2016
7/1/2016 54422 3/12/2016
7/1/2016 54420 2/18/2016
6/30/2016 43637 5/5/2016
6/30/2016 54418 1/12/2016
6/29/2016 51564 3/31/2016
6/29/2016 54407 3/20/2016
6/28/2016 54400 3/31/2016
6/28/2016 54398 3/4/2016
FILED: NASSAU COUNTY CLERK 03/08/2023 05:04 PM INDEX NO. 615766/2021
NYSCEF DOC. NO. 511 RECEIVED NYSCEF: 03/08/2023
7/31/2016 47327 4/17/2016
7/31/2016 54819 5/23/2016
7/31/2016 39638 5/21/2016
7/30/2016 54803 5/29/2016
7/30/2016 53072 5/31/2016
7/29/2016 47299 7/29/2001
7/28/2016 54782 4/29/2016
Document Filed Date
March 08, 2023
Case Filing Date
December 16, 2021
Category
Special Proceedings - Other (Pursuant to Exec Law 6312)
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