Preview
FILED: WARREN COUNTY CLERK 09/29/2023 10:42 AM INDEX NO. EF2023-71503
NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 09/29/2023
REQUEST FOR JUDICIAL INTERVENTION Îo19)
SUPREME COURT, COUNTY OF WARREN
index No: EF2023-71503 Date Index issued: 06/29/2023 For Court Use Only
CAPTION Enter the complete case caption. Do not use etal or et ano. If more space is needed, attach a captior rider sheet. IAS Entry Date
FIVE STAR BANK
Plaintiff(s)/Petitioner(s) Judge Assigned
·against-
RENEE J. LAFFERTY RJiFiled Date
Defendant(s)/Respondent(s)
NATURE.OF ACTION OR PROCEEDING Check only one box and specify where indicated.
COMMERICIAL MATRIMONIAL
Q Business Entity (includes corporations, partnerships, LLCs,LLPs,etc.) O Contested
Q 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).
Q UCC(includes sales and negotiable instruments) For Uncontested Matrimonial actions, use the Uncontested Divorce RJi(UD-13).
O Other Commercial (specify): TORTS
NOTE: For Commercial Division assignment requests pursuant to 22 NYCRR202.70(d), Q Asbestos
complete and attach the COMMERCIALDIVISION RJIADDENDUM (UCS-840C). Q Child Victims Act
REALPROPERTY Specify how many properties the application includes: O Environmental (specify):
Q Condemnation Q Medical, Dental or Podiatric Malpractice
O Mortgage Foreclosure (specify): O Residential O Commercial O Motor Vehicle
Property Address: O Products Liability (specify):
NOTE: For Mortgage Foreclosure actions involving a one to four-family, O Other Negligence (specify):
owner-occupied residential property or owner-occupied condominium, O Other Professional Malpractice (specify);
complete and attach the FORECLOSURE RJiADDENDUM (UCS-840F). O Other Tort (specify):
O Tax Certiorari SPECIALPROCEEDINGS
Q Tax Foreclosure Q CPLRArticle 75 (Arbitration) [see NOTEin COMMERCIALsection]
O Other Real Property (specify): Q CPLRArticle 78 (Body or Officer)
ŒTHERMATTERS O Election Law
O Certificate of Incorporation/Dissolution [see NOTE in COMMERCIALsection j O Extreme RiskProtectlon Order
O Emergency Medical Treatment O MHL Article 9.60 (Kendra's Law)
O Habeas Corpus O MHL Article 10 (SexOffender Confinement-Initial)
Q Local Court Appeat O MHL Article 10 (SexOffender Confinement-Review)
O Mechanic's Lien O MHL Article 81 (Guardianship)
O Name Change O Other Mental Hygiene (specify):
-Q Pistol Permit Revocation Hearing O Other Special Proceeding (specify):
O Saleor Finance of Religious/Not-for-Profit Property
attorneys'
@ Other (specify): Request for fees
STATUS OF ACTION OR PROCEEDING Ariswer YESor NO for every questicn and enter additional information where indicated.
YES NO
Has a summons and complaint or summons with notice been filed? @ O If yes, date filed: 06/29/2023
Has a summons and complaint or summons with notice been served? @ Q If yes, date served: 07/20/2023
Is this action/proceeding being filed post-judgment? O @ If yes, judgment date:
...
NATURE OF JUDICIALINTERVENTION Check one box only and enter additional information where indicated.
O infant's compromise
Q Extreme Risk Protection Order Application
Q Note of Issue/Certificate of Readiness
Q Notice of Medical, Dental or Podiatric Malpractice Date issue Joined:
O Notice of Motion Relief Requested: Return Date:
Q Notice of Petition Relief Requested: Return Date:
O Order to Show Cause Relief Requested: Return Date:
Other Ex Parte Application Relief Requested: Attorney - Fees
O Poor Person Application
O Request for Preliminary Conference
O Residential Mortgage Foreclosure Settlement Conference
O Writ of Habeas Corpus
O Other (specify):
1 of 2
FILED: WARREN COUNTY CLERK 09/29/2023 10:42 AM INDEX NO. EF2023-71503
NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 09/29/2023
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/Case Number Court judge (if assigned) Relationship to instant case
"Un-Rep"
PARTIES For parties without ar attorney, check the box and enter the party's address, phone number and email in the space provided.
If additional space is required, complete and attach the RJl ADDENDUM (UCS-840A).
Un- Parties Attorneys and Unrepresented Lltigants 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, 3rdparty plaintiff, etC.) been joined. carrier, if applicable.
Name: rive Star Bank
Khalil H. Williams, Esq., 1900 Bausch & Lomb Place, Rochester, NY 14604
D Role(s): 585-98F2800 kwilliams@woodsoviatt.com
O YES @ NO
Plaintiff
Name: Renee J.
Lafferty 83 Burch NY 12804
Road, QueenSbury, O YES O NO
Role(s): Defendant
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Roie(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED ACTIONS OR PROCEEDINGS,
EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FOR JUDICIAL INTERVENTION BEEN PREVIOUSLY FILED IN THIS ACTION OR PROCEEDING.
Dated: 09/27/2023
Signature
5962279 Khalil H. Williams
Attorney Registration Number Print Name
2 of 2
Preview
FILED: WARREN COUNTY CLERK 09/29/2023 10:42 AM INDEX NO. EF2023-71503 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 09/29/2023 REQUEST FOR JUDICIAL INTERVENTION Îo19) SUPREME COURT, COUNTY OF WARREN index No: EF2023-71503 Date Index issued: 06/29/2023 For Court Use Only CAPTION Enter the complete case caption. Do not use etal or et ano. If more space is needed, attach a captior rider sheet. IAS Entry Date FIVE STAR BANK Plaintiff(s)/Petitioner(s) Judge Assigned ·against- RENEE J. LAFFERTY RJiFiled Date Defendant(s)/Respondent(s) NATURE.OF ACTION OR PROCEEDING Check only one box and specify where indicated. COMMERICIAL MATRIMONIAL Q Business Entity (includes corporations, partnerships, LLCs,LLPs,etc.) O Contested Q 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). Q UCC(includes sales and negotiable instruments) For Uncontested Matrimonial actions, use the Uncontested Divorce RJi(UD-13). O Other Commercial (specify): TORTS NOTE: For Commercial Division assignment requests pursuant to 22 NYCRR202.70(d), Q Asbestos complete and attach the COMMERCIALDIVISION RJIADDENDUM (UCS-840C). Q Child Victims Act REALPROPERTY Specify how many properties the application includes: O Environmental (specify): Q Condemnation Q Medical, Dental or Podiatric Malpractice O Mortgage Foreclosure (specify): O Residential O Commercial O Motor Vehicle Property Address: O Products Liability (specify): NOTE: For Mortgage Foreclosure actions involving a one to four-family, O Other Negligence (specify): owner-occupied residential property or owner-occupied condominium, O Other Professional Malpractice (specify); complete and attach the FORECLOSURE RJiADDENDUM (UCS-840F). O Other Tort (specify): O Tax Certiorari SPECIALPROCEEDINGS Q Tax Foreclosure Q CPLRArticle 75 (Arbitration) [see NOTEin COMMERCIALsection] O Other Real Property (specify): Q CPLRArticle 78 (Body or Officer) ŒTHERMATTERS O Election Law O Certificate of Incorporation/Dissolution [see NOTE in COMMERCIALsection j O Extreme RiskProtectlon Order O Emergency Medical Treatment O MHL Article 9.60 (Kendra's Law) O Habeas Corpus O MHL Article 10 (SexOffender Confinement-Initial) Q Local Court Appeat O MHL Article 10 (SexOffender Confinement-Review) O Mechanic's Lien O MHL Article 81 (Guardianship) O Name Change O Other Mental Hygiene (specify): -Q Pistol Permit Revocation Hearing O Other Special Proceeding (specify): O Saleor Finance of Religious/Not-for-Profit Property attorneys' @ Other (specify): Request for fees STATUS OF ACTION OR PROCEEDING Ariswer YESor NO for every questicn and enter additional information where indicated. YES NO Has a summons and complaint or summons with notice been filed? @ O If yes, date filed: 06/29/2023 Has a summons and complaint or summons with notice been served? @ Q If yes, date served: 07/20/2023 Is this action/proceeding being filed post-judgment? O @ If yes, judgment date: ... NATURE OF JUDICIALINTERVENTION Check one box only and enter additional information where indicated. O infant's compromise Q Extreme Risk Protection Order Application Q Note of Issue/Certificate of Readiness Q Notice of Medical, Dental or Podiatric Malpractice Date issue Joined: O Notice of Motion Relief Requested: Return Date: Q Notice of Petition Relief Requested: Return Date: O Order to Show Cause Relief Requested: Return Date: Other Ex Parte Application Relief Requested: Attorney - Fees O Poor Person Application O Request for Preliminary Conference O Residential Mortgage Foreclosure Settlement Conference O Writ of Habeas Corpus O Other (specify): 1 of 2 FILED: WARREN COUNTY CLERK 09/29/2023 10:42 AM INDEX NO. EF2023-71503 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 09/29/2023 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/Case Number Court judge (if assigned) Relationship to instant case "Un-Rep" PARTIES For parties without ar attorney, check the box and enter the party's address, phone number and email in the space provided. If additional space is required, complete and attach the RJl ADDENDUM (UCS-840A). Un- Parties Attorneys and Unrepresented Lltigants 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, 3rdparty plaintiff, etC.) been joined. carrier, if applicable. Name: rive Star Bank Khalil H. Williams, Esq., 1900 Bausch & Lomb Place, Rochester, NY 14604 D Role(s): 585-98F2800 kwilliams@woodsoviatt.com O YES @ NO Plaintiff Name: Renee J. Lafferty 83 Burch NY 12804 Road, QueenSbury, O YES O NO Role(s): Defendant Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Roie(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED ACTIONS OR PROCEEDINGS, EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FOR JUDICIAL INTERVENTION BEEN PREVIOUSLY FILED IN THIS ACTION OR PROCEEDING. Dated: 09/27/2023 Signature 5962279 Khalil H. Williams Attorney Registration Number Print Name 2 of 2