Preview
FILED: CORTLAND COUNTY CLERK 09/06/2022 10:40 AM INDEX NO. EF21-165
ResetFoW|NO. 26
NYSCEF DOC. RECEIVED NYSCEF: 09/06/2022
UCS-840
REQUEST FOR JUDICIAL INTERVENTION ovov2o22)
SUPREME COURT, COUNTY OF CORTLAND
Index No: EF21-165 Date Index Issued: 03/25/2021 FOr Court Use Only:
CAPTION 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
CCRNC, CROWN PARK REHABILITATION AND NURSING CENTER, CRNC LLC
_
d/b/a CORTLAND PARK REHABILITATION AND NURSING CENTER,
Plaintiff(s)/Petitioner(s) judge Assigned_
-against-
CAROL ALEXANDER and PAUL ALEXANDER RECEIVED
RJIFifed Date
916/2022
Defendant(s)/Respondent(s)
NATURE OF ACTION OR PROCEEDING Check only one box and specify where i1dicated.
COMMERICIAL MATRIMONIAL
O Business Entity (includes corporations, partnerships, LLCs,LLPs,etc.) Q Contested
Q Contract NOTE: If there are children under the age of18, complete and attach the
O Insurance (where insurance company is a party, except arbitration) MATRIMONIAL RJiADDENDUM (UCS-840M).
O UCC(includes sales and negotiable instruments) For Uncontested Matrimonialactions, use the Uncontested Divorce RJi(UD-13).
O Other Commercial (specify): REALPROPERTY Specify how many properties the application includes:
NOTE: For Commercial Division assignment requests pursuant to 22 NYCRR202.70(d), O Condemnation
complete ond ottach the COMMERCIALDIVISION RJsADDENDUM (UCS-84OC). Q Mortgage Foreclosure (specify): Q Residential Q Commercial
TORTS Property Address:
Q Asbestos NOTE: For Mortgage Foreclosure actions involving a one tofour-family,
O Child Victims Act owner-occupied residential property or owner-occupied condominium,
O Environmental (specify): complete and attach the FORECLOSURE
RJIADDENDUM (UCS-840F).
Q Medical, Dental or Podiatric Malpractice Q Partition
O Motor Vehicle NOTE: Complete and attach the PARTITION RJiADDENDUM (UCS-840P).
O Products Liabi[ity (specify): O Tax Certiorari (specify): Section: Biock: Lot:
O Other Negligence (specify): Q Tax Foreclosure
O Other Professional Malpractice (specify): O Other Real Property (specify):
Other Tort (specify): Negligence OTHERMATTERS
SPECIALPROCEEDINGS Q Certificate of Incorporation/Dissolution [see NOTEin COMMERCIAL section]
Q Child-Parent Security Act (specify): QAssisted Reproduction OSurrogacy Agreement Q Emergency Medical Treatment
Q CPLRArticle 75 - Arbitration [see NOTEin COMMERCIAL section] Q Habeas Corpus
O CPLRArticle 78 - Proceeding against a Body or Officer Q Local Court Appeal
O Election Law O Mechanic's Lien
Q Extreme Risk Protection Order Q 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 Sale or Finance of Religious/Not-for-Profit Property
O MHL Article 81 (Guardianship) O Other (specify):
O Other Mental Hygiene (specify):
O Other Special Proceeding (specify):
STATUS OF ACTION OR PROCEEDING Answer YES or NO for every questior and enter additional information where indicated.
YES_NO_
Has a summons and complaint or summons with notice been filed? @ Q If yes, date filed: 03/25/2021
Has a summons and complaint or summons with notice been served? ® O If yes, date served: 03/25/2021
Isthis action/proceeding being filed post-judgment? O ® f Yes,judgment date:
NATURE OF JUDICIAL INTERVENTION 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:
@ Notice of Motion Relief Requested: Dismiss Return Date: 09/28/2022
O Notice of Petition Relief Requested: Return Date:
Q Order to Show Cause Relief Requested: Return Date:
O Other Ex Parte Application Relief Requested:
O Partition Settlement Conference
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: CORTLAND COUNTY CLERK 09/06/2022 10:40 AM INDEX NO. EF21-165
NYSCEF DOC. NO.
RELATED CASES
26 RECEIVED NYSCEF: 09/06/2022
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 an 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 RJI ADDENDUM (UCS-840A).
Un- Partles Attorneys and UnrepresentedLItlgants Issue Joined Insurance Carriers
Rep Listpartiesinsameorder as listed in the For represented parties, provide attorney's name, firm name, address, phone and Foreachdefendant, Foreachdefendant,
caption and indicate roles (e.g., plaintiff, email. Forunrepresentedparties,provideparty'saddress, phone and email. indicate if issue has indicate insurance
3rd been joined.
defendant, ff, etC.) carrier, if applicable.
Name: CCRNC D. Mervis, Howard & Kattell,
Harvey Esq., Hinman, LLP, 80
Role(s):
, Exchange St., Binghamton, NY 13902 (607) 723-3339
@YES O NO
p ¡ff
Name: Crown Park Rehabilitation etal. Daniel L. Sullivan, Esq., WIIson, EIser, Moskowitz, Edelman, &
D Role{s): . Dicker, LLP, 150 E. 42nd St., New York, NY 10017 (212) 490-3000 YES O NO
Plaintiff
Name: CamlAlexander&PaulAlexander Allan C. VanDeMark, Esq., WILLIAMSON, CLUNE & STEVENS, 317 North
D Role{s): Tioga Street, P.O. Box 126, Ithaca, NY 14851 (607) 273-3339 OYES Q NO
Defendant
Name:
0 Role{s): OYES Q NO
Name:
D Role{s): OYES O NO
Name:
D Role{s): OYES O NO
Name:
D Role{s): OYES Q NO
Name:
D Role{s): OYES O NO
Name:
D Role{s): OYES O NO
Name:
O Role{s): OYES O NO
Name:
D Role{s): OYES O NO
Name:
D Role{s): OYES O NO
Name:
D Role{s): QYES Q NO
Name:
D Role{s): OYES O NO
Name:
D Role{s): OYES O NO
I AIFIRM UNDER THE PENALTY OF PER.URY THAT, UPON INFORMATION AND BEUEF, THERE ARE NO OTHER ItELATED ACTIONS OR PROCEEDINGS,
DM
EXCEPT AS NOTED ABOVE, NOR H/ S A REQUEST FOR JUDICIAL INTERVENTION BEEN PREVlOUSLY FILED IN THIS ACTION OR PROCEEDING.
L. Stalila twu, Eup
Dated: 0910612022
Signature
5524343 Daniel L. Sullivan, Esq.
Attorney Registration Number Print Name
2 of 2
Preview
FILED: CORTLAND COUNTY CLERK 09/06/2022 10:40 AM INDEX NO. EF21-165 ResetFoW|NO. 26 NYSCEF DOC. RECEIVED NYSCEF: 09/06/2022 UCS-840 REQUEST FOR JUDICIAL INTERVENTION ovov2o22) SUPREME COURT, COUNTY OF CORTLAND Index No: EF21-165 Date Index Issued: 03/25/2021 FOr Court Use Only: CAPTION 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 CCRNC, CROWN PARK REHABILITATION AND NURSING CENTER, CRNC LLC _ d/b/a CORTLAND PARK REHABILITATION AND NURSING CENTER, Plaintiff(s)/Petitioner(s) judge Assigned_ -against- CAROL ALEXANDER and PAUL ALEXANDER RECEIVED RJIFifed Date 916/2022 Defendant(s)/Respondent(s) NATURE OF ACTION OR PROCEEDING Check only one box and specify where i1dicated. COMMERICIAL MATRIMONIAL O Business Entity (includes corporations, partnerships, LLCs,LLPs,etc.) Q Contested Q Contract NOTE: If there are children under the age of18, complete and attach the O Insurance (where insurance company is a party, except arbitration) MATRIMONIAL RJiADDENDUM (UCS-840M). O UCC(includes sales and negotiable instruments) For Uncontested Matrimonialactions, use the Uncontested Divorce RJi(UD-13). O Other Commercial (specify): REALPROPERTY Specify how many properties the application includes: NOTE: For Commercial Division assignment requests pursuant to 22 NYCRR202.70(d), O Condemnation complete ond ottach the COMMERCIALDIVISION RJsADDENDUM (UCS-84OC). Q Mortgage Foreclosure (specify): Q Residential Q Commercial TORTS Property Address: Q Asbestos NOTE: For Mortgage Foreclosure actions involving a one tofour-family, O Child Victims Act owner-occupied residential property or owner-occupied condominium, O Environmental (specify): complete and attach the FORECLOSURE RJIADDENDUM (UCS-840F). Q Medical, Dental or Podiatric Malpractice Q Partition O Motor Vehicle NOTE: Complete and attach the PARTITION RJiADDENDUM (UCS-840P). O Products Liabi[ity (specify): O Tax Certiorari (specify): Section: Biock: Lot: O Other Negligence (specify): Q Tax Foreclosure O Other Professional Malpractice (specify): O Other Real Property (specify): Other Tort (specify): Negligence OTHERMATTERS SPECIALPROCEEDINGS Q Certificate of Incorporation/Dissolution [see NOTEin COMMERCIAL section] Q Child-Parent Security Act (specify): QAssisted Reproduction OSurrogacy Agreement Q Emergency Medical Treatment Q CPLRArticle 75 - Arbitration [see NOTEin COMMERCIAL section] Q Habeas Corpus O CPLRArticle 78 - Proceeding against a Body or Officer Q Local Court Appeal O Election Law O Mechanic's Lien Q Extreme Risk Protection Order Q 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 Sale or Finance of Religious/Not-for-Profit Property O MHL Article 81 (Guardianship) O Other (specify): O Other Mental Hygiene (specify): O Other Special Proceeding (specify): STATUS OF ACTION OR PROCEEDING Answer YES or NO for every questior and enter additional information where indicated. YES_NO_ Has a summons and complaint or summons with notice been filed? @ Q If yes, date filed: 03/25/2021 Has a summons and complaint or summons with notice been served? ® O If yes, date served: 03/25/2021 Isthis action/proceeding being filed post-judgment? O ® f Yes,judgment date: NATURE OF JUDICIAL INTERVENTION 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: @ Notice of Motion Relief Requested: Dismiss Return Date: 09/28/2022 O Notice of Petition Relief Requested: Return Date: Q Order to Show Cause Relief Requested: Return Date: O Other Ex Parte Application Relief Requested: O Partition Settlement Conference 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: CORTLAND COUNTY CLERK 09/06/2022 10:40 AM INDEX NO. EF21-165 NYSCEF DOC. NO. RELATED CASES 26 RECEIVED NYSCEF: 09/06/2022 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 an 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 RJI ADDENDUM (UCS-840A). Un- Partles Attorneys and UnrepresentedLItlgants Issue Joined Insurance Carriers Rep Listpartiesinsameorder as listed in the For represented parties, provide attorney's name, firm name, address, phone and Foreachdefendant, Foreachdefendant, caption and indicate roles (e.g., plaintiff, email. Forunrepresentedparties,provideparty'saddress, phone and email. indicate if issue has indicate insurance 3rd been joined. defendant, ff, etC.) carrier, if applicable. Name: CCRNC D. Mervis, Howard & Kattell, Harvey Esq., Hinman, LLP, 80 Role(s): , Exchange St., Binghamton, NY 13902 (607) 723-3339 @YES O NO p ¡ff Name: Crown Park Rehabilitation etal. Daniel L. Sullivan, Esq., WIIson, EIser, Moskowitz, Edelman, & D Role{s): . Dicker, LLP, 150 E. 42nd St., New York, NY 10017 (212) 490-3000 YES O NO Plaintiff Name: CamlAlexander&PaulAlexander Allan C. VanDeMark, Esq., WILLIAMSON, CLUNE & STEVENS, 317 North D Role{s): Tioga Street, P.O. Box 126, Ithaca, NY 14851 (607) 273-3339 OYES Q NO Defendant Name: 0 Role{s): OYES Q NO Name: D Role{s): OYES O NO Name: D Role{s): OYES O NO Name: D Role{s): OYES Q NO Name: D Role{s): OYES O NO Name: D Role{s): OYES O NO Name: O Role{s): OYES O NO Name: D Role{s): OYES O NO Name: D Role{s): OYES O NO Name: D Role{s): QYES Q NO Name: D Role{s): OYES O NO Name: D Role{s): OYES O NO I AIFIRM UNDER THE PENALTY OF PER.URY THAT, UPON INFORMATION AND BEUEF, THERE ARE NO OTHER ItELATED ACTIONS OR PROCEEDINGS, DM EXCEPT AS NOTED ABOVE, NOR H/ S A REQUEST FOR JUDICIAL INTERVENTION BEEN PREVlOUSLY FILED IN THIS ACTION OR PROCEEDING. L. Stalila twu, Eup Dated: 0910612022 Signature 5524343 Daniel L. Sullivan, Esq. Attorney Registration Number Print Name 2 of 2