Document for Kathleen Kammer, Patrick Lawrence Individually and as Resident Representative of Kathleen Kammer v. 185 Old Military Road Operating Company, Llc, 185 Old Military Road, Llc d/b/a ELDERWOOD OF UIHLEIN AT LAKE PLACID

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                                FILED: ESSEX COUNTY CLERK 10/25/2023 10:29 AM                                                                                        INDEX NO. CV23-0490
NYSCEF DOC. NO. 5                                                                                                      RECEIVED NYSCEF:  10/25/2023
                                                                                                                                      OF ESSEX
                                                                                                                                        COUNTY
     SUPREME COURT OF THE STATE OF NEW YORK




     Plaintiff / Petitioner:                                                                            AFFIDIVIT OF SERVICE
     KATHLEEN l$MMER and PATRICK KAMMER, individually and as                                                    lndex No:
     Resident Representative of Kathleen Kammer                                                                 cv23-0490
     Defendant / ResPondent:                                                                                   Date Filed:
     185 OLD MILITARY ROAD OPERATING COMPANY' LLC ANd 185                                                      10111t2023
     OLD MILITARY ROAD, LLC d/b/A ELDERWOOD OF UIHLEIN AT
     LAKE PLACID



                                                                                                 1 8 year:; of age and resides in the state of New
     The undersigned being duly sworn, deposes and says; deponent is not a party herein, is over
     york. That on rue, oct-2q2023 at 1O:1d AM at 80 SJATE sJREil ALPANY.NY 1.407 denoneLt_19y_ed th^ewithin NoTlcE oF E,LES]SONIC
     FtLtNG, suMt\ii6mJFR^FtEEtoMiI{m,                  AN@pon                 1gs olp MlLtrABy RgAp,oPFRAT|NG corylPANY fLc c/o
     Corporation Service qomPanY


     E]         Corporation/Business/Government Agency: 185 OLD MILITARY           ROA.D   OPFMTI\G So-[{PANY, LfC c/o CorPgratior} Service Company
                aDefendanVNon-PartyWitness,thereinnamed@eairrtoCSCRePresentqtivepersona||y,depontlntknew
                                                                        to   be the corporation/business/govelrnment    agency described, and knew
                said corporation/business/government agency so served
                said individual to be CSC Representative thereof.

      Description:
      Age:      25-35                      Ethnicity:    Caucasian                            Gender:   Male                       weighr     2ao

      Height:      6'0"                         Hair:   Red                  Eyes: Brown                                Relationship:       CSC
                                                                                                                                            Reor,3sentative

      Other       Had facial hair


      Service Details:
                                                                               Sworn to before me on




      Marc De Fruscio - OurJob #97                                             Notary Public
                                                                                                               IVIICHELLE    M.   TERRELL
                                                                                                      NOTARY PUBLIC.SIATE OF NEW YC)RK
      GPS DAIA                                                                                                  No. 0lTE624O}52
      ili6l]ilDevice: Mozilla/5.O (iPhone; CPU iPhone os 16-6-1
      like Mac OS X) AppleWebKiu605.1 '15 (KHTML, like Gecko)                                         ,,":::H:,[::l;::lkEE V
      Version/1 6.6 Mobile/1 5E148 Safari/604.1
      GPS Coordinat es: 42.65703174838738' -73.73417 892684223
      GPS      Accuracy:78.74ft
      G   PS   Timestam pi 1 6981 57 1 1 2322
      Device TimestamP:
      GPS      Altitude: 57.3 ft
      GPS      Altitude Accurary: 8.1 ft




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