Preview
FILED: WESTCHESTER COUNTY CLERK 05/22/2023 03:34 PM INDEX NO. 56706/2023
NYSCEF DOC. NO. 8 RECEIVED NYSCEF: 05/22/2023
UCS-840
REQUEST FOR JUDICIAL INTERVENTION isne2oan
SUPREME COURT, COUNTY OF WESTCHESTER S
Index No: 56706/2023 Date Index Issued: 02/13/2023 F C Ude3i)rify
CKINIÒC! EC h'eErriplefitase'cabtEn(Do flotjifse!e)ô$tinbtifN6th)âa e WhieédEdMtacha captlòn rider sheer IAS Entry Date
SUSAN SULLIVAN
Plaintiff(s)/Petitioner(s; Judge Assigned
-against-
R HedDate
PETSMART, LLC.,
Defendant(s)/Respondent(s
'
lifATÚRE OFÄCTIOÑ OR PRÅ’CEEDING t Check only,ané 6oriáÃsdlipEffy¼herendléath'd ½
COMMERiCIAL MATRIMONIAL
Q BusinessEntity (includes corporations, partnerships, LLCs,LLPs,etc.) Q Contested
O Contract NOTE: If there are children under the age of 18, complete and attach the
O Insurance (where insurance company is a party, except arbitration) MATRIMONIAL RJIADDENDUM (UCS-840M).
Q UCC(includes salesand negotiable instruments) For Uncontested Matrimonloi actions, 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), Q Condemnation
complete and attach the COMMERCIALDIVISIONRJIADDENDUM (UCS-840C). O Mortgage Foreclosure (specify): Q Residential Q Commercial
TORTS Property Address:
Q Adult Survivors Act NOTE: For Mortgage Foreciosure actions invoMng o one to four-family,
O Asbestos 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
Q Motor Vehicle NOTE: Complete and attach the PARTITIONRJIADDENDUM (UCS-840P).
O Products Liability (specify): O Tax Certiorari (specify): Section: Block: Lot:
Other Negligence(specify): PremisesUability 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]
Q 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 O Mechanic's Lien
Q Extreme RiskProtection Order Q Name Change/SexDesignation Change
Q MHL Article 9.60-Kendra's Law O Pistol Permit Revocation Hearing
O MHL Article 10-Sex Offender Confinement (specify): O n tial O Review O Saleor Financeof Religious/Not-for-Profit Property
O MHL Article 81 (Guardianship) O Other (specify):
O Other Mentai Hygiene (specify):
O Other Special Proceeding (specify):
$TM0s!OIVAC OCEEDING M WArisWehYES obNOffoeiker questior and:enter'additionatinformation where indicated.WEGdB:4 S
YES NO
Has a summons and complaint or summons with notice been filed? ® O if yes, date filed: 02/13/2023
Has a summons and complaint or summons with notice been served? ® O If yes, date served: 03/02/2023
Is this action/proceeding being filed post-judgment? If yes, judgment date:
NATUREiOdUDICIAL INTERVENTION.D A Check'one Box only arid·enter additionaunforntation'whëre indicatedaW.m.
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:
O Notice of Motion Relief Requested: Return Date:
O Notice of Petition Relief Requested: Return Date:
Q Order to Show Cause Relief Requested: Return Date:
Q Other ExParte Application Relief Requested:
O Partition Settlement Conference
O Poor PersonApplication
O Requestfor Preliminary Conference
O Residential Mortgage Foreclosure Settlernent Conference
O writ of HabeasCorpus
O Other (specify):
1 of 2
FILED: WESTCHESTER COUNTY CLERK 05/22/2023 03:34 PM INDEX NO. 56706/2023
NYSCEF DOC. NO. 8 RECEIVED NYSCEF: 05/22/2023
t bade û ci ete E 0Â at
CaseTitle Index/Case Number Court udge (if assigned) Relationship to Instant case
"Un¿Vep"
PA 1E Forçparties without at attorney, check the box and enter the,party'Jaddress, phone ot mbeYand email In hespace provided.
MÚ RT) If a~ddi onal.s lace iÈng'uired, complet tt h the R4I AEDENDUM CS-6IOA). W ..f .
Un- Parties Attorneys and Unrepresented Litigants IssueJoined Insurance Carriers
Rep Ust partiesin same order as listed in the For represented parties, provide attorney's name, firm name, address, phoIe and For each defendant, For eaEndefendant,
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, 3'8 party plaintiff, etc.) . beenjoined. carrier f applkable
Name: SUSAN GamalielB. Delgado,Esq..MORGAN& MORGAN NY.PLLC,350FifthAvenue,Suite6705
SULLIVAN NewYork.NewYork1o118,Tel (212)7384299
Role(s): .
Plalntiff
Name: PETSMART SelhB. Rubine,Esq.,RUSINE+ CHA.LLC,201V stPassaicStreet,Suite203
LLC
O Role(s):
RochellePark,NewJersey07662,Tel 201}857-5815
Defendant
Name:
O Role(s|: OYES O NO
Name:
0 Role(s): O YES Q NO
Name:
O Role(s): OYES Q NO
Name:
O Role(s): Q YES Q NO
Name:
Role(s): Q YES Q NO
Name:
0 Role(s): OYES O NO
Name:
O Role(s): Q YES Q NO
Name:
O Role(s): Q YES O NO
Name:
O Role(s): Q YES O NO
Name:
O Role(s): Q YES O NO
Name:
Role(s): OYES ONO
Name:
O Role(s): OYES Q NO
Name:
O Role(s): Q YES Q NO
I Al FIRM UNDER THE PENALTY OF PER.URY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED ACTIONS 3R PROCEEDINGS,
EXCEPT AS NOTED ABOVE, NOR H/.S A REQUEST FOR JUDICIAL INTERVENTION BEEN PREVIOUSLY FILED 14 THIS ACTION OR PROCEEDING.
Dated: 05/22/2023
Signature
4408340 SETH B. RUBINE
Attorney Registration Number Print Name
2 of 2
Preview
FILED: WESTCHESTER COUNTY CLERK 05/22/2023 03:34 PM INDEX NO. 56706/2023 NYSCEF DOC. NO. 8 RECEIVED NYSCEF: 05/22/2023 UCS-840 REQUEST FOR JUDICIAL INTERVENTION isne2oan SUPREME COURT, COUNTY OF WESTCHESTER S Index No: 56706/2023 Date Index Issued: 02/13/2023 F C Ude3i)rify CKINIÃ’C! EC h'eErriplefitase'cabtEn(Do flotjifse!e)ô$tinbtifN6th)âa e WhieédEdMtacha captlòn rider sheer IAS Entry Date SUSAN SULLIVAN Plaintiff(s)/Petitioner(s; Judge Assigned -against- R HedDate PETSMART, LLC., Defendant(s)/Respondent(s ' lifATÚRE OFÄCTIOÑ OR PRÅ’CEEDING t Check only,ané 6oriáÃsdlipEffy¼herendléath'd ½ COMMERiCIAL MATRIMONIAL Q BusinessEntity (includes corporations, partnerships, LLCs,LLPs,etc.) Q Contested O Contract NOTE: If there are children under the age of 18, complete and attach the O Insurance (where insurance company is a party, except arbitration) MATRIMONIAL RJIADDENDUM (UCS-840M). Q UCC(includes salesand negotiable instruments) For Uncontested Matrimonloi actions, 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), Q Condemnation complete and attach the COMMERCIALDIVISIONRJIADDENDUM (UCS-840C). O Mortgage Foreclosure (specify): Q Residential Q Commercial TORTS Property Address: Q Adult Survivors Act NOTE: For Mortgage Foreciosure actions invoMng o one to four-family, O Asbestos 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 Q Motor Vehicle NOTE: Complete and attach the PARTITIONRJIADDENDUM (UCS-840P). O Products Liability (specify): O Tax Certiorari (specify): Section: Block: Lot: Other Negligence(specify): PremisesUability 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] Q 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 O Mechanic's Lien Q Extreme RiskProtection Order Q Name Change/SexDesignation Change Q MHL Article 9.60-Kendra's Law O Pistol Permit Revocation Hearing O MHL Article 10-Sex Offender Confinement (specify): O n tial O Review O Saleor Financeof Religious/Not-for-Profit Property O MHL Article 81 (Guardianship) O Other (specify): O Other Mentai Hygiene (specify): O Other Special Proceeding (specify): $TM0s!OIVAC OCEEDING M WArisWehYES obNOffoeiker questior and:enter'additionatinformation where indicated.WEGdB:4 S YES NO Has a summons and complaint or summons with notice been filed? ® O if yes, date filed: 02/13/2023 Has a summons and complaint or summons with notice been served? ® O If yes, date served: 03/02/2023 Is this action/proceeding being filed post-judgment? If yes, judgment date: NATUREiOdUDICIAL INTERVENTION.D A Check'one Box only arid·enter additionaunforntation'whëre indicatedaW.m. 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: O Notice of Motion Relief Requested: Return Date: O Notice of Petition Relief Requested: Return Date: Q Order to Show Cause Relief Requested: Return Date: Q Other ExParte Application Relief Requested: O Partition Settlement Conference O Poor PersonApplication O Requestfor Preliminary Conference O Residential Mortgage Foreclosure Settlernent Conference O writ of HabeasCorpus O Other (specify): 1 of 2 FILED: WESTCHESTER COUNTY CLERK 05/22/2023 03:34 PM INDEX NO. 56706/2023 NYSCEF DOC. NO. 8 RECEIVED NYSCEF: 05/22/2023 t bade û ci ete E 0 at CaseTitle Index/Case Number Court udge (if assigned) Relationship to Instant case "Un¿Vep" PA 1E Forçparties without at attorney, check the box and enter the,party'Jaddress, phone ot mbeYand email In hespace provided. MÚ RT) If a~ddi onal.s lace iÈng'uired, complet tt h the R4I AEDENDUM CS-6IOA). W ..f . Un- Parties Attorneys and Unrepresented Litigants IssueJoined Insurance Carriers Rep Ust partiesin same order as listed in the For represented parties, provide attorney's name, firm name, address, phoIe and For each defendant, For eaEndefendant, 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, 3'8 party plaintiff, etc.) . beenjoined. carrier f applkable Name: SUSAN GamalielB. Delgado,Esq..MORGAN& MORGAN NY.PLLC,350FifthAvenue,Suite6705 SULLIVAN NewYork.NewYork1o118,Tel (212)7384299 Role(s): . Plalntiff Name: PETSMART SelhB. Rubine,Esq.,RUSINE+ CHA.LLC,201V stPassaicStreet,Suite203 LLC O Role(s): RochellePark,NewJersey07662,Tel 201}857-5815 Defendant Name: O Role(s|: OYES O NO Name: 0 Role(s): O YES Q NO Name: O Role(s): OYES Q NO Name: O Role(s): Q YES Q NO Name: Role(s): Q YES Q NO Name: 0 Role(s): OYES O NO Name: O Role(s): Q YES Q NO Name: O Role(s): Q YES O NO Name: O Role(s): Q YES O NO Name: O Role(s): Q YES O NO Name: Role(s): OYES ONO Name: O Role(s): OYES Q NO Name: O Role(s): Q YES Q NO I Al FIRM UNDER THE PENALTY OF PER.URY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED ACTIONS 3R PROCEEDINGS, EXCEPT AS NOTED ABOVE, NOR H/.S A REQUEST FOR JUDICIAL INTERVENTION BEEN PREVIOUSLY FILED 14 THIS ACTION OR PROCEEDING. Dated: 05/22/2023 Signature 4408340 SETH B. RUBINE Attorney Registration Number Print Name 2 of 2