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FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E
NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF BRONX
------------------------------------------------------------x
CHRISTINE CHATMAN,
Plaintiff, Index No.: 819902/2023E
-against-
PSK SUPERMARKET INC. and 881 GERARD
LLC.,
Defendants.
------------------------------------------------------------x
TO: PLAINTIFF
NOTICES FOR DISCOVERY AND INSPECTION, DEMANDS and
REQUESTS FOR PRODUCTION OF DOCUMENTS:
PLEASE TAKE NOTICE, that these answering defendants PSK SUPERMARKET INC.
and 881 GERARD LLC., represented by the undersigned, demands that you respond to the
following Demands, Notices for Discovery and Inspection and Requests for Production of
Documents pursuant to the Rules of the CPLR.
PLEASE TAKE FURTHER NOTICE, that the following Demands, Notices for
Discovery and Inspection and Requests for Production of Documents are continuing. In the event
that any of the items are obtained after service of the following, and your response thereto, they
are to be furnished to the undersigned forthwith. This includes your response concerning your
intention to call any expert witness up to an including the time of the commencement of the trial
of this action.
PLEASE TAKE FURTHER NOTICE, that these answering defendants reserves the
right to supplement or amend the following up to and including the time of trial.
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PLEASE TAKE FURTHER NOTICE, that your failure to respond in a timely fashion
or to comply with the following may result in a motion to strike, compel compliance, to preclude,
and/or for the imposition or penalties pursuant to the New York Civil Practice Law and Rules and
such other and further relief as this Court deems just and proper.
PLEASE TAKE FURTHER NOTICE, that upon your failure to produce the
discovery responses, documents, etc. responsive to the following Demands, Notices for Discovery
and Inspection and Requests for Production of Documents, the undersigned reserves the right to
object at the trial of this action to the offering of any evidence contained in said discovery
responses, documents, etc., including a motion to preclude the testimony of any such expert,
medical or otherwise, who has not been properly identified, together with his prospective
testimony as demanded above.
DEMAND FOR INSURANCE
With respect to any and all insurance in effect at the time of the occurrence complained
of under which any person carrying on an insurance business may be liable to satisfy part or all
of a judgment which may be entered in this action or to indemnify or reimburse for payments
made to satisfy the judgment.
1. All primary insurance agreements and policies of liability insurance.
2. All excess and umbrella insurance agreements and policies of liability
insurance.
PLEASE TAKE FURTHER NOTICE, that any insurance document and policy
produced in response to the above demand shall be the complete document and policy, including
but not limited to, declaration sheets, riders, limitations, endorsements, amendments,
cancellations, face sheets and/or binders, etc.
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PLEASE TAKE FURTHER NOTICE, that if it is claimed that no liability insurance of
any kind, type or description was in effect at the time of the occurrence complained of, then
demand is hereby made that the above-named party set forth, by Affidavit, said claim.
DEMAND FOR PHOTOGRAPHS
1. All photographs under the control of any party depicting the area whereat plaintiffs
alleges their accident occurred.
2. All photographs depicting the plaintiff’s alleged injuries.
PLEASE TAKE FURTHER NOTICE, that in lieu of producing the original documents
and photographs as set forth in this Demand, you may comply with this Demand by forwarding
copies of all such documents and photographs (in color as per originals) to the undersigned
within the time set forth above.
DEMAND FOR NAMES AND ADDRESSES OF ALL WITNESSES:
Pursuant to the applicable rules, set forth in writing, under oath, and serve upon us within
twenty (20) days of this date:
1. The names and addresses of each person known or claimed by you or any party
you represent in this action to be a witness to:
(a) The occurrence alleged in the complaint in this action;
(b) Any acts, omissions, or conditions which allegedly caused the occurrence
alleged to the complaint;
(c) Any actual notice allegedly given to these answering Defendants of any
condition which allegedly caused the occurrence alleged in the complaint,
(d) The nature and duration of any alleged condition which allegedly caused
the occurrence alleged in the complaint.
(e) Any witness with knowledge of your complaints, physical condition
and/or injuries that you claim were the result of the subject accident.
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(f) Any witness with information concerning any medical treatment or care
that you received following the subject accident.
(g) Any witness who assisted you in any way following the accident.
(h) Any witness with any information pertinent and/or germane to the facts in
controversy of the within lawsuit, including but not limited to all
information bearing on liability and damages.
PLEASE TAKE FURTHER NOTICE, that appropriate motions will be made at the
trial of this action to preclude the testimony of any witness to the above described facts and
circumstances who is not identified by you in response to this notice.
DEMAND FOR MEDICAL INFORMATION AND AUTHORIZATIONS:
Pursuant to the applicable rules you are required to serve within twenty (20) days after
service of this notice, the following:
DEMAND FOR MEDICAL INFORMATION AND AUTHORIZATIONS:
Pursuant to the applicable rules you are required to serve within twenty (20) days after service of
this notice, the following:
1. The names and addresses of all physicians or other healthcare providers of every description who
have consulted, examined or treated the plaintiff(s) for each of the conditions allegedly caused by,
or exacerbated by, the occurrence described in the Complaint, including the date of such
treatment or examination.
2. Duly executed and acknowledged written authorizations directed to any hospital, clinic or other
healthcare facility in which the injured plaintiff(s) herein was (were) treated or confined due to
the occurrence set forth in the Complaint so as to permit the securing of a copy of the entire
hospital record or records, including x-rays and technicians’ reports.
3. Duly executed and acknowledged written authorizations to allow the Defendants to obtain the
complete office medical records relating to plaintiff(s), of each healthcare provider identified (1)
above.
4. Copies of all medical reports received from healthcare providers Identified in (1) above. These
shall include a detailed recital of the injuries and conditions as to which testimony will of offered
at the trial, referring to and identifying those x-rays and technicians’ reports which will be offered
at the trial.
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5. Duly executed and acknowledged written authorizations to allow the Defendant to obtain
complete pharmacy or drug store records with respect to any drugs prescribed for the plaintiff(s)
from one (1) year prior to the occurrence described in the Complaint to the present date.
6. Duly executed authorizations to obtain the records of all plaintiff’s healthcare providers for
treatment rendered; including their full names and addresses; as well as x-rays, MRIs, CT Scan
films, Tomograms, EMG studies, EEG Studies, Myelograms, etc.
Upon your failure to comply herewith, the plaintiff(s) herein will be precluded at the trial
of this action from offering any evidence of the conditions described in the reports or records
demanded, or offering in evidence any part of the hospital records, medical records, x-ray reports
or reports of other technicians not made available pursuant to this rule, nor will the Court hear
the testimony of any physicians whose medical reports have not been served pursuant to the
aforesaid demand.
DEMAND PURSUANT TO CPLR SECTIONS 3101 AND 4545 FOR COLLATERAL
SOURCE PAYMENTS INFORMATION:
Pursuant to Sections §§3101 and 4545, you are required to serve within twenty (20) days
after receipt of this notice, the following information:
1. The names, addresses and amounts received to date from all persons, firms, or
organizations which have reimbursed plaintiff(s) for the cost of medical care, custodial care,
rehabilitation services, loss of earnings or other economic loss, and other costs, including but not
limited to:
(a) Insurance;
(b) Social Security Benefits;
(c) Workers’ Compensation Benefits;
(d) Disability Benefits;
(e) Employee Benefits Program; and
(f) Any other source.
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2. Where reimbursement was or is pursuant to a policy, state the name of the policy holder,
the policy number, and the name of the issuer of the policy; a list of claims submitted pursuant
to the policy, and the amount of money received pursuant to each claim.
3. Duly executed and acknowledged written authorizations directed to all
persons, firms or organizations which have reimbursed Plaintiff for costs of medical care,
custodial care, rehabilitation services, loss of earnings or other economic loss, or other costs or to
whom such claims have been submitted to obtain copies of the policies under which said
payments or claims were made, copies of all checks, and other indication of payment, and copies
of any claims submitted for payment.
PLEASE TAKE FURTHER NOTICE, that authorizations for any insurance
documents and policy produced in response to the demand herein shall be for the complete
documents and policy, including but not limited to, declaration sheets, riders, limitations,
endorsements, amendments, cancellations, face sheets and/or binders, etc.
PLEASE TAKE FURTHER NOTICE, that if it is claimed that no such persons,
firms, or organizations have reimbursed Plaintiff for such costs then demand is hereby made that
the above-named party set forth, by Affidavit.
DEMAND FOR EXPERT WITNESS DISCLOSURE:
Pursuant to Section § 3101(d) of the Civil Practice Law and Rules, you are required to set
forth the following:
1. The name and address of each and every person you expect to call as an expert
witness at the trial of this action.
2. Detail, the subject matter on which each expert is expected to testify.
3. The substances of the facts and opinions on which each expert is expected to
testify.
4. The qualification of each expert witness.
5. A summary of the factual ground for each expert’s opinion.
DEMAND FOR PARTY STATEMENTS:
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Pursuant to the applicable rules of the CPLR, you are required to serve within twenty (20)
days after service of this notice, the following:
1. 1. Any signed statement, unsigned statement, or copy of any recorded statement or
document made by or taken from any party represented by the undersigned in this action, or from
any agent, servant or employee of any Defendant represented by this office;
2. Any signed statement, unsigned statement, or copy of any recorded statement or document made
by or taken from any co-Defendant or agent, servant or employee of any co-Defendant at:
DEMAND FOR TAX RETURNS:
Pursuant to the applicable rules of the CPLR, you are required to serve within twenty (20)
days after service of this notice, the following:
1. Copies of the income tax returns filed by plaintiff and the W-2 forms received by
the plaintiff and filed with the United States Federal Government and New York
State Government for the years 2007 to the present.
2. Duly executed authorizations to obtain the information described in item #1 from
the Internal Revenue Service.
DEMAND FOR EMPLOYMENT AUTHORIZATION:
Pursuant to the applicable rules of the CPLR, you are required to serve within twenty (20)
days after service of this notice, the following:
1. Duly executed authorization to obtain true and complete copies of the plaintiff’s
employment records from all employers from the years 2007 through the present
to include wages, job promotions, hours worked and absenteeism.
2. Any and all job related medical records concerning plaintiff as maintained by
plaintiff’s employer.
DEMAND FOR IMMIGRATION DOCUMENTS:
Pursuant to the applicable rules of the CPLR, you are required to serve within twenty (20)
days after service of this notice, the following:
1. All documentation relating to or concerning plaintiff’s citizenship status, birth
certificate, passport, visa, visa application, driver’s license, non-driver
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identification, Social Security card, green card, green card application, work
permit, work permit application, alien identification card, application for alien
identification card, and any related response or correspondence from any foreign
government, the United States government, any state or local government, or any
other governmental agency whether foreign or domestic.
2. Plaintiff’s W-2 form from 2007 to the present.
3. Plaintiff’s income tax returns from 2007 to the present.
4. Plaintiff’s W-4 form, employment application and pay stubs or other evidence of
Plaintiff’s wages for all of plaintiff’s employers from 2007 to the present.
5. Plaintiff’s W-4 form, employment application and pay stubs or other evidence of
Plaintiff’s wages for plaintiff’s employer at the time of the alleged accident.
6. Duly executed and acknowledged written authorizations permitting all parties to
obtain and make copies of those documents requested in this Notice including but not
limited to duly executed and acknowledged written authorizations to the United States
Citizenship and Immigration Service, the United States Department of State, the United
States Social Security Administration, the United States Internal Revenue Service, the
government of plaintiff’s Country of citizenship, and to plaintiff’s employers.
DEMAND FOR MEDICARE AND MEDICAID INFORMATION AND DOCUMENTS:
Pursuant to Article 31 of the CPLR and 42 U.S.C. 1395y (b)(8)(A), you are required to
serve within thirty (30) days after service of this notice, the following:
1. A statement as to whether the plaintiff has received benefits from either Medicare or
Medicaid at any time, for any reason, not limited to the injuries alleged in the instant
action. If so, please state and/or provide:
(a) Plaintiff’s full name;
(b) Plaintiff’s gender;
(c) Plaintiff’s date of birth;
(d) Plaintiff’s Social Security number;
(e) Plaintiff’s residence telephone number;
(f) The Health Insurance Claim Number and/or Medicare/Medicaid file
number;
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(g) The address of the office handling the plaintiff’s Medicare and/or
Medicaid file;
(h) A duly executed authorization bearing plaintiff’s date of birth and Social
Security number or Health Insurance Claim Number permitting this firm and/or the representatives
of Defendants(s) to obtain copies of plaintiff’s Medicare and/or Medicaid records. (A Consent to
Release is annexed hereto for your convenience).
2. State whether Medicare and/or Medicaid has a lien and the amount of any such lien.
3. Provide copies of all documents, records, memoranda, notes, etc., in plaintiff’s
possession pertaining to plaintiff’s receipt of Medicare and/or Medicaid benefits,
including copies of all documents provided to or received from the Medicare and/or
Medicaid administrator.
4. If any Medicaid and/or Medicare Secondary Payer (MSP) claims exist, please
provide a copy of the claim summary from Medicare and/or Medicaid regarding
those claims.
5. If plaintiff has not received Medicare and/or Medicaid benefits in the past or is not
receiving Medicare and/or Medicaid benefits now, state whether plaintiff is eligible
to receive Medicare and/or Medicaid benefits.
6. If plaintiff has been receiving Medicare and/or Medicaid benefits and is now
deceased, please provide the following:
(a) Relationship of the administrator of Plaintiff’s estate to Plaintiff’s
decedent;
(b) Name and address of Plaintiff’s administrator;
(c) Telephone number and/or email address of Plaintiff’s administrator;
(d) Social Security number of Plaintiff’s administrator;
(e) An authorization to examine and copy deceased’s Medicare and/or Medicaid
records.
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NOTICE TO PRODUCE SOCIAL MEDIA AUTHORIZATIONS AND TO PRESERVE
SOCIAL MEDIA INFORMATION:
Pursuant to the applicable rules of the CPLR and the Court’s recent holdings in Romano
v. Steelcase and Servelli v. Westchester, the plaintiff is hereby required to produce the following
items at the offices of McMAHON MARTINE & GALLAGHER, LLP, within twenty (20) days
of the service hereof:
Duly executed original authorizations to obtain full access to and copies of all of
plaintiff’s current and historical social networking accounts, including but not limited to
Facebook, MySpace, Twitter, Linked In, You Tube, etc., for the period of five (5) years prior to
the date of the plaintiff’s alleged accident through the present.
Said authorizations shall permit the release of full and complete copies of said accounts
including but not limited to: all records, information, photographs, videos, comments, messages
and posting on the aforementioned social networking accounts currently existing and deleted.
Said authorizations shall include the name, user name, screen name and e-mail account
used in creating each and every social networking account.
In lieu of producing said items at the office of the undersigned, said authorizations may
be submitted by mail to the undersigned before the return date of the within Notice.
If plaintiffs were not a registered user of any social network during the requested time
period, Defendants demands a statement from Plaintiff, under oath, to that effect.
IT IS FURTHER DEMANDED that Plaintiff preserve and prevent/refrain from the
deletion of, all of plaintiff’s social networking profiles and information with respect to any
current and historical social networking accounts, including but not limited to Facebook,
MySpace, Twitter, Linked-In, You Tube, etc., existing as of the date of this demand. Failure to
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retain social networking profiles and information will result in a motion based on the spoliation
of evidence at or before trial.
NOTICE OF DECLINATION OF SERVICE VIA FAX:
Pursuant to CPLR 2103 (5) service of litigation papers in this or any other action upon
the undersigned by “FAX” will not be accepted and is not authorized. The inclusion upon our
letterhead of a number for transmission of documents by electronic facsimile process (“FAX”) is
not to be deemed consent to service of litigation papers by such method, any provision of law or
statute to the contrary notwithstanding; and
PLEASE TAKE FURTHER NOTICE, that upon failure to produce the aforesaid
item(s) at the time and place required in this Notice, a motion will be made to the Court for the
appropriate relief with costs.
Dated: Brooklyn New York
January 29, 2024 Yours, Etc.
McMAHON, MARTINE & GALLAGHER, LLP
Attorneys for Defendants PSK SUPERMARKET
INC and 881 GERARD LLC.,
55 Washington Street, 7th Floor
Brooklyn, New York 11201
(212) 747-1230
Our File No.: 782C.0242
TO: SEE ATTACHED RIDER
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CONSENT TO RELEASE
TO: Medicare Secondary Payer Recovery Contractor
MSPRC Auto/Liability
P.O. Box 33828
Detroit, MI 48232-5828
Fax (743) 957-0998
I, _____________________________ (print your name exactly as shown on your Medicare and/or Social
Security card) hereby authorize the CMS, its agents and/or contractors to release, upon request,
information related to my injury/illness and/or settlement for the specified date of injury/illness to the
individual and/or entity listed below:
CHECK ONLY ONE OF THE FOLLOWING TO INDICATE WHO MAY RECEIVE INFORMATION
AND THEN PRINT THE REQUESTED INFORMATION:
(If you intend to have your information released to more than one individual or entity, you must complete
a separate release for each one.)
( ) Insurance Company ( ) Workers’ Compensation Carrier (X) Other
_________________________.
Name of entity: _McMahon Martine & Gallagher, LLP_______________
Contact for above entity: .
Address: __55 Washington Street, 7th Floor, Brooklyn, NY 11201
Telephone: _(212) 747-1230___________________
CHECK ONE OF THE FOLLOWING TO INDICATE HOW LONG CMS MAY RELEASE YOUR
INFORMATION (The period you check will run from when you sign and date below):
( ) One Year ( ) Two Years ( ) Other ______________________________________
(Provide a specific period of time)
I understand that I may revoke this “consent to release information” at any time, in writing.
MEDICARE BENEFICIARY INFORMATION AND SIGNATURE:
Beneficiary Signature: _______________________ Date signed: _________________________
Note: If the beneficiary is incapacitated, the submitted of this document will need to include documentation
establishing the authority of the individual signing on the beneficiary’s behalf. Please visit www.msprc.info for
further instructions.
Medicare Health Insurance claim Number (from Medicare card.) or Social Security
Number:___________
Date of Injury/Illness: _________________
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RIDER
CAMPION & CAMPSON
Attorneys for Plaintiff
43 West 43rd Street, Suite 132
New York, NY 10036
Attn: Pam J. Campson, Esq.
(212) 302-1180
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SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF BRONX Index #819902/2023E
CHRISTINE CHATMAN,
Plaintiff,
-against-
PSK SUPERMARKET INC. and 881 GERARD LLC.,
Defendants.
NOTICES FOR DISCOVERY AND INSPECTION, DEMANDS AND REQUESTS FOR
PRODUCTION OF DOCUMENTS
McMAHON, MARTINE & GALLAGHER, LLP
ATTORNEYS FOR DEFENDANTS PSK SUPERMARKET INC and 881 GERARD LLC.,
55 WASHINGTON STREET, SUITE 720
BROOKLYN, N.Y. 11201
(212) 747-1230
All Documents Contained Herein Certified Pursuant to Rule 130 By: ANDREW SHOWERS
ANDREW SHOWERS
STATE OF NEW YORK, COUNTY OF BRONX ss: (If more than one box check - indicate after names type of service used)
I, Andrew Showers, being sworn, say: I am not a party to the action, am over 18 years of age and
reside at 55 Washington Street, Brooklyn, NY On January 29, 2024, I served the within NOTICES
FOR DISCOVERY AND INSPECTION, DEMANDS AND REQUESTS FOR
PRODUCTION OF DOCUMENTS
_X___ by transmitting the papers by electronic means through the New York State E-File System. I received
an email from the New York State E-File System indicating that the transmission was received and
delivered to all counsel in the action.
TO: SEE RIDER ATTACHED
ANDREW SHOWERS
ANDREW SHOWERS
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Preview
FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF BRONX ------------------------------------------------------------x CHRISTINE CHATMAN, Plaintiff, Index No.: 819902/2023E -against- PSK SUPERMARKET INC. and 881 GERARD LLC., Defendants. ------------------------------------------------------------x TO: PLAINTIFF NOTICES FOR DISCOVERY AND INSPECTION, DEMANDS and REQUESTS FOR PRODUCTION OF DOCUMENTS: PLEASE TAKE NOTICE, that these answering defendants PSK SUPERMARKET INC. and 881 GERARD LLC., represented by the undersigned, demands that you respond to the following Demands, Notices for Discovery and Inspection and Requests for Production of Documents pursuant to the Rules of the CPLR. PLEASE TAKE FURTHER NOTICE, that the following Demands, Notices for Discovery and Inspection and Requests for Production of Documents are continuing. In the event that any of the items are obtained after service of the following, and your response thereto, they are to be furnished to the undersigned forthwith. This includes your response concerning your intention to call any expert witness up to an including the time of the commencement of the trial of this action. PLEASE TAKE FURTHER NOTICE, that these answering defendants reserves the right to supplement or amend the following up to and including the time of trial. 1 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 PLEASE TAKE FURTHER NOTICE, that your failure to respond in a timely fashion or to comply with the following may result in a motion to strike, compel compliance, to preclude, and/or for the imposition or penalties pursuant to the New York Civil Practice Law and Rules and such other and further relief as this Court deems just and proper. PLEASE TAKE FURTHER NOTICE, that upon your failure to produce the discovery responses, documents, etc. responsive to the following Demands, Notices for Discovery and Inspection and Requests for Production of Documents, the undersigned reserves the right to object at the trial of this action to the offering of any evidence contained in said discovery responses, documents, etc., including a motion to preclude the testimony of any such expert, medical or otherwise, who has not been properly identified, together with his prospective testimony as demanded above. DEMAND FOR INSURANCE With respect to any and all insurance in effect at the time of the occurrence complained of under which any person carrying on an insurance business may be liable to satisfy part or all of a judgment which may be entered in this action or to indemnify or reimburse for payments made to satisfy the judgment. 1. All primary insurance agreements and policies of liability insurance. 2. All excess and umbrella insurance agreements and policies of liability insurance. PLEASE TAKE FURTHER NOTICE, that any insurance document and policy produced in response to the above demand shall be the complete document and policy, including but not limited to, declaration sheets, riders, limitations, endorsements, amendments, cancellations, face sheets and/or binders, etc. 2 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 PLEASE TAKE FURTHER NOTICE, that if it is claimed that no liability insurance of any kind, type or description was in effect at the time of the occurrence complained of, then demand is hereby made that the above-named party set forth, by Affidavit, said claim. DEMAND FOR PHOTOGRAPHS 1. All photographs under the control of any party depicting the area whereat plaintiffs alleges their accident occurred. 2. All photographs depicting the plaintiff’s alleged injuries. PLEASE TAKE FURTHER NOTICE, that in lieu of producing the original documents and photographs as set forth in this Demand, you may comply with this Demand by forwarding copies of all such documents and photographs (in color as per originals) to the undersigned within the time set forth above. DEMAND FOR NAMES AND ADDRESSES OF ALL WITNESSES: Pursuant to the applicable rules, set forth in writing, under oath, and serve upon us within twenty (20) days of this date: 1. The names and addresses of each person known or claimed by you or any party you represent in this action to be a witness to: (a) The occurrence alleged in the complaint in this action; (b) Any acts, omissions, or conditions which allegedly caused the occurrence alleged to the complaint; (c) Any actual notice allegedly given to these answering Defendants of any condition which allegedly caused the occurrence alleged in the complaint, (d) The nature and duration of any alleged condition which allegedly caused the occurrence alleged in the complaint. (e) Any witness with knowledge of your complaints, physical condition and/or injuries that you claim were the result of the subject accident. 3 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 (f) Any witness with information concerning any medical treatment or care that you received following the subject accident. (g) Any witness who assisted you in any way following the accident. (h) Any witness with any information pertinent and/or germane to the facts in controversy of the within lawsuit, including but not limited to all information bearing on liability and damages. PLEASE TAKE FURTHER NOTICE, that appropriate motions will be made at the trial of this action to preclude the testimony of any witness to the above described facts and circumstances who is not identified by you in response to this notice. DEMAND FOR MEDICAL INFORMATION AND AUTHORIZATIONS: Pursuant to the applicable rules you are required to serve within twenty (20) days after service of this notice, the following: DEMAND FOR MEDICAL INFORMATION AND AUTHORIZATIONS: Pursuant to the applicable rules you are required to serve within twenty (20) days after service of this notice, the following: 1. The names and addresses of all physicians or other healthcare providers of every description who have consulted, examined or treated the plaintiff(s) for each of the conditions allegedly caused by, or exacerbated by, the occurrence described in the Complaint, including the date of such treatment or examination. 2. Duly executed and acknowledged written authorizations directed to any hospital, clinic or other healthcare facility in which the injured plaintiff(s) herein was (were) treated or confined due to the occurrence set forth in the Complaint so as to permit the securing of a copy of the entire hospital record or records, including x-rays and technicians’ reports. 3. Duly executed and acknowledged written authorizations to allow the Defendants to obtain the complete office medical records relating to plaintiff(s), of each healthcare provider identified (1) above. 4. Copies of all medical reports received from healthcare providers Identified in (1) above. These shall include a detailed recital of the injuries and conditions as to which testimony will of offered at the trial, referring to and identifying those x-rays and technicians’ reports which will be offered at the trial. 4 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 5. Duly executed and acknowledged written authorizations to allow the Defendant to obtain complete pharmacy or drug store records with respect to any drugs prescribed for the plaintiff(s) from one (1) year prior to the occurrence described in the Complaint to the present date. 6. Duly executed authorizations to obtain the records of all plaintiff’s healthcare providers for treatment rendered; including their full names and addresses; as well as x-rays, MRIs, CT Scan films, Tomograms, EMG studies, EEG Studies, Myelograms, etc. Upon your failure to comply herewith, the plaintiff(s) herein will be precluded at the trial of this action from offering any evidence of the conditions described in the reports or records demanded, or offering in evidence any part of the hospital records, medical records, x-ray reports or reports of other technicians not made available pursuant to this rule, nor will the Court hear the testimony of any physicians whose medical reports have not been served pursuant to the aforesaid demand. DEMAND PURSUANT TO CPLR SECTIONS 3101 AND 4545 FOR COLLATERAL SOURCE PAYMENTS INFORMATION: Pursuant to Sections §§3101 and 4545, you are required to serve within twenty (20) days after receipt of this notice, the following information: 1. The names, addresses and amounts received to date from all persons, firms, or organizations which have reimbursed plaintiff(s) for the cost of medical care, custodial care, rehabilitation services, loss of earnings or other economic loss, and other costs, including but not limited to: (a) Insurance; (b) Social Security Benefits; (c) Workers’ Compensation Benefits; (d) Disability Benefits; (e) Employee Benefits Program; and (f) Any other source. 5 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 2. Where reimbursement was or is pursuant to a policy, state the name of the policy holder, the policy number, and the name of the issuer of the policy; a list of claims submitted pursuant to the policy, and the amount of money received pursuant to each claim. 3. Duly executed and acknowledged written authorizations directed to all persons, firms or organizations which have reimbursed Plaintiff for costs of medical care, custodial care, rehabilitation services, loss of earnings or other economic loss, or other costs or to whom such claims have been submitted to obtain copies of the policies under which said payments or claims were made, copies of all checks, and other indication of payment, and copies of any claims submitted for payment. PLEASE TAKE FURTHER NOTICE, that authorizations for any insurance documents and policy produced in response to the demand herein shall be for the complete documents and policy, including but not limited to, declaration sheets, riders, limitations, endorsements, amendments, cancellations, face sheets and/or binders, etc. PLEASE TAKE FURTHER NOTICE, that if it is claimed that no such persons, firms, or organizations have reimbursed Plaintiff for such costs then demand is hereby made that the above-named party set forth, by Affidavit. DEMAND FOR EXPERT WITNESS DISCLOSURE: Pursuant to Section § 3101(d) of the Civil Practice Law and Rules, you are required to set forth the following: 1. The name and address of each and every person you expect to call as an expert witness at the trial of this action. 2. Detail, the subject matter on which each expert is expected to testify. 3. The substances of the facts and opinions on which each expert is expected to testify. 4. The qualification of each expert witness. 5. A summary of the factual ground for each expert’s opinion. DEMAND FOR PARTY STATEMENTS: 6 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 Pursuant to the applicable rules of the CPLR, you are required to serve within twenty (20) days after service of this notice, the following: 1. 1. Any signed statement, unsigned statement, or copy of any recorded statement or document made by or taken from any party represented by the undersigned in this action, or from any agent, servant or employee of any Defendant represented by this office; 2. Any signed statement, unsigned statement, or copy of any recorded statement or document made by or taken from any co-Defendant or agent, servant or employee of any co-Defendant at: DEMAND FOR TAX RETURNS: Pursuant to the applicable rules of the CPLR, you are required to serve within twenty (20) days after service of this notice, the following: 1. Copies of the income tax returns filed by plaintiff and the W-2 forms received by the plaintiff and filed with the United States Federal Government and New York State Government for the years 2007 to the present. 2. Duly executed authorizations to obtain the information described in item #1 from the Internal Revenue Service. DEMAND FOR EMPLOYMENT AUTHORIZATION: Pursuant to the applicable rules of the CPLR, you are required to serve within twenty (20) days after service of this notice, the following: 1. Duly executed authorization to obtain true and complete copies of the plaintiff’s employment records from all employers from the years 2007 through the present to include wages, job promotions, hours worked and absenteeism. 2. Any and all job related medical records concerning plaintiff as maintained by plaintiff’s employer. DEMAND FOR IMMIGRATION DOCUMENTS: Pursuant to the applicable rules of the CPLR, you are required to serve within twenty (20) days after service of this notice, the following: 1. All documentation relating to or concerning plaintiff’s citizenship status, birth certificate, passport, visa, visa application, driver’s license, non-driver 7 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 identification, Social Security card, green card, green card application, work permit, work permit application, alien identification card, application for alien identification card, and any related response or correspondence from any foreign government, the United States government, any state or local government, or any other governmental agency whether foreign or domestic. 2. Plaintiff’s W-2 form from 2007 to the present. 3. Plaintiff’s income tax returns from 2007 to the present. 4. Plaintiff’s W-4 form, employment application and pay stubs or other evidence of Plaintiff’s wages for all of plaintiff’s employers from 2007 to the present. 5. Plaintiff’s W-4 form, employment application and pay stubs or other evidence of Plaintiff’s wages for plaintiff’s employer at the time of the alleged accident. 6. Duly executed and acknowledged written authorizations permitting all parties to obtain and make copies of those documents requested in this Notice including but not limited to duly executed and acknowledged written authorizations to the United States Citizenship and Immigration Service, the United States Department of State, the United States Social Security Administration, the United States Internal Revenue Service, the government of plaintiff’s Country of citizenship, and to plaintiff’s employers. DEMAND FOR MEDICARE AND MEDICAID INFORMATION AND DOCUMENTS: Pursuant to Article 31 of the CPLR and 42 U.S.C. 1395y (b)(8)(A), you are required to serve within thirty (30) days after service of this notice, the following: 1. A statement as to whether the plaintiff has received benefits from either Medicare or Medicaid at any time, for any reason, not limited to the injuries alleged in the instant action. If so, please state and/or provide: (a) Plaintiff’s full name; (b) Plaintiff’s gender; (c) Plaintiff’s date of birth; (d) Plaintiff’s Social Security number; (e) Plaintiff’s residence telephone number; (f) The Health Insurance Claim Number and/or Medicare/Medicaid file number; 8 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 (g) The address of the office handling the plaintiff’s Medicare and/or Medicaid file; (h) A duly executed authorization bearing plaintiff’s date of birth and Social Security number or Health Insurance Claim Number permitting this firm and/or the representatives of Defendants(s) to obtain copies of plaintiff’s Medicare and/or Medicaid records. (A Consent to Release is annexed hereto for your convenience). 2. State whether Medicare and/or Medicaid has a lien and the amount of any such lien. 3. Provide copies of all documents, records, memoranda, notes, etc., in plaintiff’s possession pertaining to plaintiff’s receipt of Medicare and/or Medicaid benefits, including copies of all documents provided to or received from the Medicare and/or Medicaid administrator. 4. If any Medicaid and/or Medicare Secondary Payer (MSP) claims exist, please provide a copy of the claim summary from Medicare and/or Medicaid regarding those claims. 5. If plaintiff has not received Medicare and/or Medicaid benefits in the past or is not receiving Medicare and/or Medicaid benefits now, state whether plaintiff is eligible to receive Medicare and/or Medicaid benefits. 6. If plaintiff has been receiving Medicare and/or Medicaid benefits and is now deceased, please provide the following: (a) Relationship of the administrator of Plaintiff’s estate to Plaintiff’s decedent; (b) Name and address of Plaintiff’s administrator; (c) Telephone number and/or email address of Plaintiff’s administrator; (d) Social Security number of Plaintiff’s administrator; (e) An authorization to examine and copy deceased’s Medicare and/or Medicaid records. 9 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 NOTICE TO PRODUCE SOCIAL MEDIA AUTHORIZATIONS AND TO PRESERVE SOCIAL MEDIA INFORMATION: Pursuant to the applicable rules of the CPLR and the Court’s recent holdings in Romano v. Steelcase and Servelli v. Westchester, the plaintiff is hereby required to produce the following items at the offices of McMAHON MARTINE & GALLAGHER, LLP, within twenty (20) days of the service hereof: Duly executed original authorizations to obtain full access to and copies of all of plaintiff’s current and historical social networking accounts, including but not limited to Facebook, MySpace, Twitter, Linked In, You Tube, etc., for the period of five (5) years prior to the date of the plaintiff’s alleged accident through the present. Said authorizations shall permit the release of full and complete copies of said accounts including but not limited to: all records, information, photographs, videos, comments, messages and posting on the aforementioned social networking accounts currently existing and deleted. Said authorizations shall include the name, user name, screen name and e-mail account used in creating each and every social networking account. In lieu of producing said items at the office of the undersigned, said authorizations may be submitted by mail to the undersigned before the return date of the within Notice. If plaintiffs were not a registered user of any social network during the requested time period, Defendants demands a statement from Plaintiff, under oath, to that effect. IT IS FURTHER DEMANDED that Plaintiff preserve and prevent/refrain from the deletion of, all of plaintiff’s social networking profiles and information with respect to any current and historical social networking accounts, including but not limited to Facebook, MySpace, Twitter, Linked-In, You Tube, etc., existing as of the date of this demand. Failure to 10 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 retain social networking profiles and information will result in a motion based on the spoliation of evidence at or before trial. NOTICE OF DECLINATION OF SERVICE VIA FAX: Pursuant to CPLR 2103 (5) service of litigation papers in this or any other action upon the undersigned by “FAX” will not be accepted and is not authorized. The inclusion upon our letterhead of a number for transmission of documents by electronic facsimile process (“FAX”) is not to be deemed consent to service of litigation papers by such method, any provision of law or statute to the contrary notwithstanding; and PLEASE TAKE FURTHER NOTICE, that upon failure to produce the aforesaid item(s) at the time and place required in this Notice, a motion will be made to the Court for the appropriate relief with costs. Dated: Brooklyn New York January 29, 2024 Yours, Etc. McMAHON, MARTINE & GALLAGHER, LLP Attorneys for Defendants PSK SUPERMARKET INC and 881 GERARD LLC., 55 Washington Street, 7th Floor Brooklyn, New York 11201 (212) 747-1230 Our File No.: 782C.0242 TO: SEE ATTACHED RIDER 11 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 CONSENT TO RELEASE TO: Medicare Secondary Payer Recovery Contractor MSPRC Auto/Liability P.O. Box 33828 Detroit, MI 48232-5828 Fax (743) 957-0998 I, _____________________________ (print your name exactly as shown on your Medicare and/or Social Security card) hereby authorize the CMS, its agents and/or contractors to release, upon request, information related to my injury/illness and/or settlement for the specified date of injury/illness to the individual and/or entity listed below: CHECK ONLY ONE OF THE FOLLOWING TO INDICATE WHO MAY RECEIVE INFORMATION AND THEN PRINT THE REQUESTED INFORMATION: (If you intend to have your information released to more than one individual or entity, you must complete a separate release for each one.) ( ) Insurance Company ( ) Workers’ Compensation Carrier (X) Other _________________________. Name of entity: _McMahon Martine & Gallagher, LLP_______________ Contact for above entity: . Address: __55 Washington Street, 7th Floor, Brooklyn, NY 11201 Telephone: _(212) 747-1230___________________ CHECK ONE OF THE FOLLOWING TO INDICATE HOW LONG CMS MAY RELEASE YOUR INFORMATION (The period you check will run from when you sign and date below): ( ) One Year ( ) Two Years ( ) Other ______________________________________ (Provide a specific period of time) I understand that I may revoke this “consent to release information” at any time, in writing. MEDICARE BENEFICIARY INFORMATION AND SIGNATURE: Beneficiary Signature: _______________________ Date signed: _________________________ Note: If the beneficiary is incapacitated, the submitted of this document will need to include documentation establishing the authority of the individual signing on the beneficiary’s behalf. Please visit www.msprc.info for further instructions. Medicare Health Insurance claim Number (from Medicare card.) or Social Security Number:___________ Date of Injury/Illness: _________________ 12 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 RIDER CAMPION & CAMPSON Attorneys for Plaintiff 43 West 43rd Street, Suite 132 New York, NY 10036 Attn: Pam J. Campson, Esq. (212) 302-1180 13 of 14 FILED: BRONX COUNTY CLERK 01/29/2024 05:11 PM INDEX NO. 819902/2023E NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 01/29/2024 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF BRONX Index #819902/2023E CHRISTINE CHATMAN, Plaintiff, -against- PSK SUPERMARKET INC. and 881 GERARD LLC., Defendants. NOTICES FOR DISCOVERY AND INSPECTION, DEMANDS AND REQUESTS FOR PRODUCTION OF DOCUMENTS McMAHON, MARTINE & GALLAGHER, LLP ATTORNEYS FOR DEFENDANTS PSK SUPERMARKET INC and 881 GERARD LLC., 55 WASHINGTON STREET, SUITE 720 BROOKLYN, N.Y. 11201 (212) 747-1230 All Documents Contained Herein Certified Pursuant to Rule 130 By: ANDREW SHOWERS ANDREW SHOWERS STATE OF NEW YORK, COUNTY OF BRONX ss: (If more than one box check - indicate after names type of service used) I, Andrew Showers, being sworn, say: I am not a party to the action, am over 18 years of age and reside at 55 Washington Street, Brooklyn, NY On January 29, 2024, I served the within NOTICES FOR DISCOVERY AND INSPECTION, DEMANDS AND REQUESTS FOR PRODUCTION OF DOCUMENTS _X___ by transmitting the papers by electronic means through the New York State E-File System. I received an email from the New York State E-File System indicating that the transmission was received and delivered to all counsel in the action. TO: SEE RIDER ATTACHED ANDREW SHOWERS ANDREW SHOWERS 14 of 14