On March 18, 2024 a
Request for Judicial Intervention
was filed
involving a dispute between
Jack Brian Radin,
and
In The Matter Of,
for Other Matters - Name Change/Sex Designation Change
in the District Court of Westchester County.
Preview
FILED: WESTCHESTER COUNTY CLERK 03/18/2024 INDEX NO. 50168/2024
NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 03/19/2024
u o
REQUEST FOR JUDICIAL INTERVENTION (r,
SUPREME COURT, COUNTY OF WESTCHESTER
Index No.: So Date Index Issued: /d/ 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
In the Matter of the Application of
JACK BRIAN RADIN
Judge Assigned
For Leave to Assume the Name
JACK BRIAN TRULUCK RADIN
Petitioner RJ1 Filed Date
NATURE OF ACTION OR PROCEEDING Check only one box and t pecify where Indicated
COMMERCIAL MATRIMONIAL
O Business Entity (including corporations, partnerships, LLCs, etc.) O Contested
O Contract NOTE: If there are children under the age of 18, complete and attach the
MATRIMONIAL RJi Addendum (UCS440M)
O insurance (where insurer is a party, except arbitration)
For Uncontested Matrimonial actions, use Uncontested Divorce RJI (UD-13)
O UCC (including sales, negotiable instruments)
O Other Commercial (specify): REAL PROPERTY Specify how many properties the application
meludes:
NOTE: For Commercial Division assignment requests 22 NYCRR § 202.70(d),
complete and attach the COMMERCIAL DIV RJI Addendum (UCS-840C). O Condemnation
u Mortgage Foreclosure (specify): O Residential O Commercial
TORTS
O Adult Survivors Act Property Address:
NOTE: For Foreclosure actions involving a one-to four-family, owner-
O Asbestos
occupied, residential property, or an owner-occupied condominium, complete
O Environmental (specify): and attach the FORECLOSURE RJi Addendum (UCS-840F).
O Medical, Dental, or Podiatric Malpractice O Tax Certiorari
O Motor Vehicle O Tax Foreclosure
O Products Liability (specify): O Other Real Property (specify):
O Other Negligence (specify):
OTHER MATTERS
O Other Professional Malpractice (specify):
O Certificate of Incorporation/Dissolution [see NOTE under Commercial]
O Other Tort (specify):
O Emergency Medical Treatment
SPECIAL PROCEEDINGS O Habeas Corpus
O Child-Parent Security Act (specify): O Assisted Reproduction O Local Court Appeal
OSurrogacy Agreement O Mechanic's Lien
O CPLR Article 75 - Arbitration [see NOTE under CommerciaQ
Ilil Name Change [No fee - N.Y.Ct.Rules, § 202.6(b)]
O CPLR Article 78 - Proceeding against a Body or Officer
O Pistol Permit Revocation Hearing
O Election Law
O Sale or Finance of Religious/Not-for-Profit Property
O Extreme Risk Protection Order
O Other (specify):
O MHL Article 9.60 - Kendra's Law
O MHL Article 10- Sex Offender Confinement (specify): O Initial
O Review
O MHL Ar8cle 81 (Guardianship)
O Other Mental Hygiene (specify):
O Other Special Proceeding (specify):
STATUS OF ACTION OR PROCEEDING Answer YES or NO for every question and enter additional information where indicated
YES NO
Has a summons and complaint or summons with notice been filed? O O If yes, date filed: / /
Has a summons and complaint or summons with notice been served? O O If yes, date served: / /
Is this action/proceeding being filed post-judgment? O O If yes, judgment date: / /
1 of 2
FILED: WESTCHESTER COUNTY CLERK 03/18/2024 INDEX NO. 50168/2024
NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 03/19/2024
NATURE OF JUDICIAL INTERVENTION Check one box only and enter additional information where indicated.
O Infants Compromise
O Extreme Risk Protection Order Application
O Note of Issue and/or Certificate of Readiness
O Notice of Medical, Dental, or Podiatric Malpractice Date Issue Joined: / /
O Notice of Motion Relief Sought Retum Date: /
O Notice of Petition Relief Sought Retum Date: / /
O Order to Show Cause Relief Sought: Retum Date: / /
O Other Ex Parte Application Relief Sought
O Poor Person Application
O Request for Preliminary Conference
O Residential Mortgage Foreclosure Settlement Conference
O Writ of Habeas Corpus
O Other (specify):
RELATED CASES: List any related actions. For Matrimonial actions, include any related criminal and/or Family Court cases. If none, teave blank.
If additional space is required, complete and attach the RJI Addendum (UCS-Il40A).
Case Title Index/Case No. Court Judge (if assigned) Relationship to Instant Case
"Un-Rep"
PARTIES: For parties without an attomey, check box and enter party address, phone number and e-mail in the space pmvided.
If additional space is required, complete t nd attach the RJI Addendum (UCS-840A).
Partles Attorneys and/or Unrepresented LItlgants Issue Joined Insurance Carriers
List parties in same order as listed in the For represented parties, provide attomey's name, firm name, For each defendant, For each defendant,
Un-Re P
caption and Indicate roles (e.g. plaintiff, address, phone and e-mail . For unrepresented parties, provide indicate if issue has indicate insurance
defendant; 3'd-party plaintiff, etc.). party's address, phone and e-mall. been joined carrier, if applicable
Name: 9 Green Street
Jack Brian Radin Hastings on Hudson, NY 10706
O YES O NO N/A
Phone: (443) 847-0954
Role(s):
Email: radinbrian@yahoo.com
Petitioner
Name:
Role(s): O YES O NO
Name:
Rote(s): O YES O NO
Name:
Role(s): O YES O NO
¡
I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER
REI..ATED ACTIONS OR PROCEEDINGS, EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FOR JUDICIAL
INTERVENTION BEEN PREVIOUSLY BEEN FILED IN THIS ACTION OR PROCEEDING.
JACK BRIAN RADIN
n/a - unrepresented
ATTORNEY REGISTRATION NUMBER
2 of 2
Document Filed Date
March 18, 2024
Case Filing Date
March 18, 2024
Category
Other Matters - Name Change/Sex Designation Change
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FILED: WESTCHESTER COUNTY CLERK 03/18/2024 INDEX NO. 50168/2024 NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 03/19/2024 u o REQUEST FOR JUDICIAL INTERVENTION (r, SUPREME COURT, COUNTY OF WESTCHESTER Index No.: So Date Index Issued: /d/ 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 In the Matter of the Application of JACK BRIAN RADIN Judge Assigned For Leave to Assume the Name JACK BRIAN TRULUCK RADIN Petitioner RJ1 Filed Date NATURE OF ACTION OR PROCEEDING Check only one box and t pecify where Indicated COMMERCIAL MATRIMONIAL O Business Entity (including corporations, partnerships, LLCs, etc.) O Contested O Contract NOTE: If there are children under the age of 18, complete and attach the MATRIMONIAL RJi Addendum (UCS440M) O insurance (where insurer is a party, except arbitration) For Uncontested Matrimonial actions, use Uncontested Divorce RJI (UD-13) O UCC (including sales, negotiable instruments) O Other Commercial (specify): REAL PROPERTY Specify how many properties the application meludes: NOTE: For Commercial Division assignment requests 22 NYCRR § 202.70(d), complete and attach the COMMERCIAL DIV RJI Addendum (UCS-840C). O Condemnation u Mortgage Foreclosure (specify): O Residential O Commercial TORTS O Adult Survivors Act Property Address: NOTE: For Foreclosure actions involving a one-to four-family, owner- O Asbestos occupied, residential property, or an owner-occupied condominium, complete O Environmental (specify): and attach the FORECLOSURE RJi Addendum (UCS-840F). O Medical, Dental, or Podiatric Malpractice O Tax Certiorari O Motor Vehicle O Tax Foreclosure O Products Liability (specify): O Other Real Property (specify): O Other Negligence (specify): OTHER MATTERS O Other Professional Malpractice (specify): O Certificate of Incorporation/Dissolution [see NOTE under Commercial] O Other Tort (specify): O Emergency Medical Treatment SPECIAL PROCEEDINGS O Habeas Corpus O Child-Parent Security Act (specify): O Assisted Reproduction O Local Court Appeal OSurrogacy Agreement O Mechanic's Lien O CPLR Article 75 - Arbitration [see NOTE under CommerciaQ Ilil Name Change [No fee - N.Y.Ct.Rules, § 202.6(b)] O CPLR Article 78 - Proceeding against a Body or Officer O Pistol Permit Revocation Hearing O Election Law O Sale or Finance of Religious/Not-for-Profit Property O Extreme Risk Protection Order O Other (specify): O MHL Article 9.60 - Kendra's Law O MHL Article 10- Sex Offender Confinement (specify): O Initial O Review O MHL Ar8cle 81 (Guardianship) O Other Mental Hygiene (specify): O Other Special Proceeding (specify): STATUS OF ACTION OR PROCEEDING Answer YES or NO for every question and enter additional information where indicated YES NO Has a summons and complaint or summons with notice been filed? O O If yes, date filed: / / Has a summons and complaint or summons with notice been served? O O If yes, date served: / / Is this action/proceeding being filed post-judgment? O O If yes, judgment date: / / 1 of 2 FILED: WESTCHESTER COUNTY CLERK 03/18/2024 INDEX NO. 50168/2024 NYSCEF DOC. NO. 4 RECEIVED NYSCEF: 03/19/2024 NATURE OF JUDICIAL INTERVENTION Check one box only and enter additional information where indicated. O Infants Compromise O Extreme Risk Protection Order Application O Note of Issue and/or Certificate of Readiness O Notice of Medical, Dental, or Podiatric Malpractice Date Issue Joined: / / O Notice of Motion Relief Sought Retum Date: / O Notice of Petition Relief Sought Retum Date: / / O Order to Show Cause Relief Sought: Retum Date: / / O Other Ex Parte Application Relief Sought O Poor Person Application O Request for Preliminary Conference O Residential Mortgage Foreclosure Settlement Conference O Writ of Habeas Corpus O Other (specify): RELATED CASES: List any related actions. For Matrimonial actions, include any related criminal and/or Family Court cases. If none, teave blank. If additional space is required, complete and attach the RJI Addendum (UCS-Il40A). Case Title Index/Case No. Court Judge (if assigned) Relationship to Instant Case "Un-Rep" PARTIES: For parties without an attomey, check box and enter party address, phone number and e-mail in the space pmvided. If additional space is required, complete t nd attach the RJI Addendum (UCS-840A). Partles Attorneys and/or Unrepresented LItlgants Issue Joined Insurance Carriers List parties in same order as listed in the For represented parties, provide attomey's name, firm name, For each defendant, For each defendant, Un-Re P caption and Indicate roles (e.g. plaintiff, address, phone and e-mail . For unrepresented parties, provide indicate if issue has indicate insurance defendant; 3'd-party plaintiff, etc.). party's address, phone and e-mall. been joined carrier, if applicable Name: 9 Green Street Jack Brian Radin Hastings on Hudson, NY 10706 O YES O NO N/A Phone: (443) 847-0954 Role(s): Email: radinbrian@yahoo.com Petitioner Name: Role(s): O YES O NO Name: Rote(s): O YES O NO Name: Role(s): O YES O NO ¡ I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER REI..ATED ACTIONS OR PROCEEDINGS, EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FOR JUDICIAL INTERVENTION BEEN PREVIOUSLY BEEN FILED IN THIS ACTION OR PROCEEDING. JACK BRIAN RADIN n/a - unrepresented ATTORNEY REGISTRATION NUMBER 2 of 2