On April 10, 2024 a
Party Statement
was filed
involving a dispute between
Workers' Compensation Board Of The State Of New York,
and
523 Multiservices Inc,
for Other Matters - Workers Comp App for Judgment
in the District Court of Suffolk County.
Preview
FILED: SUFFOLK COUNTY CLERK 04/10/2024 10:32 AM INDEX NO. 608931/2024
(215)16584034-1
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/10/2024
SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF SUFFOLK
X
WORKERS'
COMPENSATION BOARD OF THE STATE OF NEW YORK,:
Plaintiff, :
-against- :
:
523 MULTISERVICES INC :
AFFIRMATION
Defendant(s) :
OF
REGULARITY
:
X
Workers'
The undersigned, an attorney in the office of the Compensation Board of the State of New
York, Plaintiff herein, hereby affirms that the following is true under the penalty of perjury, upon
information and belief:
Workers'
This affirmation is based upon a review of the file which is maintained by the Compensation
Board in its regular course of business.
Workers'
The Compensation Board of the State of New York, in accordance with the provisions of the
Workers'
Compensation Law, has made an assessment/award in the sum of $20,500.00, against the
defendant(s). Attached hereto and made a part hereof are certified copies of the Notice of Decision and
Award, and/or a certified copy of the demand for deposit of security, and/or a certified copy of the chair's
order imposing, and the demand for payment of, assessments imposed by the chair pursuant to
Workers'
subdivision five of section fifty-two and/or one hundred thirty one of the Compensation Law, as
Workers'
required for filing of judgment per Compensation Law, Section 26 and/or 219. Appeals before
the Board have been exhausted.
No payment of award has been made except $0.00, leaving $20,500.00 due and payable.
WHEREFORE, it is respectfully requested that judgment be entered against the Defendant(s) herein in
the sum stated as remaining due and payable.
Dated: day of -0
Andrew McNamara, Esq.
C-45.1 4/2007
(215)16584034-1
1 of 3
FILED: SUFFOLK COUNTY CLERK 04/10/2024 10:32 AM INDEX NO. 608931/2024
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/10/2024
SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF SUFFOLK
X
WORKERS'
COMPENSATION BOARD OF THE STATE OF NEW YORK,:
Plaintiff,
-against-
523 MULTISERVICES INC
AFFIRMATION
Defendant(s)
OF
NON-PAYMENT
:
:
:
:
X
Workers'
The undersigned, an attorney in the office of the Compensation Board of the State of New
York, Plaintiff herein, hereby affirms that the following is true under the penalty of perjury, upon
information and belief:
Workers'
This affirmation is based upon a review of the file which is maintained by the Compensation
Board in its regular course of business.
I am familiar with the status of payment in this matter. The award/penalty/assessment/demaId for
deposit of security made against the defendant(s) in the amount of $20,500.00 is in default, as more
than thirty days have elapsed since the demand upon the defendant(s) herein for payment. No payment
has been received nor has the aforesaid security been deposited in compliance with said demand to
date, except the sum of $0.00, leaving due and payble the sum of $20,500.00.
Dated: day of ,
Andrew McNamara, Esq.
C-45.45 1/2009
(216)16584036-1
2 of 3
FILED: SUFFOLK COUNTY CLERK 04/10/2024 10:32 AM INDEX NO. 608931/2024
(217)16584038-1
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/10/2024
STATE OF NEW YORK
WORKERS'
NEw Workers' COMPENSATION BOARD THIS AGENCY EMPLOYS AND SERVES
JUD.GMENT UNIT PEOPLE WITH DISABILITIES WITHOUT
Ïx E Com nsation
DISCRIMINATION.
Board 328 STATE STREET
SCHENECTADY, NY 12305-2318
866-298-7830
523 MULTISERVICES INC WCB EMPLOYER #: 3297682
2244 POND RD UlER #: 56-28469
RONKONKOMA NY 11779-6657
FEIN/SS #: *****9082
It is hereby certified that this is a true
and correct copy of the original as filed
rkers'
with the Compensation Board
* Judgment nit
FINAL NOTICE Certified on ............. ...... .....................
DATE: 02/20/2024
Non-Compliance
Item Description Dates Accident Date Balance Due
2023W0014468 Failure to Workers' Ins 12/31/2022-02/13/2024 $20,500.00
Carry Comp
Total Balance Due $20, 500. 00
*
If payment is not received immediately, judgment will be filed and the employer is subject to seizure
of assets, both business and personal, without further notice from the Board.
PAYMENT INSTRUCTIONS
To make online payments e-mail Billing@wcb.ny.gov OR
In order to insure prompt credit of your payment, complete the following with the
Date, Number and Amount of your check and return it, along with your payment to:
WORKERS'
NYS COMPENSATION BOARD
PO BOX 5530
BINGHAMTON, NY 13902-5530
..................------...__PJp..a_sp__detac_h an l_tetym_p..ottpm..p_ç_rt_ig_n.gitjl_y.g_ur..ga_ymp_F_t.___________________________
MAKE CHECKS PAYABLE TO "COMMISSIONER OF TAXATION AND FINANCE".
PLEASE INCLUDE YOUR WCB EMPLOYER NUMBER ON YOUR CHECK.
Employer 523 MULTISERVICES INC WCB Employer # 3297682
Customer ID #
Check.
Check Date Check #
Amount
C-45.37 10/2023 Page 1 of 2
(217)16584038-1
3 of 3
Document Filed Date
April 10, 2024
Case Filing Date
April 10, 2024
Category
Other Matters - Workers Comp App for Judgment
For full print and download access, please subscribe at https://www.trellis.law/.
Preview
FILED: SUFFOLK COUNTY CLERK 04/10/2024 10:32 AM INDEX NO. 608931/2024 (215)16584034-1 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/10/2024 SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF SUFFOLK X WORKERS' COMPENSATION BOARD OF THE STATE OF NEW YORK,: Plaintiff, : -against- : : 523 MULTISERVICES INC : AFFIRMATION Defendant(s) : OF REGULARITY : X Workers' The undersigned, an attorney in the office of the Compensation Board of the State of New York, Plaintiff herein, hereby affirms that the following is true under the penalty of perjury, upon information and belief: Workers' This affirmation is based upon a review of the file which is maintained by the Compensation Board in its regular course of business. Workers' The Compensation Board of the State of New York, in accordance with the provisions of the Workers' Compensation Law, has made an assessment/award in the sum of $20,500.00, against the defendant(s). Attached hereto and made a part hereof are certified copies of the Notice of Decision and Award, and/or a certified copy of the demand for deposit of security, and/or a certified copy of the chair's order imposing, and the demand for payment of, assessments imposed by the chair pursuant to Workers' subdivision five of section fifty-two and/or one hundred thirty one of the Compensation Law, as Workers' required for filing of judgment per Compensation Law, Section 26 and/or 219. Appeals before the Board have been exhausted. No payment of award has been made except $0.00, leaving $20,500.00 due and payable. WHEREFORE, it is respectfully requested that judgment be entered against the Defendant(s) herein in the sum stated as remaining due and payable. Dated: day of -0 Andrew McNamara, Esq. C-45.1 4/2007 (215)16584034-1 1 of 3 FILED: SUFFOLK COUNTY CLERK 04/10/2024 10:32 AM INDEX NO. 608931/2024 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/10/2024 SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF SUFFOLK X WORKERS' COMPENSATION BOARD OF THE STATE OF NEW YORK,: Plaintiff, -against- 523 MULTISERVICES INC AFFIRMATION Defendant(s) OF NON-PAYMENT : : : : X Workers' The undersigned, an attorney in the office of the Compensation Board of the State of New York, Plaintiff herein, hereby affirms that the following is true under the penalty of perjury, upon information and belief: Workers' This affirmation is based upon a review of the file which is maintained by the Compensation Board in its regular course of business. I am familiar with the status of payment in this matter. The award/penalty/assessment/demaId for deposit of security made against the defendant(s) in the amount of $20,500.00 is in default, as more than thirty days have elapsed since the demand upon the defendant(s) herein for payment. No payment has been received nor has the aforesaid security been deposited in compliance with said demand to date, except the sum of $0.00, leaving due and payble the sum of $20,500.00. Dated: day of , Andrew McNamara, Esq. C-45.45 1/2009 (216)16584036-1 2 of 3 FILED: SUFFOLK COUNTY CLERK 04/10/2024 10:32 AM INDEX NO. 608931/2024 (217)16584038-1 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 04/10/2024 STATE OF NEW YORK WORKERS' NEw Workers' COMPENSATION BOARD THIS AGENCY EMPLOYS AND SERVES JUD.GMENT UNIT PEOPLE WITH DISABILITIES WITHOUT Ïx E Com nsation DISCRIMINATION. Board 328 STATE STREET SCHENECTADY, NY 12305-2318 866-298-7830 523 MULTISERVICES INC WCB EMPLOYER #: 3297682 2244 POND RD UlER #: 56-28469 RONKONKOMA NY 11779-6657 FEIN/SS #: *****9082 It is hereby certified that this is a true and correct copy of the original as filed rkers' with the Compensation Board * Judgment nit FINAL NOTICE Certified on ............. ...... ..................... DATE: 02/20/2024 Non-Compliance Item Description Dates Accident Date Balance Due 2023W0014468 Failure to Workers' Ins 12/31/2022-02/13/2024 $20,500.00 Carry Comp Total Balance Due $20, 500. 00 * If payment is not received immediately, judgment will be filed and the employer is subject to seizure of assets, both business and personal, without further notice from the Board. PAYMENT INSTRUCTIONS To make online payments e-mail Billing@wcb.ny.gov OR In order to insure prompt credit of your payment, complete the following with the Date, Number and Amount of your check and return it, along with your payment to: WORKERS' NYS COMPENSATION BOARD PO BOX 5530 BINGHAMTON, NY 13902-5530 ..................------...__PJp..a_sp__detac_h an l_tetym_p..ottpm..p_ç_rt_ig_n.gitjl_y.g_ur..ga_ymp_F_t.___________________________ MAKE CHECKS PAYABLE TO "COMMISSIONER OF TAXATION AND FINANCE". PLEASE INCLUDE YOUR WCB EMPLOYER NUMBER ON YOUR CHECK. Employer 523 MULTISERVICES INC WCB Employer # 3297682 Customer ID # Check. Check Date Check # Amount C-45.37 10/2023 Page 1 of 2 (217)16584038-1 3 of 3