Preview
FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024
SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFWESTCHESTER
X
WORKERS'
COMPENSATION BOARDOFTHESTATEOF NEW YORK, :
Plaintiff,
-against- :
:
PHYSICALTHERAPYCAREANDREHABOFFICEP.C. :
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 amfamiliar with the status of payment in this matter. The award/penalty/assessment/demand for
deposit of security made against the defendant(s) in the amount of $10,500.00 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 demandto
date, except the sum of $0.00, leaving due and payble the sum of $10,500.00.
Dated: 6th day of May , 2024 .
S/
Michele A. Mealy, Esq.
Judgment Unit
C-45.45E 1/2009
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FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024
SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFWESTCHESTER
X
WORKERS'
COMPENSATION BOARDOFTHESTATEOF NEW YORK, :
Plaintiff,
-against- :
:
PHYSICALTHERAPYCAREANDREHABOFFICEP.C. :
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.
The Workers' 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 $10,500.00, 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 demandfor deposit of security, and/or a certified copy of the chair's
order imposing, and the demandfor 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 $10,500.00 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: 6th day of May , 2024
S/
Michele A. Mealy, Esq.
Judgment Unit
C-45.1E 6/2007
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FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024
STATE OFNEW YORK
WORKERS'COMPENSATION BOARD
NEw Workers' AGENCY
THIS EMPLOYS ANDSERVES
rE CompenSation JUDGMENT UNIT WITHDISABILITIES WITHOUT
PEOPLE
Board 328 STATE STREET DISCRIMINATION.
SCHENECTADY,NY 12305-2318
866-298-7830
PHYSICALTHERAPY
CAREANDREHABOFFICEP WCBEMPLOYER
#: 2428122
C. UIER #: 07-53096
1049 YONKERS AVE FEIN/SS # *****5777
YONKERS NY 10704-3035
It is hereby certified that this is a true
and correct copy of the original as filed
Workers'
with the Compensation Board
S/
* Michele A. Mealy, Esq.
DATE: 05/06/2024
FINAL NOTICE Judgment Unit
Non-Compliance
Item Description Dates Accident Date Balance Due
2023W0011616 Failure to Carry Workers' 12/25/2022-07/31/2023
Comp Ins $10,500.00
TotalBalance Due $10,500.00
*
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.
PAYMENTINSTRUCTIONS
To make online payments e-mail Biljin_g@mb.ang_oy. OR
prompt credit of your payment, complete the following with the
In order to insure
Date, Numberand Amount of your check and return it, along with your payment to:
NYSWORKERS'
COMPENSATION BOARD
PCBOX5530
BINGHAMTON,NY 13902-5530
_____..____________________Pfe_ase. e_cac_h_a_F_d_f_e!p_rp__b_9.13_om__p_9_G_i_o_F_wi!h__y_9g_p_a_y_rp_e .__________________________
MAKECHECKSPAYABLETO"COMMISSIONER
OFTAXATIONANDFINANCE".
PLEASEINCLUDE YOURWCBEMPLOYER
NUMBERONYOUR CHECK.
Employer PHYSICALTHERAPY
CAREANDREHABOFFICEP.C. WCBEmployer # 2428122
Customer ID # 1532719
Check
Check Date Check #
Amount
C-45.37 10/2023 Page 1 of 2
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FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024
Non-Compliance
Item Description Dates Accident Date Balance Due
MAKECHECKSPAYABLETO "COMMISSIONEROF TAXATIONAND FINANCE"
______________________________________________________________________
Mail payment along with this form to:
NYSWORKERS'COMPENSATION BOARD
POBOX5530
BINGHAMTON,NY 13902-5530
C-45.37 10/2023 Page 2 of 2
6 of 7
FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024
SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFWESTCHESTER
X
WORKERS'
COMPENSATION BOARDOFTHESTATEOF NEW YORK, : JUDGMENT
Plaintiff,
-against- : EMP# : 2428122
: JUD# : 2360518
PHYSICALTHERAPYCAREANDREHABOFFICEP.C. :
Defendant(s) : INDEX# :
FILING DT:
:
:
:
X
Workers'
By order of the Chair of the Compensation Board of the State of New York, demandfor the
payment of the sum of $10,500.00, representing Awards and Penalties having been made against the
above captioned Defendant(s), after due notice, having defaulted in payment thereof, except the sum of
$0.00 leaving $10,500.00 due and payable.
NOW, upon the certified copies of notices attached hereto, and upon motion of the General Counsel of
Workers'
the Compensation Board of the State of New York, attorney for Plaintiff, pursuant to Section
26 of the Workers' Compensation Law of the State of New York providing for entry of judgment by the
Workers'
County Clerk in event of such default, it is ADJUDGED,that the Plaintiff, Compensation Board
of the State of New York, 328 State Street, Schenectady, NY 12305 does recover from the
above-captioned Defendant(s), whose last known address(es) are; 1049 YONKERS AVE, YONKERS,
NY 10704-3035, respectively; the sum of $10,500.00, and the Plaintiff have execution therefore.
Judgment signed this: day of , .
Clerk
Michele A. Mealy, Esq.
Attorney for Plaintiff
Workers'
Compensation Board
328 State St.
Schenectady, NY 12305
C-45 6/2007
7 of 7
Preview
FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024 SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFWESTCHESTER X WORKERS' COMPENSATION BOARDOFTHESTATEOF NEW YORK, : Plaintiff, -against- : : PHYSICALTHERAPYCAREANDREHABOFFICEP.C. : 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 amfamiliar with the status of payment in this matter. The award/penalty/assessment/demand for deposit of security made against the defendant(s) in the amount of $10,500.00 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 demandto date, except the sum of $0.00, leaving due and payble the sum of $10,500.00. Dated: 6th day of May , 2024 . S/ Michele A. Mealy, Esq. Judgment Unit C-45.45E 1/2009 1 of 7 FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024 2 of 7 FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024 SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFWESTCHESTER X WORKERS' COMPENSATION BOARDOFTHESTATEOF NEW YORK, : Plaintiff, -against- : : PHYSICALTHERAPYCAREANDREHABOFFICEP.C. : 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. The Workers' 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 $10,500.00, 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 demandfor deposit of security, and/or a certified copy of the chair's order imposing, and the demandfor 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 $10,500.00 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: 6th day of May , 2024 S/ Michele A. Mealy, Esq. Judgment Unit C-45.1E 6/2007 3 of 7 FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024 4 of 7 FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024 STATE OFNEW YORK WORKERS'COMPENSATION BOARD NEw Workers' AGENCY THIS EMPLOYS ANDSERVES rE CompenSation JUDGMENT UNIT WITHDISABILITIES WITHOUT PEOPLE Board 328 STATE STREET DISCRIMINATION. SCHENECTADY,NY 12305-2318 866-298-7830 PHYSICALTHERAPY CAREANDREHABOFFICEP WCBEMPLOYER #: 2428122 C. UIER #: 07-53096 1049 YONKERS AVE FEIN/SS # *****5777 YONKERS NY 10704-3035 It is hereby certified that this is a true and correct copy of the original as filed Workers' with the Compensation Board S/ * Michele A. Mealy, Esq. DATE: 05/06/2024 FINAL NOTICE Judgment Unit Non-Compliance Item Description Dates Accident Date Balance Due 2023W0011616 Failure to Carry Workers' 12/25/2022-07/31/2023 Comp Ins $10,500.00 TotalBalance Due $10,500.00 * 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. PAYMENTINSTRUCTIONS To make online payments e-mail Biljin_g@mb.ang_oy. OR prompt credit of your payment, complete the following with the In order to insure Date, Numberand Amount of your check and return it, along with your payment to: NYSWORKERS' COMPENSATION BOARD PCBOX5530 BINGHAMTON,NY 13902-5530 _____..____________________Pfe_ase. e_cac_h_a_F_d_f_e!p_rp__b_9.13_om__p_9_G_i_o_F_wi!h__y_9g_p_a_y_rp_e .__________________________ MAKECHECKSPAYABLETO"COMMISSIONER OFTAXATIONANDFINANCE". PLEASEINCLUDE YOURWCBEMPLOYER NUMBERONYOUR CHECK. Employer PHYSICALTHERAPY CAREANDREHABOFFICEP.C. WCBEmployer # 2428122 Customer ID # 1532719 Check Check Date Check # Amount C-45.37 10/2023 Page 1 of 2 5 of 7 FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024 Non-Compliance Item Description Dates Accident Date Balance Due MAKECHECKSPAYABLETO "COMMISSIONEROF TAXATIONAND FINANCE" ______________________________________________________________________ Mail payment along with this form to: NYSWORKERS'COMPENSATION BOARD POBOX5530 BINGHAMTON,NY 13902-5530 C-45.37 10/2023 Page 2 of 2 6 of 7 FILED: WESTCHESTER COUNTY CLERK 06/06/2024 03:24 PM INDEX NO. 63587/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/06/2024 SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFWESTCHESTER X WORKERS' COMPENSATION BOARDOFTHESTATEOF NEW YORK, : JUDGMENT Plaintiff, -against- : EMP# : 2428122 : JUD# : 2360518 PHYSICALTHERAPYCAREANDREHABOFFICEP.C. : Defendant(s) : INDEX# : FILING DT: : : : X Workers' By order of the Chair of the Compensation Board of the State of New York, demandfor the payment of the sum of $10,500.00, representing Awards and Penalties having been made against the above captioned Defendant(s), after due notice, having defaulted in payment thereof, except the sum of $0.00 leaving $10,500.00 due and payable. NOW, upon the certified copies of notices attached hereto, and upon motion of the General Counsel of Workers' the Compensation Board of the State of New York, attorney for Plaintiff, pursuant to Section 26 of the Workers' Compensation Law of the State of New York providing for entry of judgment by the Workers' County Clerk in event of such default, it is ADJUDGED,that the Plaintiff, Compensation Board of the State of New York, 328 State Street, Schenectady, NY 12305 does recover from the above-captioned Defendant(s), whose last known address(es) are; 1049 YONKERS AVE, YONKERS, NY 10704-3035, respectively; the sum of $10,500.00, and the Plaintiff have execution therefore. Judgment signed this: day of , . Clerk Michele A. Mealy, Esq. Attorney for Plaintiff Workers' Compensation Board 328 State St. Schenectady, NY 12305 C-45 6/2007 7 of 7