Preview
FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019
REQUESTFOR JUDICIAL INTERVENTION 5M5885EE@RdEE959ERER
everaceh94AS.Entry.·Datemwgames.
®
supreme C RT, COUNTY OF
• ....1...udge Ass gned .!c :-aw.. .
Index No: O Date Index issued: 4
PETWONER (5)
Plaintiff(s)/Petitioner(s)
.egainst-
RJI APPP
ciudin
O Uncontested O Contrac
'
NOTE: actions
For all Matrimonisi where the parties
have children
onder O insurance(yvhere insurer is a party,
e scept arb t n
18, completeand attachtheMATRIMONIAL RJI Addendum. 019
the age of O UCC (including negotiable
sales, inst:
:meras)
O Other Commercial:
Asbestos '
Q . N LC FICE
O Breast Implant NOTE: For Commercing,Division
aàB '
compietêíiffr3ldiftach
the CIAL D I AddGr.d::=.
O Edden=cnte!: 202.70(d)],
O Medical,Dental, Malpractice
or Podiatric Cðhdemnation
O Motor Vehicle syre
e ress:
O ProductsLlability:
-
(8PeclM street city State 2ip
O Other Negligence: r Foreclosure a one- to four-family,
ons involving owner-
(Spedff) residential
property,or an owner-occupied
condorninium,
and attach
O Other Profesebne!Malpractice: complefe the FORECLOSURE RJi Addendurn:
(*PacIM Tax Certiorari-
Section: Lot•
Block:
O Other Tort: O OtherReal Property:
(5PedM (specify)
6ffiÈÉRÂll$ÈR5WMil$8 J$f$W$M$Ns@$fSt WWS WÑÈCÏÂWfI5RdCÈÈDÏfÑ$3MMNtmenve@&isemmXw
O of Incorpqration/Dissolution
Certificate [seeNOTE under Commsiciaij O PLR Article75 (A±!!rc2er) [seeNOTE under Commerciall
Q Emergency MedicalTreatment CPLR Article78(Body orOfficer)
O Habeas Corpus O ElectionLaw
O Ldcal Court Appeal O MHL Article9.60(Kendra'sLaw)
Q Mechanic's Lien . O MHL Article10 (sex offender Continernent-Initial)
O Name Change O MHL Article10 (Sex offender Confinernent-Review)
O PistolPermitRevocationHearing Q MHL Article81 (Guardianship)
.O of Religious/Not-for-Profit
Sale or Finance Property Q Other MentalHygiene:
(specify)
O Other:
("P°°
O OtherSpecial Proceeding:
-. (Sp8Gfry)
1 of 7
FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019
O and/or Certificate
ore of issue of Readiness
dr Podfatric
off,ce of Medical, Dental, Malpractice Date issue Joined
Noticeof Motion Relief
Sought: Refum Date:
Noticeof Petiffon Relief Sought: Retum Date: GM
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 ForeciosureSettlementConference
O writof sabeas corpus
O Other (specify):
LastName LastName FÝrstName
StreetAddress City State Zip
secondaryRole(if any):
Phone Fax e-rnalf.
. . LastName ame Name
FirstName FirmNa a
PrimaryRols: .
StreetAddress city State Zip
NO
SecondaryRote(lf any):
Phone Fax einall
. LastName LastName FirstName
YES
FirstName FirmName
PrimaryRole:
StreatAddress City State Zlp .
NO
SecondaryRole(if any);
Phone Fax e-mail
LastMame LastName FirstName
FirstName FirmNarne
PrimaryRole:
StreetAddress City State Zip
SecondaryRole(3rany):
Phone Fax e-mail
.
I AFFIRM
.....-
UNDER
.-.. ..--. -
THE PENALTY
-.
OF
,.
PERJURY
-.-,
THAT,
---...--...--
TO MY
2
..--
of 7
KNOWLEDGE,
.. .
OTHER THAN AS NOTED ABOVE, THERE ARE AND
FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019
LPrint in black ink all areas in bold letters.]
S PREME COURT OF THE STATE OF NEW YORK
COUNTY OF NEW YORK
--------------- ---
-------------x index Nuinber
In the Matter of e Application of
[fill in name(s)] Petitioner(s) NOTICE OF PETITION
- against -
FILED
ow , APR 25 2019
[fill in name(s)] Respondent(s)
CLERK'S OFFICE
- x
COUNTY
NEW YORK
P EASE TA NOTI E that upon the verified petition(s) of
h , [your name(s)], swom to on , 200
[date Verified Petition notarized], and the attached exhibits, petitioner(s) will request this Court,
at 9:30 AM on the E day of , 200 ___, [return date] at the Courthouse, at
60 Centre Street, New York, N. Y.,in the Motion Support Courtroom, Room 130, for a judgment,
pursuant to the Civil Practice Law and Rules (CPLR), granting the following relief to the
petitioner(s): [briefly describ what you re askin the Court to do)
and for h oth r and further relief as this Court may deem just and proper.
Dated: , 200 Res e Ilysubmitte ,
[date signed]
To: Respondent(s) Petitioner(s)
[your name, address, telephone number ]
3 of 7
FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019
[Pririt in b_1acf ink to fill in the spaces next to the instructions]
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF NEW YORK
-
__-----------------------------------------------x /600
In the Matter the Application o Index Nuniber
[fillin name(s)] Petitioner(s)
- against -
VERIFIED PETITION
[fill in name(s)] Respondent(s)
-------------------------------x
TO THE SUPREME COURT OFTHE STATE F NEW YORK, COUNTY OF NEW YORK:
The petition of [your name] respectfully
shows to this Court as follows:
Pet i sides at
[your address]
2. The respo de t(s) is/ re [identify t e r sponde (s)]
3. [Describe what you are requesting. Add more pages if needed. If you are appealing
the decision of a government agency, give the date and outcome of the final determination.
E plain why this Court should reverse that decision ]
4 of 7
FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019
4. Attached are copies of all relevant documents. [Attach the decision you are asking the
court to reverse as Exhibit A. Attach any other documents as Exhibit B, Exhibit C, and so
on. List additi nal E hibits on eparate page.
Exhibit A -
Exhibit B -
Exhibit C -
Exhibit D - .
Exhibit E -
5. A prior applicatio has no has [circle one] been rnade for the relief now requested.
[If you made this application before in this or other court , describe where, when, the
any
result and you are making itagain.]
why 5 of 7
FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019
WHEREFORE, your deponent sts that this Court de c ibe what
respectfully [ y
. you are requesting]: ( T f 1
,20 ,
date signed] titioner [sign your name]
[ rint your name]
[your address and telephone n ]
VERIFICATION
STATE OF NEW YORK
COUNTY OF : ss:
[your name), being duly sworn,
deposes and says that: I am the petitioner in this proceeding; I have read the foregoing petition
and know the contents thereof; the same is true to my own knowledge, except as to matters
therein stated to be alleged on information and belief; and as to those matters I believe itto be
true. .
Sworn to before me on
1 day p
r : I , 209 Petitioner [sig y r name i front of a Notary]
Nota [print your name]
Deborah Uz Estrella
Nota Public, of York 6 of 7
FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019
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Preview
FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019 REQUESTFOR JUDICIAL INTERVENTION 5M5885EE@RdEE959ERER everaceh94AS.Entry.·Datemwgames. ® supreme C RT, COUNTY OF • ....1...udge Ass gned .!c :-aw.. . Index No: O Date Index issued: 4 PETWONER (5) Plaintiff(s)/Petitioner(s) .egainst- RJI APPP ciudin O Uncontested O Contrac ' NOTE: actions For all Matrimonisi where the parties have children onder O insurance(yvhere insurer is a party, e scept arb t n 18, completeand attachtheMATRIMONIAL RJI Addendum. 019 the age of O UCC (including negotiable sales, inst: :meras) O Other Commercial: Asbestos ' Q . N LC FICE O Breast Implant NOTE: For Commercing,Division aàB ' compietêíiffr3ldiftach the CIAL D I AddGr.d::=. O Edden=cnte!: 202.70(d)], O Medical,Dental, Malpractice or Podiatric Cðhdemnation O Motor Vehicle syre e ress: O ProductsLlability: - (8PeclM street city State 2ip O Other Negligence: r Foreclosure a one- to four-family, ons involving owner- (Spedff) residential property,or an owner-occupied condorninium, and attach O Other Profesebne!Malpractice: complefe the FORECLOSURE RJi Addendurn: (*PacIM Tax Certiorari- Section: Lot• Block: O Other Tort: O OtherReal Property: (5PedM (specify) 6ffiÈÉRÂll$ÈR5WMil$8 J$f$W$M$Ns@$fSt WWS WÑÈCÏÂWfI5RdCÈÈDÏfÑ$3MMNtmenve@&isemmXw O of Incorpqration/Dissolution Certificate [seeNOTE under Commsiciaij O PLR Article75 (A±!!rc2er) [seeNOTE under Commerciall Q Emergency MedicalTreatment CPLR Article78(Body orOfficer) O Habeas Corpus O ElectionLaw O Ldcal Court Appeal O MHL Article9.60(Kendra'sLaw) Q Mechanic's Lien . O MHL Article10 (sex offender Continernent-Initial) O Name Change O MHL Article10 (Sex offender Confinernent-Review) O PistolPermitRevocationHearing Q MHL Article81 (Guardianship) .O of Religious/Not-for-Profit Sale or Finance Property Q Other MentalHygiene: (specify) O Other: ("P°° O OtherSpecial Proceeding: -. (Sp8Gfry) 1 of 7 FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019 O and/or Certificate ore of issue of Readiness dr Podfatric off,ce of Medical, Dental, Malpractice Date issue Joined Noticeof Motion Relief Sought: Refum Date: Noticeof Petiffon Relief Sought: Retum Date: GM 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 ForeciosureSettlementConference O writof sabeas corpus O Other (specify): LastName LastName FÝrstName StreetAddress City State Zip secondaryRole(if any): Phone Fax e-rnalf. . . LastName ame Name FirstName FirmNa a PrimaryRols: . StreetAddress city State Zip NO SecondaryRote(lf any): Phone Fax einall . LastName LastName FirstName YES FirstName FirmName PrimaryRole: StreatAddress City State Zlp . NO SecondaryRole(if any); Phone Fax e-mail LastMame LastName FirstName FirstName FirmNarne PrimaryRole: StreetAddress City State Zip SecondaryRole(3rany): Phone Fax e-mail . I AFFIRM .....- UNDER .-.. ..--. - THE PENALTY -. OF ,. PERJURY -.-, THAT, ---...--...-- TO MY 2 ..-- of 7 KNOWLEDGE, .. . OTHER THAN AS NOTED ABOVE, THERE ARE AND FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019 LPrint in black ink all areas in bold letters.] S PREME COURT OF THE STATE OF NEW YORK COUNTY OF NEW YORK --------------- --- -------------x index Nuinber In the Matter of e Application of [fill in name(s)] Petitioner(s) NOTICE OF PETITION - against - FILED ow , APR 25 2019 [fill in name(s)] Respondent(s) CLERK'S OFFICE - x COUNTY NEW YORK P EASE TA NOTI E that upon the verified petition(s) of h , [your name(s)], swom to on , 200 [date Verified Petition notarized], and the attached exhibits, petitioner(s) will request this Court, at 9:30 AM on the E day of , 200 ___, [return date] at the Courthouse, at 60 Centre Street, New York, N. Y.,in the Motion Support Courtroom, Room 130, for a judgment, pursuant to the Civil Practice Law and Rules (CPLR), granting the following relief to the petitioner(s): [briefly describ what you re askin the Court to do) and for h oth r and further relief as this Court may deem just and proper. Dated: , 200 Res e Ilysubmitte , [date signed] To: Respondent(s) Petitioner(s) [your name, address, telephone number ] 3 of 7 FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019 [Pririt in b_1acf ink to fill in the spaces next to the instructions] SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF NEW YORK - __-----------------------------------------------x /600 In the Matter the Application o Index Nuniber [fillin name(s)] Petitioner(s) - against - VERIFIED PETITION [fill in name(s)] Respondent(s) -------------------------------x TO THE SUPREME COURT OFTHE STATE F NEW YORK, COUNTY OF NEW YORK: The petition of [your name] respectfully shows to this Court as follows: Pet i sides at [your address] 2. The respo de t(s) is/ re [identify t e r sponde (s)] 3. [Describe what you are requesting. Add more pages if needed. If you are appealing the decision of a government agency, give the date and outcome of the final determination. E plain why this Court should reverse that decision ] 4 of 7 FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019 4. Attached are copies of all relevant documents. [Attach the decision you are asking the court to reverse as Exhibit A. Attach any other documents as Exhibit B, Exhibit C, and so on. List additi nal E hibits on eparate page. Exhibit A - Exhibit B - Exhibit C - Exhibit D - . Exhibit E - 5. A prior applicatio has no has [circle one] been rnade for the relief now requested. [If you made this application before in this or other court , describe where, when, the any result and you are making itagain.] why 5 of 7 FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019 WHEREFORE, your deponent sts that this Court de c ibe what respectfully [ y . you are requesting]: ( T f 1 ,20 , date signed] titioner [sign your name] [ rint your name] [your address and telephone n ] VERIFICATION STATE OF NEW YORK COUNTY OF : ss: [your name), being duly sworn, deposes and says that: I am the petitioner in this proceeding; I have read the foregoing petition and know the contents thereof; the same is true to my own knowledge, except as to matters therein stated to be alleged on information and belief; and as to those matters I believe itto be true. . Sworn to before me on 1 day p r : I , 209 Petitioner [sig y r name i front of a Notary] Nota [print your name] Deborah Uz Estrella Nota Public, of York 6 of 7 FILED: NEW YORK COUNTY CLERK 08/09/2019 01:58 PM INDEX NO. 100622/2019 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 08/09/2019 o o >- >c a o C O o n O O & 5 oc m O O O o ø m O D- zO o m o m o 7 of 7