Preview
FILED: CAYUGA COUNTY CLERK 05/03/2021 11:35 AM INDEX NO. E2021-0440
NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 05/03/2021
REQUEST FOR JUDICIAL INTERVENTION (r.°o°‡ªe)°om
(
SUPREME COURT, COUNTY OF _CAYUGA
Index No: Date Index Issued: F C rtl S
CAPTfO te the p ½ case caption.
Do notuse et al or et ano. If more
space is neededattacha caption'rideE
sheat) IAS Entry Date
In theMatter of theApp!!cat!onof ChristopherJames Teresa
Santillo, Ann Bosch and Stephen
Anthony Bosch
Plaintiff(s)/Petitioner(s) udge Assigned
-against-
New York State Department of Health, Vital Records Section
- RAFiled Date
Defendant(s)/Respondent(s)
NATURE OF ACTldN OR PROrpen!NG Check only one box and specify where
indicated.
COMN RICIAL. -
O BusinessEntity (includes corporations, partnerships, LLCs,LLPs,etc.)
Q Contested
O Contract NOTE: If there are children under the age of 18, complete and attach the
O Insurance (where insurance company is a party, except erbitration) MA'Em"- .RJi ADDENDU^ñ(UCS-840M).
O UCC(includes salesand negotlable instr=:nts) For Uncontested M--:2: actions, use the Uncontested Divorce RJI(UD-13).
O Other Commercial (specify): TORTS
NOTE:For CommercialDivisionassignment requests pursuant to 22 NYCRR202.70(d),
Q Asbestos
complete and attach the COMMERC!ALDIVISIONRJiADDENDUM (UCS-840C). O Child Victims Act
REALPRdPÛTY ecify how many properties the application includes:O Ene:=ental (specify):
O Condemnation O Medical, Dental or Podiatric Malpractice
O Mortgage Foreclosure(specify):O Residential O commercial O Motor Vehicle
Property Address: O Products Liability (specify):
NOTE:For Mortgage Foreclosureactions involving a one to|w
|=ity, O Other Negligence (specify):
owner-occupied residential property or owner-occupied condominium,O Other Professional Malpractice (specify):
complete and attach the FORECLOSURE
RJIADDENDUM (UCS-840F). O Other Tort (specify):
O Tax Certlorarl SPECIALPROCEEDINGS
O Tax Foreclosure O CPLRArticle 75 (Arbitration) [see NOTEin COMMERCIALsection]
O Other Real Property (specify): O CPLRArticle 78 (Body or Officer)
OTHEllNÃWi . O Election Law
O certificate of Incorp=t
en/Dissolution (see NOTEin COMurac!ALsection) O Extreme RiskProtection Order
O Emergency Medical Treatment O MHL Article 9.60 (Kendra's Law)
O HabeasCorpus O MHL Article 10 (SexOffender Conf|n=:nt-Initlal)
O LocalCourt Appeal O MHL Article 10 (SexOffender Confinement-Review)
O Mechanic's Llen O MHL Article 81 (rk!erdbnship)
O Name Change O Other Mental Hygiene (specify):
O Pistol Permit Revocation Hearing O Other Special Proceeding (specify):
O Saleor Financeof Religious/Not-for-Profit Property
RealeaseBirth Certificate
Other (specify):
STATUS OhACTION OR P¤WEruNG Answer YESor NO forevery questionand enter !±±2tbñ where Indicated
YES NO
Hasa summons and complaint or summons with notice been filed? O @ If yes, date filed:
Hasa summons and complaint or summons with notice been served? Q @ If yes, date served:
Is this action/proceeding being filed post-judgment? Q ® If yes, Judgment date:
NÂt0REWJGDkÏALINTIfRVENTION Check one box only and enter
additionaliformst:onwhere indicated.
O infant's Compromise
O Extreme RiskProtection Order Application
O Note of issue/Certificate of Readiness
O Notice of Medical, Dental or Podiatric Malpractice
Date IssueJoined:
O Notice of Motion Relief Requested: Return Date:
@ Notice of Petition Relief Requested: Return Date:
O Order to Show Cause Relief Requested: Return Date:
O Other ExParte Application Relief Requested:
O Poor PersonApplication
O Requestfor Preliminary Conference
O Residential Mortgage ForeclosureSétt|ëmbñ
Conference
Q Writ of HabeasCorpus
O Other (specify):
1 of 2
FILED: CAYUGA COUNTY CLERK 05/03/2021 11:35 AM INDEX NO. E2021-0440
NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 05/03/2021
RELATED CAS S Llsany related For Matrimonial
actions. criminal
cases, list any related or Family Court leave plànk.
cases. ,If,none,
d é(fditional
space is required,
completeand attachtheRJ1ADDENDU_M (UCS-840A). . .C .
CaseTitle Index/Case Number Court |judge (if assigned)IP.e½t 9 to instant case
:r fFor "Un-Rep"
PARTIES A partieswithout check the
an attorney, box and enter
the party's
address,phone number pnd emanin the spdge proylded.
space is required,
f hdditional completeand attachthe RJi ADDENDUM (UCS-840A).
Un- Parties Attorneysand Unrepresented Utigants Issue oined Insurance Carriers
Rep Ust parties in sameorder as listed In the
For represented parties, provide attorney's name, firm name, address, phone and For each d^'^~'-"
For each defend::nt,
email For unrcp.cwiited
caption and indicate roles (e g , pialntiff, parties, provide party's address, phone and email
indicate if issue has
indicate insurance
__ defendant, 3"I party plaintiff, etc ) been loined carrier, If applicable.
Name Ciifi5topher JamesSantillO BruceSteves,Esq.,Jonessteves,68WestAvenue,P.O.Box4400,Saratoga
NewYork
Springs,
12866,Phone:(S18)s87-0080,
Email:bsteves@saratogalaw.com O YES @ NO NA
Petitioner
Name Teresa Ann Bosch BruceSteves,
Esq.,jonesSteves,
68WestAvenue,P.O.Box4400,saratogasprings,NewYork
Email:bsteves@saratogalaw.com
12866,Phone:(s18)587-0080, O YES @ NO N/A
Petitioner
Stephen AnthonyBosch BruceSteves,Esq.,Jonessteves,68WestAvenue,P.O.Box4400,Saratoga
NewYork
Springs,
o (s). YES NO
12866,Phone:(518)587-0080,
Email:bsteves@saratogalaw.com O ® N/A
Name
Role(s): NewYorkStateAttorney GenerarsOffice,TheCapitol,Albany,NewYork 12224-0341
O YES @ NO N/A
Respondent
Name:
Role(s): O YES O NO
Name:
Role(s): O YES O NO
Name:
Role(s): O YES O NO
Name:
Role(s): O YES O NO
Name:
Role(s): Q YES O NO
Name:
Role(s): O YES O NO
Name:
Role(s): O YES O NO
Name:
Role(s): O YES O NO
Name:
Role(s): O YES O NO
Name:
Role(s): O YES Q NO
Name:
Role(s): O YES O NO
I
I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED A TIONS OR PROCEEDINGS,
EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FOR JUD!C!At INTERVENTION B PRE USLY FIL IN T SA 10 OR PROCEEDING.
Dated: 04/29/2021
4994158 Bruce D. Steves
Attorney RegistrationNumber PrintName
2 of 2
Preview
FILED: CAYUGA COUNTY CLERK 05/03/2021 11:35 AM INDEX NO. E2021-0440 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 05/03/2021 REQUEST FOR JUDICIAL INTERVENTION (r.°o°‡ªe)°om ( SUPREME COURT, COUNTY OF _CAYUGA Index No: Date Index Issued: F C rtl S CAPTfO te the p ½ case caption. Do notuse et al or et ano. If more space is neededattacha caption'rideE sheat) IAS Entry Date In theMatter of theApp!!cat!onof ChristopherJames Teresa Santillo, Ann Bosch and Stephen Anthony Bosch Plaintiff(s)/Petitioner(s) udge Assigned -against- New York State Department of Health, Vital Records Section - RAFiled Date Defendant(s)/Respondent(s) NATURE OF ACTldN OR PROrpen!NG Check only one box and specify where indicated. COMN RICIAL. - O BusinessEntity (includes corporations, partnerships, LLCs,LLPs,etc.) Q Contested O Contract NOTE: If there are children under the age of 18, complete and attach the O Insurance (where insurance company is a party, except erbitration) MA'Em"- .RJi ADDENDU^ñ(UCS-840M). O UCC(includes salesand negotlable instr=:nts) For Uncontested M--:2: actions, use the Uncontested Divorce RJI(UD-13). O Other Commercial (specify): TORTS NOTE:For CommercialDivisionassignment requests pursuant to 22 NYCRR202.70(d), Q Asbestos complete and attach the COMMERC!ALDIVISIONRJiADDENDUM (UCS-840C). O Child Victims Act REALPRdPÛTY ecify how many properties the application includes:O Ene:=ental (specify): O Condemnation O Medical, Dental or Podiatric Malpractice O Mortgage Foreclosure(specify):O Residential O commercial O Motor Vehicle Property Address: O Products Liability (specify): NOTE:For Mortgage Foreclosureactions involving a one to|w |=ity, O Other Negligence (specify): owner-occupied residential property or owner-occupied condominium,O Other Professional Malpractice (specify): complete and attach the FORECLOSURE RJIADDENDUM (UCS-840F). O Other Tort (specify): O Tax Certlorarl SPECIALPROCEEDINGS O Tax Foreclosure O CPLRArticle 75 (Arbitration) [see NOTEin COMMERCIALsection] O Other Real Property (specify): O CPLRArticle 78 (Body or Officer) OTHEllNÃWi . O Election Law O certificate of Incorp=t en/Dissolution (see NOTEin COMurac!ALsection) O Extreme RiskProtection Order O Emergency Medical Treatment O MHL Article 9.60 (Kendra's Law) O HabeasCorpus O MHL Article 10 (SexOffender Conf|n=:nt-Initlal) O LocalCourt Appeal O MHL Article 10 (SexOffender Confinement-Review) O Mechanic's Llen O MHL Article 81 (rk!erdbnship) O Name Change O Other Mental Hygiene (specify): O Pistol Permit Revocation Hearing O Other Special Proceeding (specify): O Saleor Financeof Religious/Not-for-Profit Property RealeaseBirth Certificate Other (specify): STATUS OhACTION OR P¤WEruNG Answer YESor NO forevery questionand enter !±±2tbñ where Indicated YES NO Hasa summons and complaint or summons with notice been filed? O @ If yes, date filed: Hasa summons and complaint or summons with notice been served? Q @ If yes, date served: Is this action/proceeding being filed post-judgment? Q ® If yes, Judgment date: NÂt0REWJGDkÏALINTIfRVENTION Check one box only and enter additionaliformst:onwhere indicated. O infant's Compromise O Extreme RiskProtection Order Application O Note of issue/Certificate of Readiness O Notice of Medical, Dental or Podiatric Malpractice Date IssueJoined: O Notice of Motion Relief Requested: Return Date: @ Notice of Petition Relief Requested: Return Date: O Order to Show Cause Relief Requested: Return Date: O Other ExParte Application Relief Requested: O Poor PersonApplication O Requestfor Preliminary Conference O Residential Mortgage ForeclosureSétt|ëmbñ Conference Q Writ of HabeasCorpus O Other (specify): 1 of 2 FILED: CAYUGA COUNTY CLERK 05/03/2021 11:35 AM INDEX NO. E2021-0440 NYSCEF DOC. NO. 11 RECEIVED NYSCEF: 05/03/2021 RELATED CAS S Llsany related For Matrimonial actions. criminal cases, list any related or Family Court leave plànk. cases. ,If,none, d é(fditional space is required, completeand attachtheRJ1ADDENDU_M (UCS-840A). . .C . CaseTitle Index/Case Number Court |judge (if assigned)IP.e½t 9 to instant case :r fFor "Un-Rep" PARTIES A partieswithout check the an attorney, box and enter the party's address,phone number pnd emanin the spdge proylded. space is required, f hdditional completeand attachthe RJi ADDENDUM (UCS-840A). Un- Parties Attorneysand Unrepresented Utigants Issue oined Insurance Carriers Rep Ust parties in sameorder as listed In the For represented parties, provide attorney's name, firm name, address, phone and For each d^'^~'-" For each defend::nt, email For unrcp.cwiited caption and indicate roles (e g , pialntiff, parties, provide party's address, phone and email indicate if issue has indicate insurance __ defendant, 3"I party plaintiff, etc ) been loined carrier, If applicable. Name Ciifi5topher JamesSantillO BruceSteves,Esq.,Jonessteves,68WestAvenue,P.O.Box4400,Saratoga NewYork Springs, 12866,Phone:(S18)s87-0080, Email:bsteves@saratogalaw.com O YES @ NO NA Petitioner Name Teresa Ann Bosch BruceSteves, Esq.,jonesSteves, 68WestAvenue,P.O.Box4400,saratogasprings,NewYork Email:bsteves@saratogalaw.com 12866,Phone:(s18)587-0080, O YES @ NO N/A Petitioner Stephen AnthonyBosch BruceSteves,Esq.,Jonessteves,68WestAvenue,P.O.Box4400,Saratoga NewYork Springs, o (s). YES NO 12866,Phone:(518)587-0080, Email:bsteves@saratogalaw.com O ® N/A Name Role(s): NewYorkStateAttorney GenerarsOffice,TheCapitol,Albany,NewYork 12224-0341 O YES @ NO N/A Respondent Name: Role(s): O YES O NO Name: Role(s): O YES O NO Name: Role(s): O YES O NO Name: Role(s): O YES O NO Name: Role(s): Q YES O NO Name: Role(s): O YES O NO Name: Role(s): O YES O NO Name: Role(s): O YES O NO Name: Role(s): O YES O NO Name: Role(s): O YES Q NO Name: Role(s): O YES O NO I I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED A TIONS OR PROCEEDINGS, EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FOR JUD!C!At INTERVENTION B PRE USLY FIL IN T SA 10 OR PROCEEDING. Dated: 04/29/2021 4994158 Bruce D. Steves Attorney RegistrationNumber PrintName 2 of 2