On June 15, 2021 a
Request,Application
was filed
involving a dispute between
Workers' Compensation Board Of The State Of New York,
and
Dac Medical Pc,
for Other Matters - Workers Comp App for Judgment
in the District Court of Suffolk County.
Preview
FILED: SUFFOLK COUNTY CLERK 06/15/2021 03:49 PM INDEX NO. 611329/2021
(78)14444505-1
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/15/2021
SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF SUFFOLK
X
WORKERS' YORK,:
COMPENSATION BOARD OF THE STATE OF NEW JUDGMENT
Plaintiff, :
-against- : EMP# : 397151
: JUD# : 2120911
DAC MEDICAL PC :
Defendant(s) : INDEX # :
:
FILING DT:
:
. -X
Workers'
By order of the Chair of the Compensation Board of the State of New York, demand for the
payment of the sum of $18,000.00, representing Awárds and PeñâIties having been made against the
above capticñed Defendant(s), afterdue notice, having defau!ted in payment thereof, except the sum of
$2,205.04 leaving $15,794.96 due and payable.
NOW, upon the certifiedcopies 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
Workers'
26 ofthe Compensation Law ofthe State of New York previdiñg for entry of judgment by the
Workers'
County Clerk in event of such default, itisADJUDGED, that the Plaintiff, Compensatica Board
of the State of New York, 328 State Street, Schenectady, NY 12305 does recover from the
above-captioned Defendant(s), whose lastknown address(es) are; 422 GREAT EAST NECK RD UNIT
C, WEST BABYLON, NY 11704-7628, respectively; the sum of $15,794.96, and the Plaintiffhave
execution therefore.
Judgment signed this: day of _ ,
Clerk
James R. McGinn, Esq.
Attorney for Plaintiff
Workers'
Compensation Board
328 State St.
Schenectady, NY 12305
C-45 6/2007
(78)14444505-1
1 of 1
Document Filed Date
June 15, 2021
Case Filing Date
June 15, 2021
Category
Other Matters - Workers Comp App for Judgment
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FILED: SUFFOLK COUNTY CLERK 06/15/2021 03:49 PM INDEX NO. 611329/2021 (78)14444505-1 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/15/2021 SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF SUFFOLK X WORKERS' YORK,: COMPENSATION BOARD OF THE STATE OF NEW JUDGMENT Plaintiff, : -against- : EMP# : 397151 : JUD# : 2120911 DAC MEDICAL PC : Defendant(s) : INDEX # : : FILING DT: : . -X Workers' By order of the Chair of the Compensation Board of the State of New York, demand for the payment of the sum of $18,000.00, representing Awárds and PeñâIties having been made against the above capticñed Defendant(s), afterdue notice, having defau!ted in payment thereof, except the sum of $2,205.04 leaving $15,794.96 due and payable. NOW, upon the certifiedcopies 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 Workers' 26 ofthe Compensation Law ofthe State of New York previdiñg for entry of judgment by the Workers' County Clerk in event of such default, itisADJUDGED, that the Plaintiff, Compensatica Board of the State of New York, 328 State Street, Schenectady, NY 12305 does recover from the above-captioned Defendant(s), whose lastknown address(es) are; 422 GREAT EAST NECK RD UNIT C, WEST BABYLON, NY 11704-7628, respectively; the sum of $15,794.96, and the Plaintiffhave execution therefore. Judgment signed this: day of _ , Clerk James R. McGinn, Esq. Attorney for Plaintiff Workers' Compensation Board 328 State St. Schenectady, NY 12305 C-45 6/2007 (78)14444505-1 1 of 1