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FILED: CLINTON COUNTY CLERK 07/27/2021 10:23 AM INDEX NO. 2021-00021376
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 07/27/2021
REQUEST FOR JUDICIAL INTERVENTION For Court CIMUse Only:
UCS-840 (7/2012) IAS t:ntry Date
Supreme COURT, COUNTY OF Clinton
Index No: Date Index Issued:
EMeKth t'e‡e s t Wor ét anö e
capt(ong Do If iWFréspãcë3s i#pulted,
CAEIlON
attact
a caption rideñsheet CM
TRUSTWORTHY LLC,
P!e!nt\Hin}jpgunc::er(s)
-against-
THE ASSESSOR(S) FOR THE TOWN OF PLATTSBURGH, THE BOARD OF ASSESSMENT REVIEW FOR THE TOWN OF
PLATTSBURGH, AND THE TOWN OF PLATTSBURG INTHE COUNTY OF CLINTON, NEW YORK,
Defendant(s)/Respondent(s)
NAEl E F T1ÔÑ OR PROCEEDING ecli OÑE boxenly d ecifyiM têd
MATRIMONIAL COMMERCIAL
Contested Ü Business Entity Unc!ed n s, padñs,t.;=,
LLCs, etc.)
NOTE: O Conirect
For all Matrimonial actions where the parties have children under
RJi Addendum.
the age of 18, complete and attach the MATRIMONIAL O :ñs ,us (where insurer is a party, except ±M-
For Uncontested Matrimonial actions, use RJI form UD-13. O UCC (including sales, negotiable instruments)
TORTS O Other Commercial:
(*P''W)
O Asbestos
Q Breast implant NOTE: For CommercialDivision assignment
requests [22 NYCRR §
Q E ±: ::'-!: complete and attach the COMMERCIAL
202.70(d)], DIV RJI Addendum.
(8Pech) REAL PROPERTY: How many propertiesdoes the applicationinclude?1
O Medica , Dental, or Podiatric Mâ:prâctice Condemnation
O Motor Vehicle O Mortgage FGM- 3 (specny): O Residential O Commerciai
O Products Llability: Property Address:
(specify) StreetAddress City State Zip
O Other Negligence: NOTE: For Mortgage Foreclosure actions Involving a one- to four-family,
(specify) OWner-occupied, raaidantie! property, or an owner-occupied
O Other Professional Malpractice: :::-':=!!:=,complete and attach the FORECLOSURERJi Addend==.
(spech)
_
TaX CertlOrari - SeCliOn:206.4 Block:4 Lot: 8
O Other Tort: ____ O Tax Foreclosure
(spech) Û Other Real Property:
OTHER MATTERS ("P°'W)
O Certificate of Incorporatian/D
-:-ñ[see NOTE under Cammerc!e!] SPECIAL PROCEEDINGS
O E=êa÷ñcy Medical Treatment O [see NOTE under Commercial]
CPLR Article 75 (A±!t::t!::‡
O Habeas Corpus O CPLR Article 78 (Body or Officer)
O Local Court Appeal O Election Law
O Mechanic's Lien O MHL Article 9.60 (Kendra's Law)
O Name Change Q MHL Article 10 (Sex Offenderce@•~~"
M":Q
O Pistol Permit Revocation Hearing O MHL Article 10 (Sex OffenderC
===d-Deview)
O Sale or Finance of Rü;|g|ous!Nct fcr-Profit
Property Q MHL Article 81 (Güs.L...J.W)
Q Other: ____ O Other Mental Hygiene:
(specify) (specify)
O Other Special Proceeding:
(speciM
STATUS OF ÂCTibN ÖIE PRÒÖ EDING: E ÑÎÖÂFíÊ lÊ1 Ù ÃíÃÂNO nteÊ r
|YES| NO
Has a summons and cGinp:â:ñt or cu-ámene w/notice been filed? If yes, date filed:
Has a armmene and complaint or ;:==cn:
w/notice been served? If yes, date served:
Is this -L.4, miiñÿ being filed pc:t : t? If yes, judgment
date:
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FILED: CLINTON COUNTY CLERK 07/27/2021 10:23 AM INDEX NO. 2021-00021376
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 07/27/2021
 ÜÑEDÑUóÌâÅÏEIÑTERVEÑŸlÔN ri(Èhi ÅÑ h
O intent's Compromise
O Note of Issue and/or Certificate of Ree
e99
O Notice of Medical, Dental, or Podiatric Maipractice
Date issue Joined:
O Notice of Motion Relief Sought: Return Date:
O Notice of Petition Relief Sought:Tax AssessmentReview Retum Date: 9/17/21
(on submission)
O Order to Show Cause Relief Sought: Retum Date:
O Other Ex Parte App!!cet!en Relief Sought:
O Poor Person Application
O Request for Preliminary C=nfGrêñc.a
O Writ of Habeas Corpus
O Other (specify):
List any related actions.
For =rc¶:! actions, Include any related criminal and/or Farnity Court cases.
RELATED CASES ° ' e if odd!!!:n‡!
space is required,.complete
and attach the RJI Addc=du=.
if none, leave blankt
Case Title Index/Case No. [Court Judge (ifassigned) Relationship to InstantCase
, For parties without an attomey, check "Un-Rep" box AND'enter
party addressiphone
number and e-tnaII address in space provided.
PARTIES.
if additional space Is required$onipleté
and attilch the R3I Ãddendum.
|Parties: . Attorneys and/or Unrepresented Litigants:
Un- . laauc
List parties In.caption order andProvide attomey name, firm name, business address, phone number and e-mail Insurance
Joined
Rep indicate party rofe(s) (e.gi dafendent;
address of all attomeys that have appeared In the case.
For "=; n.2d . Carrier(s):
3rd-party plaintiff). litigants, provide address, phone number and e-mall address
LLC
Trustworthy VlacLeod Kevin
LastName LastName FirstName
3PENO MACLEOD, PLLC
FirstName FirmName
PrimaryRole: 'OBox 152 Baldwinsville NewYork 13027
Petitioner streetAddress City state Zip
secondaryRole(Ifany): 3154096614 kevin@spenomacleod.com
Phone Fax e-mail
Assessor; Town of MüüGürgh;
and
LastName LastName FirstName
P!attsburgh BAR
FirstName FirmName
X p, ma,yRoie: g151BankerRoad Plattsburgh New York 12901
Respondent streetAddress state
city Zip
secondaryRole(if any):
Phone Fax e-mail
LastName LastName FirstName
FirstName FirmName
PrimaryRole:
streetAddress City state Zip
secondaryRole(if any): O
Phone Fax e-maii
LastName LastName FirstName
FirstName FirmName
PrimaryRole:
StreetAddress City state Zip
secondaryRole(if any): O
Phone Fax e-mail
I AFFIRM UNDER THE PENALTY OF PERJURY THAT, TO MY KNOWLEDGE, OTHER THAN AS NOTED ABOVE, THERE ARE AND HAVE
BEEN NO RELATED ACTIONS OR PROCEED!NGS, NOR HAS A REQUEST FOR JUDICIAL INTERVENTION PREVIOUSLY BEEN FILED IN
THIS ACTION OR PROCEEDING.
Dated: July26. 2021
GNATUAE
5192265 Kevin MacLeod, Esq
ATTORNEY REGISTRATION NUMBER PRINT OR TYPE NAME
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