Preview
FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021
SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF KINGS
X
WORKERS' :
COMPENSATION BOARD OF THE STATE OF NEW YORK,
Plaintiff,
-against- :
:
HEARTICAL UPRISING LLC :
AFFIRMATION
Defendant(s) :
OF
NON-PAYMENT
:
:
:
:
X
Workers'
The undersigned, an attorney in the officeofthe Compensation Board ofthe State ofNew
York, Plaintiffherein,hereby affirms thatthe following istrue under the penalty of perjury,upon
information and belief
Workers'
This affirmationisbased upon a review of the file
which ismaintained by the Compensation
Board initsregular course of business.
I am familiarwith the status of payment in thismatter. The award/penalty/assessment/demand for
deposit of securitymade against the defendant(s) in theamount of $40,000.00 isin default,as more
than thirtydays have elapsed since the demand upon the defendai t(s) herein forpayment. No payment
has been received nor has the aforesaid security been deposited in coiñpliaice with said demand to
date, except the sum of $0.00, leaving due and payble the sum of$40,000.00.
Dated: 17th day of Mav , 2021 .
S/
James R. McGinn, Esq.
Judgment Unit
C-45.45E 1/2009
1 of 7
FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021
2 of 7
FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021
SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF KINGS
X
WORKERS' :
COMPENSATION BOARD OF THE STATE OF NEW YORK,
Plaintiff,
-against- :
:
HEARTICAL UPRISING LLC :
AFFIRMATION
Defendant(s) :
OF
REGULARITY
:
:
:
:
X
Workers'
The undersigned, an attorney in the officeofthe Compensation Board ofthe State ofNew
York, Plaintiffherein,hereby affirms thatthe failowily istrue under the penalty of perjury,upon
information and belief
Workers'
This affirmationisbased upon a review of the file
which ismaintained by the Compensation
Board initsregular course of business.
Workers'
The Compensation Board of the State of New York, inaccordance with the provisions of the
Workers'
Compensation Law, has made an assessment/award in thesum of $40,000.00, against the
defendant(s). Attached hereto and made a part hereofare certifiedcopies of the Notice of Decision and
Award, and/or a certifiedcopy of the demand fordeposit of security,and/or a certifiedcopy ofthe chair's
order imposing, and the demand for payment of, assessments imposed by the chairpursuant to
Workers'
subdivision five ofsection fifty-twoand/or one hundred thirtyone of the Compensation Law, as
Workers'
required for of
filing 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 $40,000.00 due and payable.
WHEREFORE, it is
respectfullyrequested that judgment be entered against the Defendant(s) herein in
the sum stated as remaining due and payable.
Dated: 17th day of May , 2021
S/
James R. McGinn, Esq.
Judgment Unit
C-45.1E 6/2007
3 of 7
FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021
4 of 7
FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021
STATE OF NEW YORK
WORKERS'
"W Workers' COMPENSATION BOARD THISAGENCYEMPLOYSAND SERVES
JUDGMENT UNIT PEOPLEWITH DISABILITIESWITHOUT
ÏŸZE compensation
328 STATE STREET DISCRIMINATION.
Board
SCHENECTADY, NY 12305-2318
866-298-7830
HEARTICAL UPRISING LLC WCB EMPLOYER #: 3007886
2114A FULTON ST APT 2F UIER #: 53-38357
BROOKLYN NY 11233-3218
FEIN/SS #: *****2488
It is
hereby certified
that thisis a true
and correct copy ofthe originalas filed
Workers'
with the Compensation Board
S/
James R. McGinn, Esq.
DATE: 05/17/2021 '"dgment Unit
rartiflori
an n8/1701
Non-Comp!iance
Item Description Dates Accident Date Balance Due
2019W0018215 Failure to Workers' Ins 03/02/2019-05/09/2021 $40,000.00
Carry Comp
Total Balance Due $40,000.00
*
If payment isnot received i ediately,judgment willbe filedand the employer issubject to seizure
of assets, both business and personal, without furthernotice from the Board.
In orderto insurepron1ptcredit
of your paynient,con1pletethefollowli
g withthe
Date, Nun1ber and An1ount of yourcheck and return with
it, along your paynientto.
WORKERS'
COMPENSATION BOARD
FINANCE OFFICE
328 STATE STREET, SCHENECTADY, NY 12305-2318
Please detach and return bottom püiticiiwith your payment.
MAKE CHECKS PAYABLE TO "UNINSURED EMPLOYERS FUND".
PLEASE INCLUDE YOUR WCB EMPLOYER NUMBER ON YOUR CHECK.
E ployer HEARTICAL UPRISING LLC WCB Employer #
| 3007886
Customer ID #
Check
Check Date Check #
Amount
I
C-45.37 5/2004 Page 1 of 2
5 of 7
FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021
Non-Compliance
Item Description Dates Accident Date Balance Due
MAKE CHECKS PAYABLE TO "UNINSURED EMPLOYERS FUND".
Mail payment along with this form to:
WORKERS'
COMPENSATION BOARD
FINANCE OFFICE
328 STATE STREET
SCHENECTADY, NY 12305-2318
C-45.37 5/2004 Page 2 of 2
6 of 7
FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021
SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF KINGS
X
WORKERS' :
COMPENSATION BOARD OF THE STATE OF NEW YORK, JUDGMENT
Plaintiff,
-against- : EMP# : 3007886
: JUD# : 2123500
HEARTICAL UPRISING LLC :
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$40,000.00, representing Awards and Penalties having been made against the
above captioned Defendant(s), afterdue notice, having defaulted inpayment thereof,except the sum of
$0.00 leaving $40,000.00 due and payable.
NOW, upon the certifiedcopies of notices attached hereto,and upon motion ofthe General Counsel of
Workers'
the Compensation Board of the State of New York, attorney for pursuant
Plaintiff, toSection
Workers'
26 of the Compensation Law of the State of New York providing forentry ofjudgment by the
Workers'
County Clerk in event of such default, it is
ADJUDGED, that the Plaintiff, Compensation Board
of the Stateof New York, 328 State Street,Schenectady, NY 12305 does recover from the
above-captioned Defendant(s), whose lastknown address(es) are;2114A FULTON ST APT 2F,
BROOKLYN, NY 11233-3218, respectively; the sum of $40,000.00, and the Plaintiffhave execution
therefore.
Judgment signed this: day of
Clerk
James R. McGinn, Esq.
Attorney forPlaintiff
Workers'
Compensation Board
328 State St.
Schenectady, NY 12305
C-45 6/2007
7 of 7
Preview
FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021 SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF KINGS X WORKERS' : COMPENSATION BOARD OF THE STATE OF NEW YORK, Plaintiff, -against- : : HEARTICAL UPRISING LLC : AFFIRMATION Defendant(s) : OF NON-PAYMENT : : : : X Workers' The undersigned, an attorney in the officeofthe Compensation Board ofthe State ofNew York, Plaintiffherein,hereby affirms thatthe following istrue under the penalty of perjury,upon information and belief Workers' This affirmationisbased upon a review of the file which ismaintained by the Compensation Board initsregular course of business. I am familiarwith the status of payment in thismatter. The award/penalty/assessment/demand for deposit of securitymade against the defendant(s) in theamount of $40,000.00 isin default,as more than thirtydays have elapsed since the demand upon the defendai t(s) herein forpayment. No payment has been received nor has the aforesaid security been deposited in coiñpliaice with said demand to date, except the sum of $0.00, leaving due and payble the sum of$40,000.00. Dated: 17th day of Mav , 2021 . S/ James R. McGinn, Esq. Judgment Unit C-45.45E 1/2009 1 of 7 FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021 2 of 7 FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021 SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF KINGS X WORKERS' : COMPENSATION BOARD OF THE STATE OF NEW YORK, Plaintiff, -against- : : HEARTICAL UPRISING LLC : AFFIRMATION Defendant(s) : OF REGULARITY : : : : X Workers' The undersigned, an attorney in the officeofthe Compensation Board ofthe State ofNew York, Plaintiffherein,hereby affirms thatthe failowily istrue under the penalty of perjury,upon information and belief Workers' This affirmationisbased upon a review of the file which ismaintained by the Compensation Board initsregular course of business. Workers' The Compensation Board of the State of New York, inaccordance with the provisions of the Workers' Compensation Law, has made an assessment/award in thesum of $40,000.00, against the defendant(s). Attached hereto and made a part hereofare certifiedcopies of the Notice of Decision and Award, and/or a certifiedcopy of the demand fordeposit of security,and/or a certifiedcopy ofthe chair's order imposing, and the demand for payment of, assessments imposed by the chairpursuant to Workers' subdivision five ofsection fifty-twoand/or one hundred thirtyone of the Compensation Law, as Workers' required for of filing 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 $40,000.00 due and payable. WHEREFORE, it is respectfullyrequested that judgment be entered against the Defendant(s) herein in the sum stated as remaining due and payable. Dated: 17th day of May , 2021 S/ James R. McGinn, Esq. Judgment Unit C-45.1E 6/2007 3 of 7 FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021 4 of 7 FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021 STATE OF NEW YORK WORKERS' "W Workers' COMPENSATION BOARD THISAGENCYEMPLOYSAND SERVES JUDGMENT UNIT PEOPLEWITH DISABILITIESWITHOUT ÏŸZE compensation 328 STATE STREET DISCRIMINATION. Board SCHENECTADY, NY 12305-2318 866-298-7830 HEARTICAL UPRISING LLC WCB EMPLOYER #: 3007886 2114A FULTON ST APT 2F UIER #: 53-38357 BROOKLYN NY 11233-3218 FEIN/SS #: *****2488 It is hereby certified that thisis a true and correct copy ofthe originalas filed Workers' with the Compensation Board S/ James R. McGinn, Esq. DATE: 05/17/2021 '"dgment Unit rartiflori an n8/1701 Non-Comp!iance Item Description Dates Accident Date Balance Due 2019W0018215 Failure to Workers' Ins 03/02/2019-05/09/2021 $40,000.00 Carry Comp Total Balance Due $40,000.00 * If payment isnot received i ediately,judgment willbe filedand the employer issubject to seizure of assets, both business and personal, without furthernotice from the Board. In orderto insurepron1ptcredit of your paynient,con1pletethefollowli g withthe Date, Nun1ber and An1ount of yourcheck and return with it, along your paynientto. WORKERS' COMPENSATION BOARD FINANCE OFFICE 328 STATE STREET, SCHENECTADY, NY 12305-2318 Please detach and return bottom püiticiiwith your payment. MAKE CHECKS PAYABLE TO "UNINSURED EMPLOYERS FUND". PLEASE INCLUDE YOUR WCB EMPLOYER NUMBER ON YOUR CHECK. E ployer HEARTICAL UPRISING LLC WCB Employer # | 3007886 Customer ID # Check Check Date Check # Amount I C-45.37 5/2004 Page 1 of 2 5 of 7 FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021 Non-Compliance Item Description Dates Accident Date Balance Due MAKE CHECKS PAYABLE TO "UNINSURED EMPLOYERS FUND". Mail payment along with this form to: WORKERS' COMPENSATION BOARD FINANCE OFFICE 328 STATE STREET SCHENECTADY, NY 12305-2318 C-45.37 5/2004 Page 2 of 2 6 of 7 FILED: KINGS COUNTY CLERK 06/21/2021 11:35 AM INDEX NO. 091592/2021 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/17/2021 SUPREME COURT OF THE STATE OF NEW YORK, COUNTY OF KINGS X WORKERS' : COMPENSATION BOARD OF THE STATE OF NEW YORK, JUDGMENT Plaintiff, -against- : EMP# : 3007886 : JUD# : 2123500 HEARTICAL UPRISING LLC : 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$40,000.00, representing Awards and Penalties having been made against the above captioned Defendant(s), afterdue notice, having defaulted inpayment thereof,except the sum of $0.00 leaving $40,000.00 due and payable. NOW, upon the certifiedcopies of notices attached hereto,and upon motion ofthe General Counsel of Workers' the Compensation Board of the State of New York, attorney for pursuant Plaintiff, toSection Workers' 26 of the Compensation Law of the State of New York providing forentry ofjudgment by the Workers' County Clerk in event of such default, it is ADJUDGED, that the Plaintiff, Compensation Board of the Stateof New York, 328 State Street,Schenectady, NY 12305 does recover from the above-captioned Defendant(s), whose lastknown address(es) are;2114A FULTON ST APT 2F, BROOKLYN, NY 11233-3218, respectively; the sum of $40,000.00, and the Plaintiffhave execution therefore. Judgment signed this: day of Clerk James R. McGinn, Esq. Attorney forPlaintiff Workers' Compensation Board 328 State St. Schenectady, NY 12305 C-45 6/2007 7 of 7