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FILED: NEW YORK COUNTY CLERK 10/15/2019 12:55 PM INDEX NO. 157323/2019
NYSCEF DOC. NO. 6 RECEIVED NYSCEF: 10/15/2019
REQUEST FOR JUDICIAL INTERVENTION 58,4g°g1,)
New York Supreme COURT, COUNTY OF New York
Index No: 157323/2019 Date Index Issued: 07/26/2019 For Court Use Only:
IAS Entry Date
DEANNA ANDERSEN
Judge Assigned
-against- Plaintiff(s)/Petitioner(s)
ODYSSEY HOUSE, INC, JOHN DOE, First and Last Name Fictitious and Unknewn
RJIFiled Date
Defand=nt(s);Respondent(s)
COMMERCIAL MATRIMONIAL
O Contested
O BusinessEntity (includes corporations, partnerships, LLCs,LLPs,etc.)
NOTE: If there are children under the age of 18, complete and attach the
Contract MATRIMONDALRJRAddendum (UCS-840M).
O Insurance(where insurance company is a party, except arb!trat!en) .. . . . . .
For Uncontestedmammumanactions, use the UncontestedDivorce RJi(UD-13).
O UCC(includes sales and negotiable inst=r.ants)
O Other Commercial(specify):
TORTS
NOTE: For CommercialDivision assignment requests pursuant to 22 NYCRR202.70(d),
complete and attach the COMMERCIALDEVISIONRJRADDENDUM (UCS-840C). Asbestos
O Child Victims Act
REAL PROPERTY: Specify how many properties the application includes: . .
Env........-nt:. (specify):
O Condemnation Medical,Dental, or Podiatric Malpractice
O Mortgage Foreclosure(specify): O Residential O Commercial O Motor Vehicle
Property Address: O ProductsLiability (specify):
NOTE: For Mortgage Foreclosureactions involving a one to four-family, owner- O Other Negligence(specify):
occupied residential property or owner-occupiedcondominium, complete and O Other ProfessionalMalpractice (specify):
attach the FORECLOSURERJRADDENDUM (UCS-840F). Other Tort (specify): NEGLIGENCE
Tax Certiorari - Section: Block: Lot:
Tax Foreclosure SPECIAL PROCEEDINGS
O Other Real Property (specify): O CPLRArticle 75 (Arbitration) [see NOTE in COMMERCIALsection]
OTHER MATTERS
O CPLRArticle 78 (Body or Officer)
O Election Law
O Certificate of Incorporatior.;-|..u|d;sn [see NOTE in COMMERCIALsection] Extreme Risk ProtectionOrder
O Emergency MedicalTreatment MHLArticle 9.60 (Kendra's Law)
O HabeasCorpus O MHLArticle 10 (Sex Offender Confinement-Initial)
O LocalCourt Appeal MHLArticle 10 (Sex Offender Confinement-Review)
O Mechanic'sLien MHLArticle 81 (Guardianship)
O NameChange O Other Mental Hygiene (specify):
Pistol Permit Revocation Hearing O Other Special Proceeding(specify):
O Saleor Financeof Religious/Not-for-ProfitProperty
O Other (specify):
STATUS OF ACTION OR PROCEEDING: AnswerYESor NOfor every question and enter additional information where indicated.
YES NO
Hasa summons and complaint or summonswith notice been filed? O If yes, date filed: 07/26/2019
Hasa summons and complaint or summonswith notice been served? O If yes, date served: 08/06/2019
Is this action/proceeding being filed post-judgment? O If yes, judgment date:
NATURE OF JUDICIAL INTEiüfENTION: Checkone box only and enter additional infomet!on where indicated.
O Infant's Compromise
O Extreme Risk ProtectionOrder Application
O Note of Issue/Certificateof Readiness
O Notice of Medical, Dental, or Podiatric Malpractice Date Issuejoined:
Notice of Motion Relief Requested: Return Date:
O
Notice of Petition Relief Requested: Return Date:
O
Order to ShowCause Relief Requested: Return Date:
O
Other Ex ParteApplication Relief Requested:
O
O PoorPersonApplication
Requestfor Preliminary Conference
O ResidentialMortgage ForeclosureSe++!ementConference
O Writ of HabeasCorpus
O Other (specify):
1 of 2
FILED: NEW YORK COUNTY CLERK 10/15/2019 12:55 PM INDEX NO. 157323/2019
RELATED CASES: List any related actions. For Matrimonial cases, list any related criminal or Family Court cases. If none, leave blank. If additional space
NYSCEF DOC. NO. 6 is required, complete and attach the RJI Addendum (UCS-840A). RECEIVED NYSCEF: 10/15/2019
Case Title Index/Case Number Court Judge (if assigned) Relationship to instant case
PARTIES: For parties without an attorney, check the "Un-Rep" box and enter the party's address, phone number and email in the space
provided. If additional space is required, complete and attach the RJI Addendum (UCS-840A).
Un- Parties Attorneys and/or Unrepresented Litigants Issue Joined Insurance Carriers
Rep List parties in same order as listed in the For represented parties, provide attorney's name, firm name, address, phone For each defendant, For each defendant,
caption and indicate roles (e.g., plaintiff, and email. For unrepresented parties, provide party's address, phone and indicate if issue has indicate insurance
defendant; 3rdparty plaintiff, etC.) email. beenjoined. carrier, if applicable.
Name: ANDERSEN,DEANNA SETHMILBAUER,GREENSTEIN & MILBAUER,LLP,1825 ParkAvenue 9th Floor,
New York, NY 10035, 212-685-8500, smilbauer@nyclawfirm.com 2 YES O NO
Role(s):Plaintiff/Petitioner
Name: ODYSSEY
HOUSE,INC ERICKOPLOWITZ, HARDIN,KUNDLA,MCKEON& POLETTO,110 William St FL
24 , New York, NY 10038, ekoplowitz@hkmpp.com O YES O NO
Role(s):Defendant/Respondent
Name:JOHNDOE,First and Last Name
Fictitious and Unknown
O YES O NO
Role(s):Defendant/Respondent
Name:
0 YES 0 NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
0 YES 0 NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
0 YES 0 NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
0 YES 0 NO
Role(s):
Name:
O YES O NO
Role(s):
Name:
O YES O NO
Role(s):
I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED ACTIONS OR
PROCEEDINGS, EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FORJUDICIAL INTERVENTION BEEN PREVIOUSLY FILED IN THIS
ACTION OR PROCEEDING.
Dated: 10/15/2019 ERIC J. KOPLOWITZ
Signature
5083845 ERIC J. KOPLOWITZ
Attorney Registration Number Print Name
This form was generated by NYSCEF
2 of 2
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FILED: NEW YORK COUNTY CLERK 10/15/2019 12:55 PM INDEX NO. 157323/2019 NYSCEF DOC. NO. 6 RECEIVED NYSCEF: 10/15/2019 REQUEST FOR JUDICIAL INTERVENTION 58,4g°g1,) New York Supreme COURT, COUNTY OF New York Index No: 157323/2019 Date Index Issued: 07/26/2019 For Court Use Only: IAS Entry Date DEANNA ANDERSEN Judge Assigned -against- Plaintiff(s)/Petitioner(s) ODYSSEY HOUSE, INC, JOHN DOE, First and Last Name Fictitious and Unknewn RJIFiled Date Defand=nt(s);Respondent(s) COMMERCIAL MATRIMONIAL O Contested O BusinessEntity (includes corporations, partnerships, LLCs,LLPs,etc.) NOTE: If there are children under the age of 18, complete and attach the Contract MATRIMONDALRJRAddendum (UCS-840M). O Insurance(where insurance company is a party, except arb!trat!en) .. . . . . . For Uncontestedmammumanactions, use the UncontestedDivorce RJi(UD-13). O UCC(includes sales and negotiable inst=r.ants) O Other Commercial(specify): TORTS NOTE: For CommercialDivision assignment requests pursuant to 22 NYCRR202.70(d), complete and attach the COMMERCIALDEVISIONRJRADDENDUM (UCS-840C). Asbestos O Child Victims Act REAL PROPERTY: Specify how many properties the application includes: . . Env........-nt:. (specify): O Condemnation Medical,Dental, or Podiatric Malpractice O Mortgage Foreclosure(specify): O Residential O Commercial O Motor Vehicle Property Address: O ProductsLiability (specify): NOTE: For Mortgage Foreclosureactions involving a one to four-family, owner- O Other Negligence(specify): occupied residential property or owner-occupiedcondominium, complete and O Other ProfessionalMalpractice (specify): attach the FORECLOSURERJRADDENDUM (UCS-840F). Other Tort (specify): NEGLIGENCE Tax Certiorari - Section: Block: Lot: Tax Foreclosure SPECIAL PROCEEDINGS O Other Real Property (specify): O CPLRArticle 75 (Arbitration) [see NOTE in COMMERCIALsection] OTHER MATTERS O CPLRArticle 78 (Body or Officer) O Election Law O Certificate of Incorporatior.;-|..u|d;sn [see NOTE in COMMERCIALsection] Extreme Risk ProtectionOrder O Emergency MedicalTreatment MHLArticle 9.60 (Kendra's Law) O HabeasCorpus O MHLArticle 10 (Sex Offender Confinement-Initial) O LocalCourt Appeal MHLArticle 10 (Sex Offender Confinement-Review) O Mechanic'sLien MHLArticle 81 (Guardianship) O NameChange O Other Mental Hygiene (specify): Pistol Permit Revocation Hearing O Other Special Proceeding(specify): O Saleor Financeof Religious/Not-for-ProfitProperty O Other (specify): STATUS OF ACTION OR PROCEEDING: AnswerYESor NOfor every question and enter additional information where indicated. YES NO Hasa summons and complaint or summonswith notice been filed? O If yes, date filed: 07/26/2019 Hasa summons and complaint or summonswith notice been served? O If yes, date served: 08/06/2019 Is this action/proceeding being filed post-judgment? O If yes, judgment date: NATURE OF JUDICIAL INTEiüfENTION: Checkone box only and enter additional infomet!on where indicated. O Infant's Compromise O Extreme Risk ProtectionOrder Application O Note of Issue/Certificateof Readiness O Notice of Medical, Dental, or Podiatric Malpractice Date Issuejoined: Notice of Motion Relief Requested: Return Date: O Notice of Petition Relief Requested: Return Date: O Order to ShowCause Relief Requested: Return Date: O Other Ex ParteApplication Relief Requested: O O PoorPersonApplication Requestfor Preliminary Conference O ResidentialMortgage ForeclosureSe++!ementConference O Writ of HabeasCorpus O Other (specify): 1 of 2 FILED: NEW YORK COUNTY CLERK 10/15/2019 12:55 PM INDEX NO. 157323/2019 RELATED CASES: List any related actions. For Matrimonial cases, list any related criminal or Family Court cases. If none, leave blank. If additional space NYSCEF DOC. NO. 6 is required, complete and attach the RJI Addendum (UCS-840A). RECEIVED NYSCEF: 10/15/2019 Case Title Index/Case Number Court Judge (if assigned) Relationship to instant case PARTIES: For parties without an attorney, check the "Un-Rep" box and enter the party's address, phone number and email in the space provided. If additional space is required, complete and attach the RJI Addendum (UCS-840A). Un- Parties Attorneys and/or Unrepresented Litigants Issue Joined Insurance Carriers Rep List parties in same order as listed in the For represented parties, provide attorney's name, firm name, address, phone For each defendant, For each defendant, caption and indicate roles (e.g., plaintiff, and email. For unrepresented parties, provide party's address, phone and indicate if issue has indicate insurance defendant; 3rdparty plaintiff, etC.) email. beenjoined. carrier, if applicable. Name: ANDERSEN,DEANNA SETHMILBAUER,GREENSTEIN & MILBAUER,LLP,1825 ParkAvenue 9th Floor, New York, NY 10035, 212-685-8500, smilbauer@nyclawfirm.com 2 YES O NO Role(s):Plaintiff/Petitioner Name: ODYSSEY HOUSE,INC ERICKOPLOWITZ, HARDIN,KUNDLA,MCKEON& POLETTO,110 William St FL 24 , New York, NY 10038, ekoplowitz@hkmpp.com O YES O NO Role(s):Defendant/Respondent Name:JOHNDOE,First and Last Name Fictitious and Unknown O YES O NO Role(s):Defendant/Respondent Name: 0 YES 0 NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: 0 YES 0 NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: 0 YES 0 NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): Name: 0 YES 0 NO Role(s): Name: O YES O NO Role(s): Name: O YES O NO Role(s): I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED ACTIONS OR PROCEEDINGS, EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FORJUDICIAL INTERVENTION BEEN PREVIOUSLY FILED IN THIS ACTION OR PROCEEDING. Dated: 10/15/2019 ERIC J. KOPLOWITZ Signature 5083845 ERIC J. KOPLOWITZ Attorney Registration Number Print Name This form was generated by NYSCEF 2 of 2