FILED: ONTARIO COUNTY CLERK 10/12/2020 04:24 PM
`NYSCEF DOC. NO. 22
`
`202010130133
`
`REQUEST
`
`FOR JUDICIAL
`
`INTERVENTION
`
`INDEX NO. 127226-2020
`
`RECEIVED NYSCEF: 10/12/2020
`Index
`# : 127226-2020
`
`Ontario
`
`Supreme
`
`COURT, COUNTY OF Ontario
`
`Index No:
`
`127226-2020
`
`Date Index
`
`Issued:
`
`06/04/2020
`
`For Court Use Only:
`
`Route 96 Propsties
`
`LLC
`
`-against-
`
`.tures
`
`in Movement
`
`and 9netian
`
`Inc, Mark Klyczek
`
`pfsheet.
`
`IAS Entry Date
`
`Plaintiff(s)/Petitioner(s)
`
`Judge Assigned
`
`RJIFiled Date
`
`naha®wc),"espondent(s)
`
`nd s ecify-whereindicated.
`MATRIMONIAL
`Contested
`O
`NOTE: If there are children under the age of 18, complete and attach the
`MATRIMONDALRJRAddendum (UCS-840M).
`For UncontestedMatrimonial actions, use the Uncen*ªstedDivorce RJi(UD-13).
`
`COMMERCIAL
`O BusinessEntity (includes corperet!ens,partnerships, LLCs,LLPs,etc.)
`Contract
`O Insurance(where insurancecompany is a party, except arbitration)
`O UCC(includes salesand negotiable instruments)
`O Other Commercial(specify):
`NOTE: For CommercialDivision assignment requestspursuant to 22 NYCRR202.70(d),
`complete and attach the COMMERCIALDEVISIONRJRADDENDUM (UCS-840C).
`Specifyhow many properties the application includes:
`REAL PROPERTY:
`O Condemnation
`O MortgageForeclosure(specify): O iiesiuerdioi
`PropertyAddress:
`NOTE: ForMortgage Foreclosureactions involving a one to four-family, owner-
`occupiedresidential property or owner-occupiedcondominium, complete and
`attach the FORECLDSURERJRADDENDUM (UCS-840F).
`Tax Certiorari - Section:
`Block:
`Tax Foreclosure
`O Other RealProperty (specify):
`OTHER MATTERS
`O Certificate of incorporatior./Disc:ution
`O EmergencyMedicalTreatment
`O HabeasCorpus
`O LocalCourtAppeal
`O Mechanic'sLien
`O NameChange
`PistolPermit RevocationHearing
`O Saleor Financeof Religious/Not-for-ProfitProperty
`O Other (specify):
`STATUS OF ACTION OR PROCEEDING:
`
`O Commercial
`
`Lot:
`
`[see NOTE in COMMERCIALsection]
`
`| TORTS
`Asbestos
`O ChildVictims Act
`
`Medical,Dental, or PodiatricMalpractice
`O MotorVehicle
`O ProductsLiability (specify):
`O Other Negligence(specify):
`O Other ProfessionalMalpractice(specify):
`O Other Tort (specify):
`
`| SPECIAL PROCEEDINGS
`[see NOTE in COMMERCIALsection]
`O CPLRArticle 75 (Arbitration)
`O CPLRArticle 78 (Bodyor Officer)
`O ElectionLaw
`Extreme RiskProtectionOrder
`MHLArticle 9.60 (Kendra'sLaw)
`O MHLArticle 10 (SexOffender Confinement-:.iitial)
`MHLArticle 10 (SexOffender Cunniinierrieuit-Review)
`MHLArticle 81 (Guardianship)
`O Other Mental Hygiene (specify):
`O Other SpecialProceeding(specify):
`
`AnswerYESor NOfor every question and enter additional information where indicated.
`YES NO
`O
`O
`
`If yes, date filed:
`If yes, date served:
`If yes,judgment date:
`O
`Checkone box only and enter additional information where indicated.
`
`06/04/2020
`07/07."020
`
`Hasa summonsand complaint or summonswith notice been filed?
`Hasa summonsand complaint or summonswith notice been served?
`Is this action/proceedingbeing filed pon-judgment?
`NATURE OF JUDICIAL
`INTEiüfENTION:
`O Infant's Compromise
`O Extreme RiskProtectionOrderApplication
`O Note of Issue/Certificateof Readiness
`O Notice of Medical,Dental, or PodiatricMalpractice
`Notice of Motion
`O Notice of Petition
`O Order to ShowCause
`O Other Ex ParteApplication
`O PoorPersonApplication
`O Requestfor PreliminaryConference
`O ResidentialMortgageForeclosureSe*!ement Conference
`O Writ of HabeasCorpus
`O Other (specify):
`
`Date Issuejoined:
`ReliefRequested:
`ReliefP.equeMad:
`ReliefRequested:
`ReliefRequested:
`
`Judgment- Summary
`
`Return Date:
`Return Date:
`Return Date:
`
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`202010130133
`
`FILED: ONTARIO COUNTY CLERK 10/12/2020 04:24 PM
`NYSCEF DOC. NO. 22
`
`INDEX NO. 127226-2020
`Index #: 127226-2020
`
`RECEIVED NYSCEF: 10/12/2020
`
`RELATED CASES: List any related actions. For Matrimonial cases, list any related criminal or Family Court cases. If none, leave blank. If additional space
`is required, complete and attach the RJI Addendum (UCS-840A).
`Index/Case Number
`Court
`
`Judge (if assigned)
`
`Relationship to instant case
`
`Case Title
`
`PARTIES:
`Parties
`List parties in same order as listed in the
`caption and indicate roles (e.g., plaintiff,
`defendant; 3rd party plaintiff, etc.)
`Name: Route 96 Properties LLC
`
`Un-
`Rep
`
`☐
`
`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).
`Attorneys and/or Unrepresented Litigants
`Issue Joined
`For represented parties, provide attorney's name, firm name, address, phone
`For each defendant,
`and email. For unrepresented parties, provide party's address, phone and
`indicate if issue has
`email.
`been joined.
`MICHAEL WEGMAN, LACY KATZEN LLP, 600 Bausch and
`Lomb Pl , Rochester, NY 14604,
`mwegman@lacykatzen.com
`
`Insurance
`For each defendant,
`indicate insurance
`carrier, if applicable.
`
`☒ YES ☐ NO
`
`Role(s): Plaintiff/Petitioner
`
`☐
`
`☐
`
`☐
`
`☐
`
`☐
`
`☐
`
`☐
`
`☐
`
`☐
`
`Name: Adventures in Movement
`and Sensation Inc
`Role(s): Defendant/Respondent
`
`EDWARD KENYON, KENYON & KENYON, 11 NORTH ST STE
`100 , CANANDAIGUA, NY 14424, 585-394-2068,
`Russ@kenyonandkenyonlaw.com
`
`☒ YES ☐ NO
`
`Name: Klyczek, Mark
`
`Role(s): Defendant/Respondent
`
`EDWARD KENYON, KENYON & KENYON, 11 NORTH ST STE
`100 , CANANDAIGUA, NY 14424, 585-394-2068,
`Russ@kenyonandkenyonlaw.com
`
`☒ YES ☐ NO
`
`Name:
`
`Role(s):
`
`Name:
`
`Role(s):
`
`Name:
`
`Role(s):
`
`Name:
`
`Role(s):
`
`Name:
`
`Role(s):
`
`Name:
`
`Role(s):
`
`Name:
`
`Role(s):
`
`☐ YES ☐ NO
`
`☐ YES ☐ NO
`
`☐ YES ☐ NO
`
`☐ YES ☐ NO
`
`☐ YES ☐ NO
`
`☐ YES ☐ NO
`
`☐ YES ☐ NO
`
`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 FOR JUDICIAL INTERVENTION BEEN PREVIOUSLY FILED IN THIS
`ACTION OR PROCEEDING.
`
`Dated:
`
`10/12/2020
`
`4799839
`Attorney Registration Number
`
`This form was generated by NYSCEF
`
`MICHAEL JOSEPH WEGMAN
`Signature
`
`MICHAEL JOSEPH WEGMAN
`Print Name
`
`2 of 2
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