FILED: KINGS COUNTY CLERK 10/13/ :29 AM INDEX NO /2016 NYSCEF DOC. NO. 10 RECEIVED NYSCEF: 10/13/ PDF Free Download

FILED: KINGS COUNTY CLERK 10/13/2016 10:29 AM INDEX NO. 513727/2016 NYSCEF DOC. NO. 10 RECEIVED NYSCEF: 10/13/2016 SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DEMAND FOR NAMES OF ATTORNEYS DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., PLEASE TAKE NOTICE, that pursuant to Rule 2103 (e) of the CPLR, you are hereby required to serve upon SHAUB, AHMUTY, CITRIN & SPRATT, attorneys for the defendant(s) within ten (10) days of joinder of issue a list of those who appear in this action and the names and addresses of their attorneys. Dated: New York, New York October 13, 2016 By: ANDREW T. SHEELEY, ESQ. SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC 77 Water Street (212) 599-8200 OUR FILE NO.: 1011-00027 TO: Arnold I. Goldstein GOLDSTEIN & GOLDSTEIN Attorneys for Plaintiff 26 Court Street, 20 th Floor Brooklyn, NY 11242 (718) 855-0551 File No: 16-10991 1 of 26

SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., DEMAND FOR EXPERT WITNESS INFORMATION PLEASE TAKE NOTICE, that demand is hereby made upon you, pursuant to CPLR Section 3101(d) to produce: 1. The names of any and all persons plaintiff expects to call as expert witnesses at the time of trial of the above-captioned action. 2. In reasonable detail, a written statement as to the qualifications of each expert witness to be called, in a medical malpractice action, including but not limited to: a. The undergraduate school attended by such expert, with the year of graduation; b. The medical school attended by such expert, with the year of graduation; c. The institutions attended by the expert in connection with any internship, residency, fellowship, or other specialized training, and the dates of such attendance; d. The expert s area(s) of specialization; e. In the case of a board-certified expert, the name of each certifying board and the year of certification; f. State(s) of licensure in the United States. If not licensed to practice in the United States, a statement as to where licensure was attained; 2 of 26

g. The title of any text authored, contributed to, or edited by, the expert, together with an appropriate citation (by name of publication, volume number, date, or other appropriate identifying matter); and h. The title of any articles authored, contributed to, or edited by, the expert, together with an appropriate citation (by name of publication, volume number, date, or other appropriate identifying matter). 3. In reasonable detail, a statement as to the subject matter upon which the expert is expected to testify. 4. In reasonable detail, the substance of the facts and opinions on which each expert is expected to testify. 5. In reasonable detail, a summary of the grounds for each expert s opinion [including records, textbooks, treatises and/or articles relied on]. Dated: New York, New York October 13, 2016 By: ANDREW T. SHEELEY, ESQ. SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC 77 Water Street (212) 599-8200 OUR FILE NO.: 1011-00027 TO: Arnold I. Goldstein GOLDSTEIN & GOLDSTEIN Attorneys for Plaintiff 26 Court Street, 20 th Floor Brooklyn, NY 11242 (718) 855-0551 File No: 16-10991 3 of 26

SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., DEMAND FOR COLLATERAL SOURCE INFORMATION COUNSEL: PLEASE TAKE NOTICE, that pursuant to CPLR 4545(a), a demand is hereby made for plaintiff to provide the undersigned with a verified statement setting forth: l. Whether plaintiff has been reimbursed or indemnified for physician expenses claimed in this action from Blue Cross/Blue Shield, Major Medical insurance coverage, or other health or disability insurance coverage or collateral source. a. If the answer to the foregoing is in the affirmative, state for which of such claims plaintiff has received payment, the amount thereof and the name and address of the person, firm or organization who made such payment. b. If such payment was made by an insurance company, state the number of the policy under which the payment was made. 2. Whether plaintiff has made claim for payment for physician expenses which have not as yet been paid. a. If the answer to the foregoing is in the affirmative, state the name of the person, firm or organization to whom such claim was presented, the date of presentation and the amount claimed. b. If such claim was presented to an insurance company, state the number of the policy under which such presentation was made. 4 of 26

3. Whether plaintiff has been reimbursed or indemnified for hospital expenses claimed in this action from Blue Cross/Blue Shield, Major Medical insurance coverage, or other health or disability insurance coverage or collateral source. a. If the answer to the foregoing is in the affirmative, state for which of such claims plaintiff has received payment, the amount thereof, and the name and address of the person, firm or organization who made such payment. b. If such payment was made by an insurance company, state the number of the policy under which the payment was made. 4. Whether plaintiff has made claim for payment for hospital expenses which has not as yet been paid. a. If the answer to the foregoing is in the affirmative, state the name of the person, firm or organization to whom such claim was presented, the date of presentation and the amount claimed. b. If such claim was presented to an insurance company, state the number of the policy under which such presentation was made. 5. Whether plaintiff has been reimbursed or indemnified for medical costs, including, but not limited to nursing service, physical therapy or other rehabilitative training, counseling service, home care, mediation and medical apparatus claimed in this action from Blue Cross/Blue Shield, Major Medical insurance coverage, or other health or disability insurance coverage or collateral source. a. If the answer to the foregoing is in the affirmative, state for which of such claims plaintiff has received payment, the amount thereof and the name and address of the person, firm or organization who made such payment. b. If such payment was made by an insurance company, state the number of the policy under which the payment was made. 6. Whether plaintiff has made claim for payment for medical costs which has not yet been paid. a. If the answer to the foregoing is in the affirmative, state the name of the person, firm or organization to whom such claim was presented, the date of presentation and the amount claimed. b. If such claim was presented to an insurance company, state the number of the policy under which such presentation was made. 5 of 26

7. Whether plaintiff has been reimbursed or indemnified for loss of earnings claimed in this action from Social Security (except those benefits provided under Title XVIII of the Social Security Act), Worker's Compensation, Union benefits, employee benefit plan or any other collateral source. a. If the answer to the foregoing is in the affirmative, state for which of such claims plaintiff has received payment, the amount thereof and the name and address of the person, firm or organization who made such payment. b. If such payment was made by an insurance company, state the number of the policy under which the payment was made. 8. Whether plaintiff has made claim for payment for loss of earnings which has not as yet been paid. a. If the answer to the foregoing is in the affirmative, state the name of the person, firm or organization to whom such claim was presented, the date of presentation and the amount claimed. b. If such claim was presented to an insurance company, state the number of the policy under which such presentation was made. 9. Whether plaintiff has been reimbursed or indemnified for any other special damage claimed in this action from any collateral source. a. If the answer to the foregoing is in the affirmative, state for which of such claims plaintiff has received payment, the amount thereof and the name and address of the person, firm or organization who made such payment. b. If such claim was presented to an insurance company, state the number of the policy under which such presentation was made. l0. Whether plaintiff has made claim for payment for any other special damage which has not as yet been paid. a. If the answer to the foregoing is in the affirmative, state the name of the person, firm or organization to whom such claim was presented, the date of presentation and the amount claimed. b. If such claim was presented to an insurance company, state the number of the policy under which such presentation was made. PLEASE TAKE FURTHER NOTICE, that your failure to comply with the foregoing demand within twenty (20) days will result in a motion for appropriate relief. 6 of 26

Dated: New York, New York October 13, 2016 By: ANDREW T. SHEELEY, ESQ. SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC 77 Water Street (212) 599-8200 OUR FILE NO.: 1011-00027 TO: Arnold I. Goldstein GOLDSTEIN & GOLDSTEIN Attorneys for Plaintiff 26 Court Street, 20 th Floor Brooklyn, NY 11242 (718) 855-0551 File No: 16-10991 7 of 26

SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., NOTICE FOR DISCOVERY AND INSPECTION OF STATEMENTS PLEASE TAKE NOTICE, that pursuant to CPLR 3101(e), you are hereby required to produce and permit discovery by the attorneys for defendant(s) of the following documents, statements and things for inspection at the offices of SHAUB, AHMUTY, CITRIN & SPRATT, LLP, 77 Water Street, within twenty (20) days after receipt of this Notice. 1. All writings and/or documents made by the defendant, its agents, servants, or employees, whether current or formerly employed including but not limited to bills, records, reports, correspondence, notes, insurance forms, prescriptions and any other memorandum in the possession or control of plaintiffs or their representatives and/or attorneys. 2. Any and all original statements made by the defendant, its agents, servants or employees to plaintiffs, their agents, servants, or representatives. 3. With respect to any statements made by the defendant, its agents, servants or employees which were not reduced to writing, state the names and addresses of each and every individual who spoke, discussed or otherwise communicated with the defendant together with any notes or memoranda made by such individuals with respect to each such conversation, discussion or review. Said inspection September also be made by means of furnishing photocopies within twenty (20) days after receipt of this Notice. 8 of 26

PLEASE TAKE FURTHER NOTICE, that defendant will object to the introduction of any mentioned documents, statements or things in evidence at trial if plaintiff fails to comply with this notice of discovery and inspection. Dated: New York, New York October 13, 2016 By: ANDREW T. SHEELEY, ESQ. SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC 77 Water Street (212) 599-8200 OUR FILE NO.: 1011-00027 TO: Arnold I. Goldstein GOLDSTEIN & GOLDSTEIN Attorneys for Plaintiff 26 Court Street, 20 th Floor Brooklyn, NY 11242 (718) 855-0551 File No: 16-10991 9 of 26

SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., DEMAND FOR NAMES OF WITNESSES PLEASE TAKE NOTICE, that pursuant to Article 31 of the CPLR, the undersigned demands that you produce within twenty (20) days the following items for discovery and inspection. 1. The name and address of each person claimed to be a witness to the following: (a) (b) (c) (d) The occurrence alleged in plaintiff's complaint; Any acts, omissions or conditions which allegedly caused the occurrence; The nature and duration of any alleged condition which caused the occurrence; Any actual notice given to the defendant or claimed to be given to the defendant. If no such witnesses are known to you, then so state under oath in reply to this demand. The undersigned will object at the time of trial to the testimony of any persons not so identified. PLEASE TAKE FURTHER NOTICE, that the foregoing are continuing demands and supplemental responses up to the time of trial are required. Failure to provide the aforesaid items within twenty (20) days after receipt of this notice will leave you subject to the provisions of the CPLR. 10 of 26

SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., DEMAND FOR MEDICAL INFORMATION AND REPORTS PLEASE TAKE NOTICE, that you are hereby required to serve upon SHAUB, AHMUTY, CITRIN & SPRATT, LLP, attorneys for defendant(s) within twenty (20) days after receipt of this demand, the following: l. Copies of all medical reports of those doctors and other licensed professional persons who have treated and/or examined the plaintiff with respect to the claimed injuries and medical conditions. The reports shall include a detailed recital of said injuries and conditions as to which testimony will be offered at the trial, referring to and identifying those x-rays and other reports which will be offered, or testified to, at the trial. 2. Duly executed and acknowledged HIPAA compliant authorizations permitting, to obtain photostatic copies and have full disclosure of all such records comprising medical treatment rendered to plaintiff before, during and after the claimed malpractice. Dated: New York, New York October 13, 2016 By: ANDREW T. SHEELEY, ESQ. SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC 77 Water Street (212) 599-8200 OUR FILE NO.: 1011-00027 12 of 26

TO: Arnold I. Goldstein GOLDSTEIN & GOLDSTEIN Attorneys for Plaintiff 26 Court Street, 20 th Floor Brooklyn, NY 11242 (718) 855-0551 File No: 16-10991 13 of 26

SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DEMAND FOR PHOTOGRAPHS DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., PLEASE TAKE NOTICE, that pursuant to Article 31 of the CPLR, the undersigned demands that you produce within twenty (20) days any and all photographs in the possession, custody and or control of the plaintiff or the plaintiff's representatives depicting any of the injuries which are alleged in the complaint. If no such photograph is in the possession, custody or control of the plaintiff or the plaintiff's representatives, then so state under oath in reply to this Demand. Dated: New York, New York October 13, 2016 By: ANDREW T. SHEELEY, ESQ. SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC 77 Water Street (212) 599-8200 OUR FILE NO.: 1011-00027 TO: Arnold I. Goldstein GOLDSTEIN & GOLDSTEIN Attorneys for Plaintiff 26 Court Street, 20 th Floor Brooklyn, NY 11242 (718) 855-0551 File No: 16-10991 14 of 26

SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., NOTICE FOR DISCOVERY AND INSPECTION OF EMPLOYMENT RECORDS AND INCOME TAX RETURNS PLEASE TAKE NOTICE, that the plaintiff is required to produce for discovery, inspection and copying by counsel for defendant, the following: 1. The names and address of all institutions, firms, corporations, partnerships, persons or others by whom the decedent was employed by or from whom the decedent received salary and/or income benefits for the past five (5) years prior to decedent's demise. 2. Duly executed authorizations to permit SHAUB, AHMUTY, CITRIN & SPRATT, LLP, to obtain the records of the aforesaid with respect to the decedent's earnings, positions, title, working capacity, record of attendance, record of illness and employment status. 3. In the event that the decedent was self-employed, an independent contractor, employed by relatives, or in the presence of any other special circumstances, it is demanded that the plaintiff provide duly executed authorizations to permit the defendant to obtain copies of any and all federal, state and city income tax returns for the years specified in item 1, and it is further demanded that the plaintiff produce for copying and inspection all W-2 forms for the years specified in item 1. It is requested that the aforesaid production be made within twenty (20) days of the date herein at 10:00 a.m. at the law offices of SHAUB, AHMUTY, CITRIN & SPRATT, 77 Water Street,. 15 of 26

SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., DEMAND FOR LETTERS OF ADMINISTRATION, DEATH CERTIFICATE AND AUTOPSY REPORT PLEASE TAKE NOTICE, that pursuant to the CPLR, you are hereby required to furnish to the undersigned copies of: 1. Letters of Administration; 2. Autopsy Report; 3. Death Certificate. PLEASE TAKE FURTHER NOTICE, that failure to provide the above mentioned items within twenty (20) days after receipt of this Notice, will leave you subject to the provisions of the CPLR. PLEASE TAKE FURTHER NOTICE, that failure to comply with this demand will serve as a basis for a motion to preclude the plaintiff upon the trial of this action from offering proof relative to medical damages, if such authorizations and/or records are not forthcoming within twenty (20) days after service of a copy of the within Demand. Dated: New York, New York October 13, 2016 By: ANDREW T. SHEELEY, ESQ. SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC 77 Water Street (212) 599-8200 OUR FILE NO.: 1011-00027 17 of 26

TO: Arnold I. Goldstein GOLDSTEIN & GOLDSTEIN Attorneys for Plaintiff 26 Court Street, 20 th Floor Brooklyn, NY 11242 (718) 855-0551 File No: 16-10991 18 of 26

SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DEMAND FOR AD DAMNUM DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., PLEASE TAKE NOTICE, that defendant, request(s) a supplemental demand setting forth the damages to which the plaintiff deems himself/herself entitled, in accordance with the provisions of CPLR 3017(c). Dated: New York, New York October 13, 2016 By: ANDREW T. SHEELEY, ESQ. SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC 77 Water Street (212) 599-8200 OUR FILE NO.: 1011-00027 TO: Arnold I. Goldstein GOLDSTEIN & GOLDSTEIN Attorneys for Plaintiff 26 Court Street, 20 th Floor Brooklyn, NY 11242 (718) 855-0551 File No: 16-10991 19 of 26

TO: Arnold I. Goldstein GOLDSTEIN & GOLDSTEIN Attorneys for Plaintiff 26 Court Street, 20 th Floor Brooklyn, NY 11242 (718) 855-0551 File No: 16-10991 21 of 26

SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., DEMAND FOR DISCLOSURE OF MEDICARE BENEFITS/ELIGIBILITY PLEASE TAKE NOTICE that demand is hereby made that plaintiff(s) provide the following information pursuant to 42 U.S.C. Section 1395y(b)(8)(A): 1. Has plaintiff been the recipient of Medicare benefits? 2. Is plaintiff currently the recipient of Medicare benefits? 3. If plaintiff has or is currently receiving Medicare benefits, please provide the following: a. State the full name under which plaintiff was/is receiving Medicare benefits. b. State plaintiff s full address, including city, state and zip code. c. Plaintiff s telephone number. d. Plaintiff s e-mail address. e. Plaintiff s date of birth. f. Plaintiff s social security number. g. Plaintiff s Medicare beneficiary number (HICN). 4. If plaintiff has not received Medicare benefits in the past or is not receiving Medicare benefits now, state whether plaintiff is eligible to receive Medicare benefits. 5. If plaintiff has been receiving Medicare benefits and is now deceased, please provide the following: a. Relationship of the administrator of plaintiff s estate to plaintiff s decedent. b. Name and address of Plaintiff s administrator. c. Telephone number and/or e-mail address of plaintiff s administrator. d. Social Security Number of plaintiff s administrator 22 of 26

PLEASE TAKE FURTHER NOTICE, that failure to comply with this Demand for Disclosure of Medicare Benefits/Eligibility may result in the necessity of a motion to compel discovery accompanied by a request for the appropriate costs. Dated: New York, New York October 13, 2016 By: ANDREW T. SHEELEY, ESQ. SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC 77 Water Street (212) 599-8200 OUR FILE NO.: 1011-00027 TO: Arnold I. Goldstein GOLDSTEIN & GOLDSTEIN Attorneys for Plaintiff 26 Court Street, 20 th Floor Brooklyn, NY 11242 (718) 855-0551 File No: 16-10991 23 of 26

SUPREME COURT OF THE STATE OF NEW YORK JUDY E. HINDS, as Executor of the Estate of EARL H. CLARKE, and JUDY E. HINDS, Individually, DANIEL J. MORGAN, M.D., MOUNT SINAI HEALTH SYSTEM, INC., MOUNT SINAI HOSPITAL GROUP, INC., and SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC., DEMAND FOR DISCLOSURE OF MEDICAID/PUBLIC ASSISTANCE LIEN PLEASE TAKE NOTICE, that pursuant to Article 31 of the Civil Practice Law and Rules, the undersigned attorneys for defendant demand that you furnish within thirty (30) days of service of this notice the following: 1. Statement as to whether the plaintiff has received benefits from Medicaid/Public Assistance at any time, for any reason, not limited to the injuries alleged in the instant action. If so, please state: a. Plaintiff s date of birth; b. Plaintiff s Social Security number; c. Medicaid file number; d. Address of the office handling the plaintiff s Medicaid/Public Assistance file; e. Copies of all documents, records, memorandums, notes, etc. in plaintiff s possession pertaining to plaintiffs receipt of Medicaid/Public Assistance benefits; and f. Duly executed authorization bearing plaintiff s date of birth and Social Security number permitting this firm or other representatives of the defendants to obtain copies of plaintiff s Medicaid/Public Assistance records. PLEASE TAKE FURTHER NOTICE, that pursuant to the CPLR, this is a continuing demand and you are required to serve the demanded information by the earliest of the following: a. within thirty (30) days of the date of this demand; b. within twenty (20) days of receiving the above-requested information; 24 of 26

c. no later than thirty (30) days prior to commencement of trial. If you do not possess the above-requested information, a letter or affidavit to that effect should be submitted. If you fail to comply, we shall rely on all sanctions provided by law. PLEASE TAKE FURTHER NOTICE, that failure to comply with this demand will serve as a basis for a motion to preclude the plaintiff upon the trial of this action from offering proof relative to medical damages, if such authorizations and/or records are not forthcoming within twenty (20) days after service of a copy of the within Demand. Dated: New York, New York October 13, 2016 By: ANDREW T. SHEELEY, ESQ. SHEEPSHEAD NURSING AND REHABILITATION CENTER, LLC 77 Water Street (212) 599-8200 OUR FILE NO.: 1011-00027 TO: Arnold I. Goldstein GOLDSTEIN & GOLDSTEIN Attorneys for Plaintiff 26 Court Street, 20 th Floor Brooklyn, NY 11242 (718) 855-0551 File No: 16-10991 25 of 26

FILED: KINGS COUNTY CLERK 10/13/ :29 AM INDEX NO /2016 NYSCEF DOC. NO. 10 RECEIVED NYSCEF: 10/13/2016