Form UCS-840C, Request for Judicial Intervention Commercial Division Addendum Instructions

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This form contains 24 fields organized into 11 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Actions
Click the Reset Form button to clear all fillable form fields Button
This button clears all the data currently entered in the form. Use it if you want to start over.
Click the button to print the form Button
Click this button to print the completed form.
Case Identification
Enter the index number assigned to the case by the court Text
Input the index number assigned by the court to this case, which identifies it in official records.
Case Information
Enter the index number assigned to the case by the court Text
Provide the index number assigned to the case by the court.
Case Parties
Enter the name(s) of the persons or entities that started the case Text
Provide the full name(s) of the person(s) or entity/entities that initiated the case (Plaintiff/Petitioner).
Enter the name(s) of the persons or entities who the case is against Text
Enter the full name(s) of the person(s) or entity/entities against whom the case is brought (Defendant).
Claim Options
CommercialInsuranceCoverage CheckBox
Select this option if the dispute involves issues related to commercial insurance coverage.
Dissolution CheckBox
Check this box if the case involves matters of dissolution.
StayOrCompelArbitration CheckBox
Select this option if you are seeking to stay proceedings or compel arbitration as part of your claims.
Claim Relief
Briefly describe any equitable or declaratory relief that the plaintiff/petitioner is claiming Text
Briefly describe any equitable or declaratory relief being claimed by the plaintiff/petitioner.
Claims
BreachOfContract CheckBox
Select this box if your claim includes a breach of contract issue.
UCC CheckBox
Tick this box if the dispute involves issues related to the Uniform Commercial Code (UCC).
CommercialRealProperty CheckBox
Mark this option if the case involves matters pertaining to commercial real property.
ShareholderDerivativeActions CheckBox
Select this box if the legal action involves shareholder derivative actions.
CommercialClassActions CheckBox
Tick this box to indicate that the dispute constitutes a commercial class action.
CommercialBankTransactions CheckBox
Select this option if the case involves issues arising from commercial bank transactions.
InternalAffairs CheckBox
Mark this box if the dispute relates to internal affairs of a company or organization.
Malpractice CheckBox
Tick this box if the case involves malpractice claims.
EnvironmentalInsuranceCoverage CheckBox
Select this option if the case involves issues regarding environmental insurance coverage.
Counterclaims
Briefly describe the defendant/respondent's counterclaims, including any monetary relief that the defendant/respondent is claiming Text
Describe the defendant/respondent's counterclaims, including details of any monetary relief they are seeking.
Court Details
Select the county where the court is located ComboBox
Choose the county where the court handling the case is located from the list provided.
ALBANY CHENANGO YATES QUEENS WASHINGTON CATTARAUGUS NIAGARA GENESEE LEWIS PUTNAM ST. LAWRENCE WESTCHESTER CHEMUNG GREENE ULSTER COLUMBIA ESSEX DELAWARE MADISON SUFFOLK ONTARIO JEFFERSON BROOME ALLEGANY OSWEGO WARREN KINGS SARATOGA ONEIDA FRANKLIN MONTGOMERY TIOGA CAYUGA LIVINGSTON ORANGE MONROE NASSAU NEW YORK WAYNE ROCKLAND SCHENECTADY HAMILTON ORLEANS RENSSELAER DUTCHESS ONONDAGA SENECA TOMPKINS CHAUTAUQUA WYOMING FULTON RICHMOND CORTLAND SULLIVAN STEUBEN HERKIMER ERIE BRONX SCHUYLER OTSEGO SCHOHARIE CLINTON
Damages
Enter the dollar amount that the plaintiff/petitioner is claiming in compensatory damages Number
Enter the dollar amount that the plaintiff/petitioner is claiming in compensatory damages.
Signature
Enter the date you are signing the form as MM/DD/YYYY Date
Provide the date you are signing the form in MM/DD/YYYY format.
Enter the name of the person signing the form Text
Enter the full name of the person signing the form.