FILED: NEW YORK COUNTY CLERK 03/01/2022 11:43 PM
`NYSCEF DOC. NO. 328
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`INDEX NO. 154010/2021
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`RECEIVED NYSCEF: 03/01/2022
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`Exhibit B
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`FILED: NEW YORK COUNTY CLERK 03/01/2022 11:43 PM
`NYSCEF DOC. NO. 328
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`INDEX NO. 154010/2021
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`RECEIVED NYSCEF: 03/01/2022
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`Informational Statement (Pursuant to 22 NYCRR 1250.3 [a]) - Civil
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`Case Title: Set forth the title of the case as it appears on the summons, notice of petition or order to
`show cause by which the matter was or is to be commenced, or as amended.
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`For Court of Original Instance
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`- against -
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`Date Notice of Appeal Filed
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`For Appellate Division
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`Case Type
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`Civil Action
`CPLR article 75 Arbitration
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`CPLR article 78 Proceeding
`Special Proceeding Other
`Habeas Corpus Proceeding
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`Filing Type
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`Appeal
`Original Proceedings
`CPLR Article 78
`Eminent Domain
`Labor Law 220 or 220-b
`Public Officers Law § 36
`Real Property Tax Law § 1278
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`Transferred Proceeding
`CPLR Article 78
`Executive Law § 298
`CPLR 5704 Review
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`Nature of Suit: Check up to
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` of the following categories which best reflect the nature of the case.
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`Administrative Review
`Declaratory Judgment
`Family Court
`Real Property
`(other than foreclosure)
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`Business Relationships
`Domestic Relations
`Mortgage Foreclosure
`Statutory
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`Commercial
`Election Law
`Miscellaneous
`Taxation
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`Contracts
`Estate Matters
`Prisoner Discipline & Parole
`Torts
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`FILED: NEW YORK COUNTY CLERK 03/01/2022 11:43 PM
`NYSCEF DOC. NO. 328
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`INDEX NO. 154010/2021
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`RECEIVED NYSCEF: 03/01/2022
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`Paper Appealed From (Check one only):
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`Appeal
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`Amended Decree
`Amended Judgement
`Amended Order
`Decision
`Decree
`Court:
`Dated:
`Judge (name in full):
`Stage:
` Interlocutory
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`Determination
`Finding
`Interlocutory Decree
`Interlocutory Judgment
`Judgment
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` Final
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` Post-Final
`Prior Unperfected Appeal
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`If an appeal has been taken from more than one order or
`judgment by the filing of this notice of appeal, please
`indicate the below information for each such order or
`judgment appealed from on a separate sheet of paper.
`Order
`Resettled Order
`Order & Judgment
`Ruling
`Partial Decree
`Other (specify):
`Resettled Decree
`Resettled Judgment
`County:
`Entered:
`Index No.:
` No If Yes:
`Trial:
` Yes
`Information
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` Non-Jury
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` Jury
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`Are any appeals arising in the same action or proceeding currently pending in the court?
`If Yes, please set forth the Appellate Division Case Number assigned to each such appeal.
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`Yes
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` No
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`Where appropriate, indicate whether there is any related action or proceeding now in any court of this or any other
`jurisdiction, and if so, the status of the case:
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` Writ of Habeas Corpus Date Filed:
` Notice of Petition
`Commenced by: Order to Show Cause
`Statute authorizing commencement of proceeding in the Appellate Division:
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`Original Proceeding
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`Court:
`Judge (name in full):
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`Court:
`Judge (name in full):
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`Proceeding Transferred Pursuant to CPLR 7804(g)
`County:
`Order of Transfer Date:
`CPLR 5704 Review of Ex Parte Order:
`County:
`Dated:
`Description of Appeal, Proceeding or Application and Statement of Issues
`Description: If an appeal, briefly describe the paper appealed from. If the appeal is from an order, specify the relief
`requested and whether the motion was granted or denied. If an original proceeding commenced in this court or transferred
`pursuant to CPLR 7804(g), briefly describe the object of proceeding. If an application under CPLR 5704, briefly describe the
`nature of the ex parte order to be reviewed.
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`FILED: NEW YORK COUNTY CLERK 03/01/2022 11:43 PM
`NYSCEF DOC. NO. 328
`
`INDEX NO. 154010/2021
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`RECEIVED NYSCEF: 03/01/2022
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`Issues: Specify the issues proposed to be raised on the appeal, proceeding, or application for CPLR 5704 review
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`Party Information
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`Instructions: Fill in the name of each party to the action or proceeding, one name per line. If this form is to be filed for an
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` appeal, indicate the status of the party in the court of original instance and his, her, or its status in this court, if any. If this
`form is to be filed for a proceeding commenced in this court, fill in only the party’s name and his, her, or its status in this
`court.
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`Party Name
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`Original Status
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`Appellate Division Status
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`No.
`1
`2
`3
`4
`5
`6
`7
`8
`9
`10
`11
`12
`13
`14
`15
`16
`17
`18
`19
`20
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`FILED: NEW YORK COUNTY CLERK 03/01/2022 11:43 PM
`NYSCEF DOC. NO. 328
`
`INDEX NO. 154010/2021
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`RECEIVED NYSCEF: 03/01/2022
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`Attorney Information
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`Instructions: Fill in the names of the attorneys or firms for the respective parties. If this form is to be filed with the
`notice of petition or order to show cause by which a special proceeding is to be commenced in the Appellate Division,
`only the name of the attorney for the petitioner need be provided. In the event that a litigant represents herself or
`himself, the box marked “Pro Se” must be checked and the appropriate information for that litigant must be supplied
`in the spaces provided.
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`Attorney/Firm Name:
`Address:
`City:
`E-mail Address:
` Government
` Assigned
`Retained
`Attorney Type:
`Party or Parties Represente (set forth party number(s) from table above :
`Attorney/Firm Name:
`Address:
`City:
`E-mail Address:
` Government
` Assigned
`Retained
`Attorney Type:
`Party or Parties Represented (set forth party number(s) from table above :
`Attorney/Firm Name:
`Address:
`City:
`E-mail Address:
` Government
` Assigned
`Retained
`Attorney Type:
`Party or Parties Represented (set forth party number(s) from table above :
`Attorney/Firm Name:
`Address:
`City:
`E-mail Address:
` Government
` Assigned
`Retained
`Attorney Type:
`Party or Parties Represented (set forth party number(s) from table above :
`Attorney/Firm Name:
`Address:
`City:
`E-mail Address:
` Government
` Assigned
`Retained
`Attorney Type:
`Party or Parties Represented (set forth party number(s) from table above :
`Attorney/Firm Name:
`Address:
`City:
`E-mail Address:
`Government
`Assigned
`Retained
`Attorney Type:
`Party or Parties Represented (set forth party number(s) from table above :
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`Zip:
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`Zip:
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`Zip:
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`Zip:
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`Zip:
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`Zip:
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`Telephone No:
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` Pro Se
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` Pro Hac Vice
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`Telephone No:
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` Pro Se
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` Pro Hac Vice
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`Telephone No:
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` Pro Se
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` Pro Hac Vice
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`Telephone No:
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` Pro Se
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` Pro Hac Vice
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`Telephone No:
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` Pro Se
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` Pro Hac Vice
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`Telephone No:
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`Pro Se
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`Pro Hac Vice
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`State:
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`State:
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`State:
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`State:
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`State:
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`State:
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