RJI (AMENDED) Redacted Amended RJI (Doc #22) pursuant to Court Order (Doc #44)

--- Page 1 --- FILED: NEW YORK COUNTY CLERK 10/19/2026 03:39 P INDEX NO. 161704/2026 NYSCEF DOC. NO. 73 RECEIVED NYSCEF: 10/19/2026 ene | REQUEST FOR JUDICIAL INTERVENTION (rev. 12/16/2024) Kt yy SUPREME COURT, CoUNTY of NEW YORK SS ame Index No: 161704 Date Index Issued: _ 09/17/2026 For Court Use Only: IAS Entry Date Plaintiff(s)/Petitioner(s -against- CORNELL UNIVERSITY, INC., CHI PHI CHAPTER HOUSE ASSOCIATION, CHI PHI FRATERNITY, INC., CHI PHI EDUCATIONAL TRUST, ALPHA BETA HOUSE FETE CORPORATION OF DELTA DELTA DELTA, DELTA DELTA DELTA SORORITY, Defendant(s)/Respondent(s NATURE OF ACTION OR PROCEEDING _ Check only one box and specify where indicated. Business Entity (includes corporations, partnerships, LLCs, LLPs, etc.) C) Contested Contract NOTE: If there are children under the age of 18, complete and attach the Insurance (where insurance company is a party, except arbitration) MATRIMONIAL RJI ADDENDUM (UCS-840M). UCC (includes sales and negotiable instruments) For Uncontested Matrimonial actions, use the Uncontested Divorce RJI (UD-13). Other Commercial (specify REAL PROPERTY Specify how many properties the application inudest NOTE: For Commercial Division assignment requests pursuant to 22 NYCRR 202.70(d), iO Condemnation complete and attach the COMMERCIAL DIVISION RJI ADDENDUM (UCS-840C). iO Mortgage Foreclosure (specify): Onesidential Ocommercial Property Address: Asbestos NOTE: For Mortgage Foreclosure actions involving a one to four-family, Environmental (specify): owner-occupied residential property or owner-occupied condominium, Medical, Dental or Podiatric Malpractice complete and attach the FORECLOSURE RJI ADDENDUM (UCS-840F). Motor Vehicle Partition Products Liability (specify): NOTE: Complete and attach the PARTITION RJI ADDENDUM (UCS-840P). Other Negligence (specify): oO Tax Certiorari (specify): | Section: Block: Lot: Other Professional Malpractice (specify): O Tax Foreclosure Other Tort (specify): Sexual Assault © other Real Property (specify): Certificate of Incorporation/Dissolution [see NOTE in COMMERCIAL section] CPLR Article 75 — Arbitration [see NOTE in COMMERCIAL section] Emergency Medical Treatment CPLR Article 78 — Proceeding against a Body or Officer Habeas Corpus Election Law Local Court Appeal Extreme Risk Protection Order Mechanic’s Lien MHL Article 9.60 — Kendra’s Law Name Change/Sex Designation Change MHL Article 10 — Sex Offender Confinement (specify): Olnitial OrReview Pistol Permit Revocation Hearing MHL Article 81 (Guardianship) Sale or Finance of Religious/Not-for-Profit Property Other Mental Hygiene (specify): Other (specify): Other Special Proceeding (specify): STATUS OF ACTION OR PROCEEDING Answer YES or NO for every question and enter additional information where indicated. Has a summons and complaint or summons with notice been filed? © O If yes, date filed: 09/16/2026 Has a summons and complaint or summons with notice been served? oO © If yes, date served: Is this action/proceeding being filed post-judgment? oO © If yes, judgment date: Infant’s Compromise Extreme Risk Protection Order Application Note of Issue/Certificate of Readiness Notice of Medical, Dental or Podiatric Malpractice Date Issue Joined: Notice of Motion Relief Requested: Return Date: Notice of Petition Relief Requested: Return Date: Order to Show Cause Relief Requested: Return Date: 10/23/2026 Other Ex Parte Application Relief Requested: Partition Settlement Conference Request for Preliminary Conference Residential Mortgage Foreclosure Settlement Conference Waiver of Court Costs, Fees, and Expenses Writ of Habeas Corpus Other (specify): 1 of 3 --- Page 2 --- FILED: NEW YORK COUNTY CLERK 10/19/2026 03:39 P INDEX NO. 161704/2026 RELATED CXS VV tist any related actions. For Matrimonial cases, list any related criminal or Family Court cases.“ Yt hohe, leave blank: * g WY AUG If additional space is required, complete and attach the RJI ADDENDUM (UCS-840A). case Title ————————iindex/CaseNumber [Court ————=————*dudge (ifassigned) 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). Parties Attorneys and Unrepresented Litigants Issue Joined Insurance Carriers List parties in same order as listed in the |For represented parties, provide attorney's name, firm name, address, phone and _ |For each defendant, |For each defendant, caption and indicate roles (e.g., plaintiff, |email. For unrepresented parties, provide party's address, phone and email. indicate if issue has |indicate insurance defendant, 3" party plaintiff, etc.) been joined. carrier, if applicable. Rolet) Jane Doe ETHAN COHEN, RHEINGOLD GIUFFRA RUFFO @ves Ono oles): Plaintiff PLOTKIN & Role(s): YES NO oe(s) Defendant Name: Chi Phi Chapter HouseAss O © Role(s): YES NO Defendant Name: Chi Phi Fratemity, Inc. Role(s): Oyes @NOo EJ ole(s) Defendant Name: Chi Phi Educational Trust O © Role(s): YES NO oe(s) Defendant Name: Alpha Beta House Corpo Role(s): Oves @no EJ ole(s) Defendant Name: Delta Delta Delta Sorority Role(s): Oyes @no Defendant Name: Zareen Enterprise LLC d/ Role(s): Oyes Ono EJ ole(s) Defendant Name: Matthew Ingalls Role(s): YES NO EJ Defendant 0 ® Name: Johnathan Newell O © Role(s): YES NO Defendant Name: Winston Lee O © Role(s): YES NO oe(s) Defendant Name: Gillio Lopes Role(s): Oyes @nNo EJ ole(s) Defendant Role) Diego Sarabia O © Role(s): YES NO Defendant Name: A Scott Norris Role(s): Oyves @NO EJ Defendant Name: Scott Ketzschmar O © Role(s): YES NO Defendant | 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: 09/30/2026 . Signature 6213144 ETHAN J COHEN Attorney Registration Number Print Name 2 of 3 --- Page 3 --- FILED: NEW YORK COUNTY CLERK 10/19/2026 03:39 P INDEX NO.| 16priQForRy? © NYSCEF Doc. no. 73Request for Judicial Intervention Addendum —s2EcEIVED NyYSCEF pes-eqa P29TE 6 Supreme New York 161704/2026 COURT, COUNTY OF Index No: For use when additional space is needed to provide party or related case information. PARTIES: For parties without an attomey, check "Un-Rep" box AND enter party address, phone number and e-mail address in "Attorneys" space. Parties: === ==~~~~—_ {Attorneys and/or Unrepresented Litigants: Un- |List parties in caption order and Provide attorney name, firm name, business address, phone number and e-mail issue Insurance Carrier(s): Rep |indicate party role(s) (e.g. defendant; |address of all attomeys that have appeared in the case. For unrepresented (YIN): 3rd-party plaintiff). litigants, provide address, phone number and e-mail address. Doe John Last Name Last Name First Name e YES First Name Firm Name Primary Role: Defendant Street Add City State Zi Secondary Role (if any): mes P {no Phone Fax e-mail Doe John Last Name Last Name First Name CX) YES First Name Firm Name Primary Role: Defendant Address chy State Zip Secondary Role (if any): (e)NO Phone Fax e-mail Doe John Last Name Last Name First Name e YES First Name Firm Name Primary Role: Defendant Street Add City State Zi Secondary Role (if any}: mes P (e)NO Phone Fax e-mail Petito Petito Orazio Last Name Last Name First Name Orazio Se YES First Name Firm Name Defendant Primary Row — . Address = City — = Secondary Role (if any): (© )NO Phone Fax e-mail Last Name Last Name First Name e YES First Name Firm Name Primary Role: Street Add City State Zi Secondary Role (if any): mes P NO Phone Fax email Last Name Last Name First Name e YES First Name Firm Name Primary Role: Street Add City State Zi Secondary Role (if any): mes P (JNO Phone Fax e-mail RELATED CASES: List any related actions. For Matrimonial actions, include any related criminal and/or Family Court cases. Case Title Index/Case No. Court Judge (if assigned) Relationship to Instant Case O