Form UCS-840C at a glance
What it is: The Request for Judicial Intervention Commercial Division Addendum of the New York State Unified Court System is form UCS-840C (12/2023).
Who signs: Sign on the Signature line to certify that the case meets the Commercial Division's jurisdictional requirements as set forth in 22 NYCRR 202.70(a), (b) and (c); enter the date and write the Print Name.
A filled-in Form UCS-840C example: a supplier files the addendum

How to fill out Form UCS-840C, box by box
Supreme Court County, Plaintiff, Defendant and Index
Enter the county in Supreme Court County of.
Enter the Plaintiff/Petitioner, the persons or entities that started the case, and the Index #.
Enter the Defendant/Respondent, the persons or entities the case is against.
Plaintiff/Petitioner's cause(s) of action

Under Plaintiff/Petitioner's cause(s) of action, check all that apply.
Check Breach of contract or fiduciary duty, fraud, misrepresentation, business tort (e.g., unfair competition), or statutory and/or common law violation where the breach or violation is alleged to arise out of business dealings (e.g., sales of assets or securities; corporate restructuring; partnership, shareholder, joint venture, and other business agreements; trade secrets; restrictive covenants; and employment agreements not including claims that principally involve alleged discriminatory practices). Check Transactions governed by the Uniform Commercial Code, excluding those concerning individual cooperative or condominium units. Check Transactions involving commercial real property, including Yellowstone injunctions and excluding actions for the payment of rent only. Check Shareholder derivative actions (without consideration of the monetary threshold). Check Commercial class actions (without consideration of the monetary threshold).
Check Business transactions involving or arising out of dealings with commercial banks and other financial institutions. Check Internal affairs of business organizations. Check Malpractice by accountants or actuaries, and legal malpractice arising out of representation in commercial matters. Check Environmental insurance coverage.
Check Commercial insurance coverage (e.g., directors and officers, errors and omissions, and business interruption coverage). Check Dissolution of corporations, partnerships, limited liability companies, limited liability partnerships and joint ventures (without consideration of the monetary threshold). Check Applications to stay or compel arbitration and affirm or disaffirm arbitration awards and related injunctive relief pursuant to CPLR Article 75 involving any of the enumerated commercial issues (where the applicable agreement provides for the arbitration to be heard outside the United States, the monetary threshold set forth in 22 NYCRR 202.70(a) shall not apply).
Claims and counterclaims
Enter the Plaintiff/Petitioner's claim for compensatory damages, excluding punitive damages, interest, costs, and counsel fees claimed.
Describe briefly the Plaintiff/Petitioner's claim for equitable or declaratory relief.
Describe briefly the Defendant/Respondent's counterclaims, including claims for monetary relief.
Request and certify
Request that this case is assigned to the Commercial Division.
Certify that the case meets the Commercial Division's jurisdictional requirements as set forth in 22 NYCRR 202.70(a), (b) and (c).
Sources
[1] Form UCS-840C (12/2023), Request for Judicial Intervention Commercial Division Addendum, New York State Unified Court System (the Official source link on this page).
