EXHIBIT B-1 

Case:17-03283-LTS Doc#:19995-4 Filed:02/02/22 Entered:02/02/22 17:51:17 Desc:

Exhibit B-1 Gladys Minguela En Page 1 of 6
Certified to be a correct and true translation from the source text in Spanish to the target language English.

29/DECEMBER/2021 - Andreea I. Boscor ATA-certified Spanish-English #525556

By Targem Translations Inc.

[Note: all handwriting is in italics.]

Proof of Claim Number: 179367

Claimant. MINGUELA VAZQUEZ, GLADYS

INFORMATION REQUESTED TO PROCESS YOUR CLAIM

Instructions 

Answer the four (4) applicable questions and sub-questions. Include as many details as possible in your 

answers. Your answers must provide more information than is included in the initial proof of claim. 

By way of example, if you previously wrote “Act 96” as the basis for your claim, please now explain on 

which specific laws you purport to rely, the year in which the law in question was passed, and how and why 

you believe this law in particular constitutes a basis for your claim. Furthermore, if available and applicable 

to your claim, provide:

• A copy of an initial pleading, such as, for example, a Claim or Reply;

• An unpaid ruling or settlement agreement;

• Written notice of your intention to file a claim with record of sending by mail;

• All documentation that, in your opinion, supports your claim.

Send the completed form and supporting documents by email to PRClaimsInfo@primeclerk.com, or by 

mail by hand delivery to the following addresses:

By Mail Hand Delivery or Overnight Mail

Commonwealth of Puerto Rico Supplemental

Information Processing Center

c/o Prime Clerk LLC

Grand Central Station, PO Box 4708

New York, NY 10163-4708

Commonwealth of Puerto Rico Supplemental

Information Processing Center

c/o Prime Clerk LLC

850 Third Avenue, Suite 412

Brooklyn, NY 11232

Questionnaire

1. What is the basis of your claim?

 A pending or concluded legal action with or against the government of Puerto Rico 

 Current or former employment with the government of Puerto Rico

 Other (please provide as much detail as possible. Attach additional pages if necessary.)

_________________________________________________________________________

2. What is the amount of your claim (how much money you claim you are owed):

Thousands

Case:17-03283-LTS Doc#:19995-4 Filed:02/02/22 Entered:02/02/22 17:51:17 Desc:

Exhibit B-1 Gladys Minguela En Page 2 of 6
Certified to be a correct and true translation from the source text in Spanish to the target language English.

29/DECEMBER/2021 - Andreea I. Boscor ATA-certified Spanish-English #525556

By Targem Translations Inc.

Proof of Claim Number: 179367

Claimant. MINGUELA VAZQUEZ, GLADYS

3. Employment. Is your claim related to current or former employment with the Puerto Rico 

government?

 No. Proceed to Question 4

 Yes. Answer questions 3(a)-(d).

3(a). Identify the specific agency or department in which you work or worked:

Department of Education

3(b). Identify the dates of your employment in relation to your claim:

Year 2009 through the present

3(c). Last four digits of your social security number: 7617

3(d). Cuál es la naturaleza de sus reclamaciones de empleo (seleccione todo lo que sea aplicable):

 Retirement

 Unpaid wages

 Sick days

 Union grievance

 Vacation

 Other (Provide as much detail as possible. Attach additional pages if necessary.)

I have stopped receiving payments for five-year raises, salary increases, reclassification, excess sick 

leave and vacation leave. Contributions and fringe benefits

4. Legal action. Is your claim related to a legal action already closed or pending resolution?

 No. 

 Yes. Answer questions 4(a)-(f).

4(a). Identify the department or agency that is part of this action.

Public Service Commission, PR 

4(b). Identify the name and address of the court or agency where this action is pending resolution.

Public Service Commission, PR 

4(c). Case Number

________________________________________________________________________

4(d). Case title, caption, or name:

________________________________________________________________________

Case:17-03283-LTS Doc#:19995-4 Filed:02/02/22 Entered:02/02/22 17:51:17 Desc:

Exhibit B-1 Gladys Minguela En Page 3 of 6
Certified to be a correct and true translation from the source text in Spanish to the target language English.

29/DECEMBER/2021 - Andreea I. Boscor ATA-certified Spanish-English #525556

By Targem Translations Inc.

Proof of Claim Number: 179355 

Claimant. MINGUELA VAZQUEZ, GLADYS

4(e). Case status (pending resolution, on appeal, or closed):

Pending

4(f). Do you have an unpaid judgment? Yes / No (Check one) If yes, what is the date and amount 

of the judgment?

___________________________________

Case:17-03283-LTS Doc#:19995-4 Filed:02/02/22 Entered:02/02/22 17:51:17 Desc:

Exhibit B-1 Gladys Minguela En Page 4 of 6
Certified to be a correct and true translation from the source text in Spanish to the target language English.

29/DECEMBER/2021 - Andreea I. Boscor ATA-certified Spanish-English #525556

By Targem Translations Inc.

Case:17-03283-LTS Doc#:19995-4 Filed:02/02/22 Entered:02/02/22 17:51:17 Desc:

Exhibit B-1 Gladys Minguela En Page 5 of 6
TRANSLATOR’S CERTIFICATE OF TRANSLATION

Translation from: Spanish (Puerto Rico) into English (US)

TARGEM Translations Inc.

I, Andreea I. Boscor, ATA-certified Spanish-English #525556, acting as translator at TARGEM Translations Inc., a NEW 

YORK City corporation, with its principal office at 185 Clymer Street, Brooklyn, NY, 11211, USA, certify that:

the English translated document is a true and accurate translation of the original Spanish and has been translated to 

the best of my knowledge.

Original Document Name: Claim No. 179367

 

Signed this 29th day of December 2021 

__________________________ 

 Andreea I. Boscor

Case:17-03283-LTS Doc#:19995-4 Filed:02/02/22 Entered:02/02/22 17:51:17 Desc:

Exhibit B-1 Gladys Minguela En Page 6 of 6