Official Court Forms of the Connecticut Judicial Branch

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Form No.	Name Of Form	Category	Status	Date	Download
General Forms

JD-AP-048	Affidavit of Indigency — Fee Waiver, Criminal	General	Rev.	08/15	AP048.pdf
JD-AP-048P	Affidavit of Indigency — Fee Waiver, Criminal - Polish	General	New	08/15	AP048P.pdf
JD-AP-048PT	Affidavit of Indigency — Fee Waiver, Criminal - Portuguese	General	New	08/15	AP048PT.pdf
JD-AP-048S	Affidavit of Indigency — Fee Waiver, Criminal - Spanish	General	New	08/15	AP048S.pdf
JD-AP-182	Split Sentence, Domestic Violence, Victim Notice	General	Rev.	05/19	AP182.pdf
JD-AP-182P	Split Sentence, Domestic Violence, Victim Notice - Polish	General	Rev.	05/19	AP182P.pdf
JD-AP-183	Domestic Violence, Victim Notice	General	Rev.	05/19	AP183.pdf
JD-AP-183S	Domestic Violence, Victim Notice - Spanish	General	Rev.	05/19	AP183S.pdf
JD-AP-187	Certificate of Employability Application - CSSD	General	Rev.	02/19	AP187.pdf
JD-CL-006	Short Calendar List, Claim/Reclaim	General	Rev.	06/12	cl006.pdf
JD-CL-012	Appearance Form (How-To Slidecast)	General	Rev.	09/13	cl012.pdf
JD-CL-012H	Help Text For Appearance Form (With Spanish Translation)	General	Rev.	07/12	CL012H.pdf
JD-CL-012S	Appearance (Spanish)	General	Rev.	09/13	CL012S.pdf
JD-CL-028	List of Exhibits	General	Rev.	07/19	CL028.pdf
JD-CL-028A	List of Exhibits (Continued)	General	Rev.	06/16	CL028A.pdf
JD-CL-043	Subpoena - Civil/Housing/Small Claims/Family/Family Support Magistrate/Criminal/Motor Vehicle	General	Rev.	12/15	CL043.pdf
JD-CL-046	Authorization for Information	General	Rev.	07/12	cl046.pdf
JD-CL-046P	Authorization for Information - Polish	General	New	07/12	CL046P.pdf
JD-CL-046PT	Authorization for Information - Portuguese	General	Rev.	07/12	CL046PT.pdf
JD-CL-046S	Authorization for Information - Spanish	General	New	07/12	CL046S.pdf
JD-CL-051	Affidavit, Lost Bond Receipt	General	Rev.	07/14	cl051.pdf
JD-CL-053	Claim for Jury	General	Rev.	01/17	CL053.pdf
JD-CL-054	Request And Stipulation For Referral To A Private Alternative Dispute Resolution (ADR) Provider	General	Rev.	03/15	CL054.pdf
JD-CL-067	Federal Poverty Level Chart 2019	General	Rev.	02/19	CL067.pdf
JD-CL-071	Request for Exemption from Dormancy Docket Dismissal	General	Rev.	06/16	CL071.pdf
JD-CL-073	Facsimile Filing Cover Sheet	General	Rev.	05/10	cl073.pdf
JD-CL-077	Request For Adjudication, Complex Litigation Docket (CLD)	General	Rev.	02/18	CL077.pdf
JD-CL-080	Request for Nondisclosure of Information in Protection Order Registry	General	Rev.	12/16	CL080.pdf
JD-CL-090	Request to Bring Items Into the Courthouse	General	Rev.	09/18	CL090.pdf
JD-CL-092	Request for Exemption from Electronic Services Requirement	General	Rev.	04/19	CL092.pdf
JD-CL-096	Request to Conform Case Initiation Data Entry to Summons	General	New	01/09	CL096.pdf
JD-CL-111	General Case Management Order, Complex Litigation Docket (CLD)	General	Rev.	07/19	CL111.pdf
JD-CL-114	Affidavit — Federal Loss Mitigation Programs (For cases filed before January 3, 2017)	General	Rev.	03/12	CL114.pdf
JD-CL-116	Request To Conform Case Initiation Data Entry Information To Small Claims Writ and Notice of Suit	General	New	01/11	CL116.pdf
JD-CL-117	Volunteer Attorney Program — Notice of Foreclosure (New Haven)	General	Rev.	04/19	CL117.pdf
JD-CL-117H	Volunteer Attorney Program — Notice of Foreclosure (Hartford)	General	Rev.	04/19	CL117H.pdf
JD-CL-117NL	Volunteer Attorney Program — Notice of Foreclosure (New London)	General	New	04/19	CL117NL.pdf
JD-CL-117W	Volunteer Attorney Program — Notice of Foreclosure (Waterbury)	General	Rev.	04/19	CL117W.pdf
JD-CL-118	Volunteer Attorney Program — Notice of Foreclosure (Bridgeport)	General	Rev.	04/19	CL118.pdf
JD-CL-120	Volunteer Attorney Program — Notice of Foreclosure (Stamford)	General	Rev.	04/19	CL120.pdf
JD-CL-121	Limited Appearance	General	Rev.	02/16	CL121.pdf
JD-CL-122	Certificate of Completion of Limited Appearance	General	Rev.	02/16	CL122.pdf
JD-CL-125	Volunteer Attorney Program — Notice of Foreclosure (Ansonia-Milford)	General	Rev.	04/19	CL125.pdf
JD-CL-127	Volunteer Attorney Program - Notice of Foreclosure (New Britain)	General	Rev.	04/19	CL127.pdf
JD-CL-134, formerly JD-CV-001c	Civil Case Type Codes	General	Rev.	08/18	CL134.pdf
JD-CL-136 (Formerly JD-CV-062)	Application for Issuance of Subpoena	General	Rev.	01/17	CL136.pdf
JD-CL-137	Request for Hearing, Denied Application for Issuance of Subpoena	General	New	12/15	CL137.pdf
JD-CL-141	Application for Permission for Attorney to Appear Pro Hac Vice in a Court Case	General	Rev.	05/17	CL141.pdf
JD-CL-142	Application for Permission for Attorney to Appear Pro Hac Vice Before a Municipal or State Agency, Commission, Board or Tribunal	General	Rev.	05/17	CL142.pdf
JD-CL-143	Affidavit of Attorney Seeking Permission to Appear Pro Hac Vice	General	Rev.	05/17	CL143.pdf
JD-JA-016	One Day/One Trial Juror Application For Reimbursement and Request for Social Security Number	General	Rev.	06/18	JA016.pdf
JD-JA-047	Request for Medical Disqualification from Jury Service	General	New	11/16	JA047.pdf
JD-JA-049	Request for Disqualification from Jury Service Based on Previous Federal Jury Service	General	New	09/17	JA049.pdf

Forms Found : 53

Important Notices (Expand to view)[+]

ADA notice :The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court clerk or an ADA contact person.

Important Notice : If you save forms on your computer, the version you save may not be the most current version and may not satisfy current Practice Book or statutory requirements. It is recommended that you periodically compare the “Rev.” date (revision date) on the version of the form you saved with the revision date of the form in the list below to ensure that you are using the latest version.

QR Codes on Judicial Branch Forms:“QR” (or “quick response”) codes store information in the form of a two-dimensional square barcode. QR codes may direct QR code imageusers to a mobile website, video or information page. The use of QR codes has become increasingly popular in the U.S. with the widely adopted use of smartphones capable of reading and processing this information directly from a user’s mobile device. The Judicial Branch has implemented this technology by encoding website URLs into some of its forms.Utilizing a QR Code reader application, users can quickly display content from a computer on their smart phone by clicking the QR Code icon and scanning the code. A QR reader application is needed to detect the QR code. You can download a QR reader application through your mobile device’s marketplace or store. The Judicial Branch does not endorse or recommend a specific QR code reader. Many QR reader apps are available.

Civil Forms grouped by Subject[+]

Family Forms grouped by Case Type[+]

State Agency Forms[+]

Form Number	Name of form	State Agency
CCSG-1	Worksheet for the Connecticut Child Support and Arrearage Guidelines	Commission for Child Support Guidelines
CO-17	Invoice/Voucher for Goods or Services	Office of the State Comptroller
SMC-1	Restraining Order / Civil Protection Order Service Instructions	State Marshal Commission
SMC-2	Restraining Order / Civil Protection Order Service Respondent Profile	State Marshal Commission

Information on using PDF Forms[+]

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