Free AFFIDAVIT OF DEBT RE - Connecticut

AFFIDAVIT OF DEBT RE: MOTION FOR DEFAULT FOR FAILURE TO APPEAR, JUDGMENT AND ORDER FOR WEEKLY PAYMENTS
JD-CV-52 Rev. 5-99 P.B. §17-25

COURT USE ONLY

STATE OF CONNECTICUT SUPERIOR COURT
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INSTRUCTIONS 1. Complete this affidavit and send original with your completed Motion for Default to Appear, Judgment and Order for Weekly Payments (JD-CV-49) and Notice of Judgment and Order of Payments (JD-CV-50) to the Clerk's Office. 2. Attach a copy of the contract, lease or other document, if applicable, to the completed affidavit. 3. If interest is being claimed, the period covered and the rate claimed must be stated. 4. If claiming attorney's fees, a copy of the agreement must be attached. 5. Send one copy of the completed Affidavit and Motion to each defendant. RETURN DATE DOCKET NO. ADDRESS OF COURT (No., street, town, and zip code)

TO: The Superior Court
COURT HOUSING JUDICIAL SESSION DISTRICT NAME OF CASE (Plaintiff v. Defendant) G.A. NO.

NAME(S) OF (ALL) DEFENDANT(S) AGAINST WHOM MOTION IS FILED

AFFIDAVIT OF DEBT

(title) Plaintiff or The undersigned deposes and says that (s)he is the Plaintiff and is familiar with the facts stated below. The Defendant(s) is/are indebted to the Plaintiff(s) as follows:

of the

Continuation of this affidavit of debt is attached and made a part hereof.
SIGNED (Affiant) PRINT NAME OF AFFIANT SIGNED (Comm. of Sup. Court/Notary) DATE SIGNED

Subscribed and sworn to before me:

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