Free CLAIM FOR JURY - Connecticut


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State: Connecticut
Category: Court Forms - State
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http://www.jud2.ct.gov/webforms/forms/cl053.pdf

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CLAIM FOR JURY
JD-CL-53 Rev. 4-08 C.G.S. 52-215, 52-258 Pr. Bk. 14-4, 14-8, 14-10

STATE OF CONNECTICUT

COURT USE ONLY

SUPERIOR COURT
www.jud.ct.gov

CLAIM6

INSTRUCTIONS 1. This claim must be accompanied by the appropriate jury fee (C.G.S. 52-258). 2. When pleadings are closed, a Certificate for Closed Pleadings (JD-CV-11) must also be filed.
Return Date Docket Number

TO: The Superior Court
Name of Case (First named plaintiff v. First named Defendant)

Judicial District

Housing Session

G.A. Number

Address of Court (Number, street, and town)

The above-entitled case is hereby CLAIMED FOR THE INVENTORY OF JURY CASES.
(A certificate of closed pleadings must be filed before the above-entitled case can be placed on the inventory of jury cases.)

I hereby certify that this claim is filed in accordance with Connecticut General Statute 52-215 and that a copy of this claim was mailed/delivered to all counsel and self-represented parties of record on the date shown below.
Date Copy(ies) Mailed/Delivered Claim filed By ("X" One)

Plaintiff's Attorney
Name of Law Firm, Attorney, or Self-Represented Party Mailing Address (Number, street, town, state and zip) Name of Each Party Served*

Plaintiff

Defendant's Attorney

Defendant

Telephone Number Address at Which Service Was Made*

* If necessary, attach additional sheet
Signed (Individual attorney or self-represented party) Print or Type Name of Person Signing at Left Date Signed

FOR COURT USE ONLY
FILE DATE

CLAIM FOR JURY
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