CERTIFICATE OF SERVICE

Case Caption

SUPERIOR COURT OF CONNECTICUT
JUDICIAL DISTRICT OF [DISTRICT] AT [LOCATION]

[PLAINTIFF NAME],
Plaintiff,

v. Docket No. [DOCKET NUMBER]

[DEFENDANT NAME],
Defendant.

Service Representation

Pursuant to Practice Book § 10-12 et seq., I certify that on [DATE OF SERVICE] a copy of [TITLE OF DOCUMENT SERVED] was served on:

• Recipient: [NAME]
• Capacity: [E.G., "Counsel for Defendant"]
• Address/Email/Fax: [SERVICE INFORMATION]
• Method(s) of Service:
• [ ] Electronic delivery via Judicial Branch E-Services (registered user)
• [ ] Electronic mail (consent on file in accordance with § 10-13)
• [ ] Facsimile (consent received, fax number: [FAX])
• [ ] First-Class Mail, postage prepaid
• [ ] Certified/Registered Mail
• [ ] Hand delivery / courier
• Time of Service: [TIME]

[Repeat bullet list for additional recipients.]

Additional Compliance Information

• Mailing deposited in the United States Mail at [CITY, STATE].
• If any party is self-represented, indicate the method authorized by court order: [DETAILS].
• Include any standing order references (e.g., complex litigation docket requirements): [REFERENCE OR "N/A"].

Declaration

I declare under the penalties of false statement that the foregoing is true and correct.

Date: [DATE]

[NAME OF CERTIFYING ATTORNEY OR PARTY]
[JURIS NO.]
[FIRM NAME]
[ADDRESS]
[PHONE]
[EMAIL]
Attorney for [PARTY] / Self-Represented [PARTY]

Practitioner Notes

• Confirm compliance with Privacy Policy § 4 (redaction of personal identifying information).
• Housing and Family dockets may require additional certification language—consult local standing orders.
• Retain service documentation in accordance with Connecticut Rules of Professional Conduct Rule 1.15.