Connecticut Civil Cover Sheet (JD-CV-1)

STATE OF CONNECTICUT — SUPERIOR COURT

CIVIL COVER SHEET / SUMMONS WORKSHEET (JD-CV-1)

Official Form Reference: Connecticut Judicial Branch Form JD-CV-1 (Summons — Civil) and JD-CL-134 (Civil Case Type Codes)
Authority: Conn. Practice Book § 8-1; Conn. Gen. Stat. §§ 52-45a, 52-259

SECTION 1: COURT DESIGNATION

State of Connecticut — Superior Court

☐ Judicial District of [________________________________]
☐ Geographical Area (GA) No. [________________________________]
☐ Housing Session at [________________________________]

Court Address: [________________________________]

Docket Number: [________________________________] (Assigned by Clerk)

SECTION 2: RETURN DATE

Per Conn. Gen. Stat. § 52-48 and Practice Book § 10-12, the Return Date must be a Tuesday at least 12 days after service. To select a Return Date, find the next Tuesday after the date process will be served and count ahead to at least the second Tuesday from that date.

Return Date (must be a Tuesday): [__/__/____]

Note: The Return Date is NOT a hearing date. You do not need to appear on the Return Date unless separately noticed.

SECTION 3: CASE CAPTION

STATE OF CONNECTICUT                        SUPERIOR COURT
                                            www.jud.ct.gov

JUDICIAL DISTRICT OF _________________________
GA NO. _______    HOUSING SESSION AT _________________________
COURT ADDRESS: _______________________________________________

RETURN DATE: _________________ (TUESDAY)    DOCKET NO.: _______________

________________________________________,
                    Plaintiff(s),

        v.

________________________________________,
                    Defendant(s).

Number of Plaintiffs: [____]        Number of Defendants: [____]

SECTION 4: PARTY INFORMATION

Plaintiff(s)

Additional Plaintiff(s): ☐ See attached list (Total number of plaintiffs: [____])

Defendant(s)

Additional Defendant(s): ☐ See attached list (Total number of defendants: [____])

SECTION 5: ATTORNEY / SELF-REPRESENTED PARTY INFORMATION

☐ Attorney Representation

☐ Self-Represented (Pro Se) Party

SECTION 6: CASE TYPE CODE (JD-CL-134)

Enter the Major Code (letter) and Minor Code (number) from form JD-CL-134. Select only one primary case type.

Major Code: [____] Minor Code: [____]

A. Torts (Major Code: T)

• ☐ T01 — Motor Vehicle — Personal Injury
• ☐ T02 — Motor Vehicle — Property Damage
• ☐ T03 — Motor Vehicle — Wrongful Death
• ☐ T04 — Premises Liability
• ☐ T05 — Products Liability — Personal Injury
• ☐ T06 — Products Liability — Property Damage
• ☐ T07 — Medical Malpractice (Conn. Gen. Stat. § 52-190a; requires good faith certificate)
• ☐ T08 — Legal Malpractice
• ☐ T09 — Other Professional Malpractice
• ☐ T10 — Defamation / Libel / Slander
• ☐ T11 — Wrongful Death (non-motor vehicle)
• ☐ T12 — Other Negligence
• ☐ T13 — Intentional Tort
• ☐ T14 — Toxic Tort / Environmental
• ☐ T99 — Other Tort: [________________________________]

B. Contracts (Major Code: C)

• ☐ C01 — Commercial / Business Contract
• ☐ C02 — Consumer Contract / Debt Collection
• ☐ C03 — Insurance Coverage / Bad Faith
• ☐ C04 — Construction Contract
• ☐ C05 — Employment Contract / Noncompete
• ☐ C06 — UCC / Secured Transactions
• ☐ C99 — Other Contract: [________________________________]

C. Real Property (Major Code: R)

• ☐ R01 — Foreclosure — Residential
• ☐ R02 — Foreclosure — Commercial
• ☐ R03 — Quiet Title / Boundary / Easement
• ☐ R04 — Landlord/Tenant (non-Housing Session)
• ☐ R05 — Ejectment
• ☐ R06 — Condemnation / Eminent Domain (Major Code: E)
• ☐ R99 — Other Real Property: [________________________________]

D. Equity (Major Code: Q)

• ☐ Q01 — Injunction / Temporary Restraining Order
• ☐ Q02 — Declaratory Judgment
• ☐ Q03 — Specific Performance
• ☐ Q04 — Accounting
• ☐ Q99 — Other Equity: [________________________________]

E. Administrative / Statutory (Major Code: M)

• ☐ M01 — Administrative Appeal (Conn. Gen. Stat. § 4-183)
• ☐ M02 — Zoning / Planning Appeal
• ☐ M03 — Tax Appeal
• ☐ M04 — Workers' Compensation Appeal
• ☐ M05 — Statutory Action
• ☐ M99 — Other Administrative / Statutory: [________________________________]

F. Housing Session (Major Code: H)

• ☐ H01 — Summary Process / Eviction (Conn. Gen. Stat. § 47a-23 et seq.)
• ☐ H02 — Housing Code Violation
• ☐ H03 — Other Housing Matter: [________________________________]

G. Other Civil (Major Code: X)

• ☐ X01 — Civil Rights
• ☐ X02 — Employment Discrimination (Conn. Gen. Stat. § 46a-100)
• ☐ X03 — Name Change
• ☐ X04 — Habeas Corpus
• ☐ X99 — Other Civil: [________________________________]

SECTION 7: AMOUNT IN CONTROVERSY

☐ Under $2,500 (reduced filing fee applies per Conn. Gen. Stat. § 52-259(a))
☐ $2,500 to $14,999
☐ $15,000 to $49,999
☐ $50,000 to $99,999
☐ $100,000 to $249,999
☐ $250,000 to $999,999
☐ $1,000,000 or more

Specific monetary demand (if applicable): $[________________________________]

☐ Non-monetary / equitable relief sought: [________________________________]
☐ Punitive damages claimed
☐ Treble damages claimed (e.g., CUTPA, Conn. Gen. Stat. § 42-110g)

SECTION 8: JURY DEMAND

Per Practice Book § 14-10, a claim for a jury trial must be endorsed on the writ, summons, and complaint, or filed as a separate claim within 10 days after the Return Date.

☐ Jury trial claimed on complaint
☐ Six-person jury (default per Conn. Gen. Stat. § 52-215)
☐ Jury trial not claimed (court trial)

SECTION 9: RELATED CASES

Are there any related pending or previously filed cases in any Connecticut court?

☐ No
☐ Yes — Provide details below:

SECTION 10: SERVICE OF PROCESS

Per Conn. Gen. Stat. § 52-57, service of civil process must be made by a state marshal, constable, or other proper officer. Per Conn. Gen. Stat. § 52-45a, the complaint and summons must be served at least 12 days before the Return Date.

Method of Service

☐ State Marshal (Conn. Gen. Stat. § 52-57)
☐ Constable (where authorized)
☐ Indifferent person (Practice Book § 10-3, for certain actions)
☐ Abode service (Conn. Gen. Stat. § 52-57(a))
☐ Service on agent / registered agent (corporate defendants)
☐ Secretary of State — Long Arm (Conn. Gen. Stat. § 52-59b)
☐ Service by publication (Conn. Gen. Stat. § 52-52; court order required)
☐ Other authorized method: [________________________________]

Service Details

Out-of-State Service: For defendants outside Connecticut, service under the Long Arm Statute (Conn. Gen. Stat. § 52-59b) requires service upon the Secretary of the State with a copy sent by registered or certified mail to the defendant's last known address.

SECTION 11: SPECIAL REQUIREMENTS AND DESIGNATIONS

A. Medical Malpractice Certificate

☐ Good faith certificate and written opinion letter attached (Conn. Gen. Stat. § 52-190a)
Note: Failure to attach a good faith certificate with a medical malpractice complaint is grounds for dismissal.

B. CUTPA Claims

☐ Connecticut Unfair Trade Practices Act claim included (Conn. Gen. Stat. § 42-110a et seq.)

C. Complex Litigation

☐ Request for assignment to Complex Litigation Docket (Practice Book § 23-13 et seq.)

D. Prejudgment Remedy

☐ Application for prejudgment remedy attached (Conn. Gen. Stat. § 52-278a et seq.)

E. Emergency / Expedited Matters

☐ Emergency TRO / Preliminary Injunction sought (Practice Book § 11-15)
☐ Order to show cause filed
☐ Expedited proceedings requested — Basis: [________________________________]

F. Accessibility / Accommodations

☐ Interpreter needed — Language: [________________________________]
☐ ADA accommodation needed — Describe: [________________________________]
☐ Hearing assistance required

SECTION 12: FILING FEE INFORMATION

Per Conn. Gen. Stat. § 52-259:

Payment method: ☐ Check payable to "Clerk, Superior Court" ☐ Money Order ☐ Credit Card ☐ E-Filing Payment ☐ Fee waiver filed

☐ Application for Waiver of Fees is attached (Practice Book § 8-2)

SECTION 13: E-FILING INFORMATION

Per Conn. Gen. Stat. § 51-164s, electronic filing is available through the Connecticut Judicial Branch E-Filing System.

☐ This filing is being submitted electronically
☐ Attorney has registered for e-filing and has a Juris Number
☐ This filing is exempt from electronic filing — Basis: [________________________________]

• ☐ Self-represented litigant
• ☐ Emergency filing
• ☐ Other exemption: [________________________________]

SECTION 14: APPEARANCE REQUIREMENT

Per Practice Book § 3-1, the defendant or the defendant's attorney must file an Appearance (Form JD-CL-12) with the clerk on or before the second day after the Return Date.

Appearance Filing Deadline: [__/__/____] (Second day after Return Date)

SECTION 15: ATTORNEY / PARTY CERTIFICATION

I certify that:

1. The information provided in this Civil Cover Sheet is true and accurate to the best of my knowledge.
2. This action is not frivolous and is brought in good faith per Practice Book § 4-2 (sanctions for vexatious litigation).
3. I have complied with all applicable pre-filing requirements, including:
   - ☐ Good faith certificate for medical malpractice (Conn. Gen. Stat. § 52-190a), if applicable
   - ☐ Pre-suit notice requirements, if applicable
   - ☐ Correct Return Date selection (Tuesday; at least 12 days after service)
4. Service of process will be/has been made by a state marshal or other authorized person.
5. The filing fee has been paid or a fee waiver application has been filed.

SECTION 16: SIGNATURE

Date: [__/__/____]

____________________________________________
Signature

Printed Name: [________________________________]
Juris Number: [________________________________]
(or "Self-Represented Litigant")

Attorney for: ☐ Plaintiff(s) ☐ Defendant(s)

Law Firm: [________________________________]
Address: [________________________________]
         [________________________________]
Telephone: [________________________________]
Fax: [________________________________]
Email: [________________________________]

IMPORTANT NOTICES

Form Usage: This worksheet supplements but does not replace the official JD-CV-1 (Summons — Civil) form required by the Connecticut Judicial Branch. The official form must be used for all civil filings. This form should NOT be used for: family matters (divorce, child support, custody, paternity, visitation), summary process actions, applications for change of name, probate appeals, administrative appeals, arbitration proceedings, or actions seeking attachment, garnishment, or replevy.

Return Date Must Be a Tuesday: Per Conn. Gen. Stat. § 52-48, the Return Date must be a Tuesday. Service must be completed at least 12 days before the Return Date. To calculate: find the date process will be served, count ahead at least 12 days, then select the next Tuesday on or after that date.

Service by State Marshal: Connecticut requires that civil process be served by a state marshal, constable (in towns that still have them), or other proper officer per Conn. Gen. Stat. § 52-57. Private process servers are generally not authorized for original service.

Medical Malpractice Requirement: Per Conn. Gen. Stat. § 52-190a, any medical malpractice complaint must be accompanied by a good faith certificate signed by the attorney or party stating that there has been a reasonable inquiry and that the complaint is not filed for improper purposes, along with a written opinion from a similar health care provider that there is evidence of medical negligence.

Appearance Filing: The defendant must file an Appearance (Form JD-CL-12) on or before the second day after the Return Date to receive further court notices.

Sources and References

• Connecticut Practice Book: https://www.jud.ct.gov/pb.htm
• Connecticut Judicial Branch Official Civil Forms: https://www.jud.ct.gov/webforms/default.aspx?load_catg=Civil
• JD-CV-1 (Summons — Civil): https://www.jud.ct.gov/webforms/forms/cv001.pdf
• Civil Case Type Codes (JD-CL-134): https://www.jud.ct.gov/webforms/
• Court Fees: https://www.jud.ct.gov/external/super/courtfee.htm
• Return Date Information: https://www.jud.ct.gov/lawlib/palm_cards/Return_Day.pdf
• Conn. Gen. Stat. § 52-259 (Court Fees): https://www.lawserver.com/law/state/connecticut/ct-laws/connecticut_statutes_52-259
• Connecticut E-Filing: https://www.jud.ct.gov/external/super/E-Services/efile/
• Conn. Gen. Stat. § 52-45a (Civil Process): https://www.cga.ct.gov/current/pub/chap_896.htm
• Conn. Gen. Stat. § 52-59b (Long Arm Statute): https://www.cga.ct.gov/current/pub/chap_897.htm