JD–CV–___ (Proposed)
STATE OF CONNECTICUT
SUPERIOR COURT – GENERAL CIVIL CASE COVER SHEET
[// GUIDANCE: This template is modeled on current Connecticut Judicial Branch practice forms (e.g., JD-CV series). It is not an official Judicial Branch document and must be conformed to the most recent court-issued form requirements prior to filing.]
I. COURT & DOCKET INFORMATION
| Field | Entry |
|---|---|
| Judicial District / Geographic Area | [JUDICIAL DISTRICT OR G.A. NUMBER & NAME] |
| Address of Court | [COURTHOUSE STREET ADDRESS, CITY, ZIP] |
| Docket Number | (To be assigned by Clerk) |
| Return Date | [MM/DD/YYYY] |
[// GUIDANCE: Under Conn. Gen. Stat. § 52-46a the Return Date must be a Tuesday at least two months after the writ is signed.]
II. PARTY INFORMATION
A. Plaintiff(s)
- Name: [PLAINTIFF FULL LEGAL NAME]
- Entity Type: [INDIVIDUAL / CORPORATION / LLC / ETC.]
- Address: [STREET, CITY, STATE, ZIP]
- Telephone / E-Mail: [(###) ###-####] / [EMAIL]
B. Defendant(s)
- Name: [DEFENDANT FULL LEGAL NAME]
- Entity Type: [INDIVIDUAL / CORPORATION / LLC / ETC.]
- Address: [STREET, CITY, STATE, ZIP]
- Telephone / E-Mail: [(###) ###-####] / [EMAIL]
[// GUIDANCE: Add additional plaintiff/defendant blocks as needed. Attach Schedule 1 if more space is required.]
III. CASE CLASSIFICATION
| Item | Entry |
|---|---|
| Major Case Type Code | [T – TORT / P – PROPERTY / M – MISC. / F – FAMILY / W – WRIT, ETC.] |
| Minor Case Type Code | [e.g., T12 – PREMISES LIABILITY; P01 – FORECLOSURE] |
| Short Title (per Practice Book § 10-21) | “[PLAINTIFF LAST NAME] v. [DEFENDANT LAST NAME]” |
| Claim for Jury | ☐ Yes ☐ No |
| Relief Sought (check all that apply) | ☐ Monetary Damages ☐ Equitable / Injunctive ☐ Declaratory ☐ Other: [DESCRIBE] |
[// GUIDANCE: The Major/Minor codes drive automated docketing. Use the latest “Civil, Family and Housing Case Type Codes” list issued by the Judicial Branch. Mis-coding will result in rejection or reclassification by the Clerk.]
IV. AMOUNT IN DEMAND
- ☐ Amount exceeds $15,000 (exclusive of interest and costs)
- ☐ Amount is $15,000 or less
- ☐ Non-monetary relief only
[// GUIDANCE: Although Connecticut no longer requires a statement of monetary demand in most civil complaints, the Clerk’s office still tracks this data for statistical and service-of-process fee purposes.]
V. STATUTORY OR SPECIAL PROCEEDINGS (IF APPLICABLE)
| Statute / Rule Invoked | Description / Citation | ☐ Check if Applicable |
|---|---|---|
| prejudgment remedy | Conn. Gen. Stat. § 52-278a et seq. | ☐ |
| expedited process | [INSERT] | ☐ |
| administrative appeal | Conn. Gen. Stat. ch. 54 | ☐ |
| other | [INSERT] | ☐ |
[// GUIDANCE: Complete only if the matter proceeds under a specialized statutory scheme that affects filing fees, timing, or service.]
VI. FILING FEE CALCULATION
| Fee Category | Amount (as of [DATE]) |
|---|---|
| Civil Entry Fee | $[360.00]* |
| Motion to Open/Jury Claim (if claimed) | $[125.00] |
| Additional Statutory Surcharges | $[10.00] |
| Total Due to Clerk at Filing | $[495.00] |
*Fee amounts reflect the Connecticut Judicial Branch schedule in effect [MONTH, YEAR]; verify current fees at the time of filing.
[// GUIDANCE: Indigent parties should file form JD-CV-120 (“Application for Waiver of Fees/Appointment of Counsel”).]
VII. ATTORNEY OR SELF-REPRESENTED APPEARANCE
| Field | Entry |
|---|---|
| Counsel / Pro Se | [ATTORNEY NAME / SELF-REPRESENTED] |
| Juris No. | [ATTORNEY JURIS NUMBER] |
| Firm Name | [LAW FIRM NAME] |
| Mailing Address | [STREET, CITY, STATE, ZIP] |
| Phone | [(###) ###-####] |
| E-mail (required by P.B. § 10-13) | [EMAIL ADDRESS] |
☐ I am entering an appearance for the Plaintiff(s).
☐ I am entering an appearance for the Defendant(s).
VIII. CERTIFICATION
I certify that a copy of this Civil Case Cover Sheet and the accompanying complaint or other initiating pleading was or will be served in compliance with Connecticut Practice Book §§ 10-12 and 10-13.
| Signature | Date | Printed Name |
|---|---|---|
| _______ | _____ | ________ |
IX. CLERK’S OFFICE USE ONLY
| Data Entry Verified By | Date | Fee Paid | Receipt No. |
|---|---|---|---|
| _____ | ______ | $__ | ____ |
[// GUIDANCE:
1. File this Cover Sheet together with the Summons (JD-CV-1) and Complaint.
2. Attach completed Marshal Request Form JD-CV-123 if state marshal service is required.
3. E-file in eServices or deliver paper originals to the Clerk’s Office if exempt from e-filing.]
END OF TEMPLATE