APPEAL FORM JD-SC-033 (ADAPTED) / NOTICE OF APPEAL
(Connecticut Superior Court — Civil Division)
1. CAPTION AND CASE INFORMATION
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STATE OF CONNECTICUT
SUPERIOR COURT
JUDICIAL DISTRICT OF [JUDICIAL_DISTRICT]
AT [LOCATION]
[PLAINTIFF_NAME]
v. DOCKET NO. [TRIAL_DOCKET_NUMBER]
[DEFENDANT_NAME]
2. APPELLANT INFORMATION
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Name of Appellant: [CLIENT_NAME]
Trial Court Status: [Plaintiff/Defendant/Intervenor]
Attorney for Appellant: [ATTORNEY_NAME] (Juris No. [JURIS_NUMBER])
Firm Name: [LAW_FIRM_NAME]
Office Address: [ADDRESS]
Telephone: [PHONE] | Fax: [FAX]
E-Mail (per Practice Book § 10-13): [EMAIL]
3. NOTICE OF APPEAL
Pursuant to Practice Book § 63-1, Appellant hereby appeals from the judgment/order entered on [JUDGMENT_DATE] by the Honorable [JUDGE_NAME] in the Superior Court for the Judicial District of [JUDICIAL_DISTRICT]. The judgment [brief description] and is appealable under Conn. Gen. Stat. § 52-263 and Practice Book § [SECTION].
- Date notice of judgment was mailed or delivered: [NOTICE_DATE]
- Date of this filing: [FILING_DATE]
- Appellate tribunal: [Connecticut Appellate Court / Connecticut Supreme Court]
4. GROUNDS OF APPEAL / ISSUES ANTICIPATED (Practice Book § 63-4)
- [ISSUE_ONE]
- [ISSUE_TWO]
- [ISSUE_THREE]
[// File a separate Preliminary Statement of Issues within 10 days unless exempt.]
5. RECORD AND TRANSCRIPTS
- Appellant [has ordered / will order] transcripts of proceedings dated [HEARING_DATES] from [COURT_REPORTER], with certification per Practice Book § 63-8.
- Appellant [will file] designation of contents of the record and statement regarding exhibits by [DEADLINE].
6. FEE, BOND, AND STAY INFORMATION
- Entry fee of $250 has been [paid / waived].
- [If applicable] Appellant seeks a stay of execution and will file motion pursuant to Practice Book § 61-11 and § 61-12.
7. RELIEF REQUESTED
Appellant requests reversal, modification, or other appropriate relief with respect to the judgment/order identified above, along with costs as allowed by law.
8. SIGNATURE
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Date: [DATE]
[ATTORNEY_NAME]
Attorney for Appellant [CLIENT_NAME]
9. CERTIFICATION OF SERVICE (Practice Book § 63-3)
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I certify that a copy of the foregoing was delivered on [SERVICE_DATE] to all counsel and self-represented parties of record and transmitted to the appellate clerk as follows:
☐ Electronic delivery via e-filing system to: [NAMES/EMAILS]
☐ Mail delivery to: [ADDRESSES]
Signed: _____ [SERVERNAME]