Fill and Sign the Notice of Application for Prejudgment Remedyclaim for Hearing Form

NO. COUNTS that the amount sought in the application for prejudgment remedy is unreasonably high. that any judgment that may be rendered is adequately secured by insurance. that the plaintiff be required to post a bond to secure me against any damages that may result from the prejudgment remedy. SEE ATTACHED FORM JD-CV-67 FOR CONTINUATION OF PARTIES NAME(S), ADDRESS(ES) AND TELEPHONE NO(S). OF DEFENDANT(S) AGAINST WHOM PREJUDGMENT REMEDY IS SOUGHT (No., street, town and zip code) (Attach additional sheet if necessary) SECTION I - CASE INFORMATION (To be completed by Plaintiff/Applicant) SECTION II - NOTICE TO DEFENDANT SECTION III - DEFENDANT'S CLAIM AND REQUEST FOR HEARING (To be completed by Defendant) STATE OF CONNECTICUT SUPERIOR COURT SUPERIOR COURT NOTICE OF APPLICATION FOR PREJUDGMENT REMEDY/CLAIM FORHEARING TO CONTEST APPLICATIONOR CLAIM EXEMPTION JD-CV-53 Rev. 7-01 C.G.S. §§ 52-278c et seq. COURT ADDRESS Housing Session G.A. No. Judicial District Has a temporary restraining order been requested? NAME OF CASE (First-named plaintiff vs. First-named defendant) CASE TYPE (From Judicial Branch code list) MAJOR: MINOR: YESNO NAME AND ADDRESS OF PLAINTIFF/APPLICANT (Person making application for Prejudgment Remedy) (No., street, town and zip code) NAME AND ADDRESS OF ANY THIRD PERSON HOLDING PROPERTY OF DEFENDANT WHO IS TO BE MADE A GARNISHEE BY PROCESS PREVENTING DISSIPATION FOR THE PLAINTIFF(S) ENTER THEAPPEARANCE OF: NAME AND ADDRESS OF ATTORNEY, LAW FIRM OR PLAINTIFF IF PRO SE (No., street, town and zip code) TELEPHONE NO. JURIS NO. (If atty. or law firm) SIGNED You have rights specified in the Connecticut General Statutes, including Chapter 903a, that you may wish to exercise concerning this application for a prejudgment remedy. These rights include the right to a hearing: (1) to object to the proposed prejudgment remedy because you have a defense to or set-off against the action or a counterclaim against the plaintiff or because the amount sought in the application for the prejudgment remedy is unreasonably high or because payment of any judgment that may be rendered against you is covered by any insurance that may be available to you; (2) to request that the plaintiff post a bond in accordance with section 52-278d of the General Statutes to secure you against any damages that may result from the prejudgment remedy; (3) to request that you be allowed to substitute a bond for the prejudgment remedy sought; and (4) to show that the property sought to be subjected to the prejudgment remedy is exempt from such a prejudgment remedy. You may request a hearing to contest the application for a prejudgment remedy, assert any exemption or make a request concernin g the posting or substitution of a bond in connection with the prejudgment remedy. The hearing may be requested by any proper motion or by completing section III below and returning this form to the superior court at the Court Address listed above. You have a right to appear and be heard at the hearing on the application to be held at the above court location on: DATE TIME COURTROOM M. NAME OF EACH PARTY SERVED* ADDRESS AT WHICH SERVICE WAS MADE* TYPE OR PRINT NAME AND ADDRESS OF DEFENDANT DOCKET NO. PJR CV DATE COPY(IES) MAILED/DELIVERED SIGNED (Defendant) DATE SIGNED FOR COURT USE ONLY I, the defendant named below, request a hearing to contest the application for prejudgment remedy, claim an exemption or request the posting or substitution of a bond. I claim: ("X" the appropriate boxes) I certify that a copy of the above claim was mailed/delivered to the Plaintiff or the Plaintiff's attorney on the Date Mailed/Delivered shown below. a defense, counterclaim, set-off, or exemption. that I be allowed to substitute a bond for the prejudgment remedy. *If necessary, attach additional sheet with names of each party served and the address at which service was made. AMOUNT, LEGAL INTEREST, OR PROPERTY IN DEMAND, EXCLUSIVE OF INTEREST AND COSTS IS ("X" one of the following) LESS THAN $2500 $2500 THROUGH $14,999.99$15,000 OR MORE ("X" if applicable) CLAIMING OTHER RELIEF IN ADDITION TO OR IN LIEU OF MONEY DAMAGES C L P J R H G C L P J R A COURT USE ONLY CLPJRA Application For PJR CLPJRHG Contest PJR Application(If Section III Completed) INSTRUCTIONS TO PLAINTIFF/APPLICANT 1. Complete section I in connection with all prejudgment remedies EXCEPT ex parte prejudgment remedies and submit to the Clerk along with your application and other required documents. 2. Upon receipt of signed order for hearing from clerk, serve this form on defendant(s) with other required documents. www.jud. ct.gov DATE SIGNED