Connecticut > Statewide > Civil
Statement Of Service (Delivery) JD-CV-123 - Connecticut
| Statement Of Service (Delivery) Form. This is a Connecticut form and can be used in Civil Statewide . |
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STATEMENT OF SERVICE -- (DELIVERY) SMALL CLAIMS JD-CV-123 New 1-11 Instructions Fill out 1 form for each defendant. Attach all documents that show how the Small Claims Writ and Notice of Suit and related documents were served on (delivered to) the defendant, and check the box below that applies. Keep all receipts that show how much you paid to have the Small Claims Writ and Notice of Suit and related documents served on (delivered to) the defendant. For service on (delivery to) the Defendant: (Write name of Defendant) The attached Small Claims Writ and Notice of Suit with related documents, if any, were served on (delivered to) the defendant named above by: (Check the box that applies) 1.) 2.) 3.) priority mail with delivery confirmation; delivery confirmation is attached. I paid $ certified mail, return receipt requested; signed return receipt is attached. I paid $ for this, or for this, or a nationally recognized courier service providing delivery confirmation; tracking information showing delivery is attached. I paid $ for this, or 4.) a proper officer in the manner in which a writ of summons is served in a civil action; officer's return of service filed with the court. Signature of Plaintiff or Plaintiff's Representative (Check one) Plaintiff Plaintiff's representative Type or print name of signer Date The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court clerk or an ADA contact person listed at www.jud.ct.gov/ADA/. Print Form Reset Form American LegalNet, Inc. www.FormsWorkFlow.com
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