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Foreclosure Mediation Certificate JD-CV-108 - Connecticut

Foreclosure Mediation Certificate Form. This is a Connecticut form and can be used in Civil Statewide .
 Fillable pdf Last Modified 10/11/2013
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FORECLOSURE MEDIATION CERTIFICATE JD-CV-108 Rev. 8-13 C.G.S. ยงยง 49-31k, 49-31l; P.A. 13-136 STATE OF CONNECTICUT SUPERIOR COURT JUDICIAL BRANCH www.jud.ct.gov FMREQ *FMREQ* Instructions to Homeowner Applicant 1. Use this form if return date in your case is on or after July 1, 2009. 2. Fill out this Certificate form and an Appearance form, JD-CL-12 (available at the courthouse or online at www.jud2.ct.gov/webforms) and file them with the court not more than 15 days after the return date on the Summons. 3. You must mail or deliver a copy of this completed Certificate form to the plaintiff's attorney, or to the plaintiff if the plaintiff is not represented by an attorney. ADA NOTICE 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. Type or Print Legibly Name of case (Plaintiff on Summons vs. Defendant on Summons) Return date (On upper right portion of Summons) Judicial District of (On upper left portion of Summons) Docket number (To be filled in by court staff) Homeowner(s) Information Your name(s) Address (Number, street, town, state, zip code) Telephone number Business phone Cell phone ( ) ( ) ( ) Is this property your primary residence? Do you occupy the property? Is it a 1, 2, 3 or 4 family residential property located in Connecticut? Are you the borrower? Is this a mortgage foreclosure? Signed Yes Yes Yes Yes Yes No No No No No OR Is this property owned by a religious organization? Is the property located in Connecticut? Is the religious organization the borrower? Is the the return date in the case on or after October 1, 2011? Yes Yes Yes Yes No No No No Print name of person signing Date signed Name and address of each party (plaintiff's attorney, or the plaintiff if the plaintiff is not represented by an attorney) this Certificate was mailed or delivered to:* Name (Of each party (plaintiff's attorney, or the plaintiff if the plaintiff is not represented by an attorney) copy was mailed or delivered to) Address (At which copy was mailed or delivered ) *If necessary, attach an additional sheet or sheets with the name of each party (plaintiff's attorney, or the plaintiff if the plaintiff is not represented by an attorney) and the address at which the copy was mailed or delivered to. Certification to all attorneys I certify that a copy of this document was mailed or delivered electronically or non-electronically on (date) and self-represented parties of record and that written consent for electronic delivery was received from all attorneys and self-represented parties receiving electronic delivery. Name and address of each party and attorney that copy was mailed or delivered to* *If necessary, attach additional sheet or sheets with name and address which the copy was mailed or delivered to. Signed (Signature of filer) Print or type name of person signing Date signed Telephone number X Mailing address (Number, street, town, state and zip code) American LegalNet, Inc. www.FormsWorkFlow.com
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