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Appeal From Family Support Magistrate JD-FM-111 - Connecticut
| Appeal From Family Support Magistrate Form. This is a Connecticut form and can be used in Family Statewide . |
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APPEAL FROM FAMILY SUPPORT MAGISTRATE JD-FM-111 Rev. 4-11 C.G.S. § 46b-231(n), P.B. §§ 25a-5, 25a-29 STATE OF CONNECTICUT SUPERIOR COURT www.jud.ct.gov COURT USE ONLY APFFSM *APFFSM* Instructions To Clerk 1. Provide a copy of the filed appeal form and all sheets that are attached, if any, to the Family Support Magistrate whose decision is being appealed. 2. Provide a copy of the Superior Court Judge's verbal or written decision on the appeal to the Family Support Magistrate. Instructions To Person Appealing The Decision (Appellant) 1. Type or print this form neatly and sign the certification section below. 2. Give the reasons for the appeal on this form and, if necessary, on a separate piece of paper (petition) and attach that petition to this form. 3. Mail or deliver a copy of this form and all sheets that are attached, if any, to each party in the case, and mail one copy, by certified mail, to the following address: OFFICE OF ATTORNEY GENERAL, CHILD SUPPORT DEPARTMENT, 55 ELM ST., HARTFORD, CT 06106 4. Give this form, and all sheets that are attached, if any, to the clerk of the court for the Judicial District where the magistrate's decision was made WITHIN 14 DAYS OF a. the date the final decision of the magistrate was given to the clerk, or b. if a rehearing was asked for, and a decision was made on that request, the date the notice of the decision on the request was given to the clerk, whichever is later. Name of case Name and address of Court Docket number Name of magistrate who made decision Date magistrate's decision was filed with (given to) the Court Date decision on request for hearing was filed with the Court (If a request was filed) Attorneys or self-represented (pro se) party or parties at magistrate hearing Transcript Attorney for plaintiff (Include Juris number or name of self-represented party) Attorney for respondent (Include Juris number or name of selfrepresented party) Has been ordered Additional evidence requested No Yes - If yes, attach statement pursuant to C.G.S. 46b-231(n)(5) Not necessary Notice When a Family Support Magistrate decision is appealed, the support order stays in effect until the appeal is decided. When the appeal is decided, the decision may change the original support order or the original support order may stay in effect without any changes. Any order made by the court as a result of this appeal may be made effective beginning on the date the original order was made. Petition The reasons for this appeal are:* *If necessary, attach additional sheet(s). Signed (Individual attorney or self-represented party) Telephone number Mailing address Juris number of attorney Appeal by: Name of person signing above (type or print) Certification I certify that a copy of this document and all attachments to it, if any, were mailed or delivered electronically or non-electronically to all attorneys and self-represented parties of record on 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 (Individual attorney or self-represented party) Court Use Only File date Print or type name and mailing address of person signing I further certify that a copy was mailed, by certified mail, to the Office of the Attorney General, Child Support Department, 55 Elm Street, Hartford, CT 06106. Print Form Reset Form American LegalNet, Inc. www.FormsWorkFlow.com
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