Form JD-CV-138 "Administrative Appeals Under Connecticut General Statutes Section 4-183 - Notice of Filing" - Connecticut

What Is Form JD-CV-138?

This is a legal form that was released by the Connecticut Superior Court - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2020;
  • The latest edition provided by the Connecticut Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form JD-CV-138 by clicking the link below or browse more documents and templates provided by the Connecticut Superior Court.

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Download Form JD-CV-138 "Administrative Appeals Under Connecticut General Statutes Section 4-183 - Notice of Filing" - Connecticut

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ADMINISTRATIVE APPEAL UNDER CONNECTICUT
STATE OF CONNECTICUT
GENERAL STATUTES SECTION 4-183 — CITATION
SUPERIOR COURT
(For use when service is made by a proper officer or indifferent person)
www.jud.ct.gov
JD-CV-138 Rev. 2-20
C.G.S. § 4-183; P.B. § 14-7A
Instructions to Person Appealing Decision :
1. The Judicial District you name in this Citation must be the Judicial District of New Britain or Judicial
District where the plaintiff resides.
For information on ADA
2. Attach the original Appeal to the original Citation.
accommodations,
3. If you are self-represented, bring this Citation and the Appeal to a clerk of court for the Judicial District
contact a court clerk or go to:
you name below. The clerk will review and sign the Citation.
www.jud.ct.gov/ADA.
4. Give this Citation and the Appeal to a proper officer or indifferent person for service on each defendant.
5. After service has been made, file this Citation, Appeal, and the Officer's Return of Service with the clerk
of court for the Judicial District named below.
To Any Proper Officer or Indifferent Person:
By the authority of the State of Connecticut, you are commanded to serve, according to law, a copy of the Appeal and this Citation by personal
service on the agency that made the decision that is being appealed at the address of the agency or, if allowed by law, at the Office of the Attorney
General, 165 Capitol Avenue, Hartford, Connecticut. Also serve, according to law, a copy of the Appeal and this Citation on each party named as a
defendant in this Appeal, at the address provided on this form.
Name of case (Plaintiff v. Defendant)
Case type code (See reverse for codes)
Major:
Minor:
Judicial District
Address of Court
Telephone number of Court (with area code)
For the plaintiff(s) enter the appearance of:
Name and address of attorney, law firm or plaintiff if self-represented (Number, street, town and zip code)
Juris number (if attorney or law firm)
Telephone number
Signature of plaintiff (if self-represented)
(
)
E-mail address for delivery of papers under Section 10-13 of the
The attorney or law firm appearing for the plaintiff, or the plaintiff if
Connecticut Practice Book (if agreed)
self-represented, agrees to accept papers (service) electronically
Yes
No
in this case under Section 10-13 of the Connecticut Practice Book.
Parties
Name (Last, First, Middle Initial) and Address of Each party (Number; Street; P.O. Box; Town; State; Zip; Country, if not USA)
P-01
First
Name:
Address:
Plaintiff
P-02
Additional
Name:
Address:
Plaintiff
D-01
First
Name:
Defendant
Address:
D-02
Additional
Name:
Address:
Defendant
D-03
Additional
Name:
Address:
Defendant
Form JD-CV-2 attached for additional parties
Total number of plaintiffs:
Total number of defendants:
Notice to each defendant
1. The Plaintiff will file the attached Appeal of a final administrative decision. The Appeal attached to these papers states the claims that the
Plaintiff is making.
2. To receive further notices, you or your attorney must file an Appearance (form JD-CL-12) with the clerk at the address above within thirty
(30) days of the mailing of the Appeal. You do not have to come to court on that date unless you receive a separate notice telling you to
come to court.
3. If you do not file an Appearance on time, the Court may enter sanctions against you.
4. You can get an Appearance form at the Court address above or on-line at https://jud.ct.gov/webforms/.
5. If you have questions about the Notice of Filing and the Appeal, you should talk to an attorney.
The court staff is not allowed to give advice on legal matters.
*
Name of person signing at left
Date
Signed (Sign and "x" proper box)
Commissioner of the Superior Court
*
Assistant Clerk
If this Citation is signed by a Clerk:
For Court Use Only
File Date
a. The signing has been done so that the plaintiff(s) will not be denied access to the courts.
b. It is the responsibility of the plaintiff(s) to ensure that service is made in the manner provided by law.
c. The court staff is not permitted to give any legal advice in connection with any lawsuit.
d. The Clerk signing this Citation at the request of the plaintiff(s) is not responsible in any way for any
errors or omissions in the Citation, any allegations contained in the Appeal, or the service of the
Citation or Appeal.
Date
Signed (Self-Represented Plaintiff)
Docket number
I certify I have read and
understand the above:
Print Form
Reset Form
ADMINISTRATIVE APPEAL UNDER CONNECTICUT
STATE OF CONNECTICUT
GENERAL STATUTES SECTION 4-183 — CITATION
SUPERIOR COURT
(For use when service is made by a proper officer or indifferent person)
www.jud.ct.gov
JD-CV-138 Rev. 2-20
C.G.S. § 4-183; P.B. § 14-7A
Instructions to Person Appealing Decision :
1. The Judicial District you name in this Citation must be the Judicial District of New Britain or Judicial
District where the plaintiff resides.
For information on ADA
2. Attach the original Appeal to the original Citation.
accommodations,
3. If you are self-represented, bring this Citation and the Appeal to a clerk of court for the Judicial District
contact a court clerk or go to:
you name below. The clerk will review and sign the Citation.
www.jud.ct.gov/ADA.
4. Give this Citation and the Appeal to a proper officer or indifferent person for service on each defendant.
5. After service has been made, file this Citation, Appeal, and the Officer's Return of Service with the clerk
of court for the Judicial District named below.
To Any Proper Officer or Indifferent Person:
By the authority of the State of Connecticut, you are commanded to serve, according to law, a copy of the Appeal and this Citation by personal
service on the agency that made the decision that is being appealed at the address of the agency or, if allowed by law, at the Office of the Attorney
General, 165 Capitol Avenue, Hartford, Connecticut. Also serve, according to law, a copy of the Appeal and this Citation on each party named as a
defendant in this Appeal, at the address provided on this form.
Name of case (Plaintiff v. Defendant)
Case type code (See reverse for codes)
Major:
Minor:
Judicial District
Address of Court
Telephone number of Court (with area code)
For the plaintiff(s) enter the appearance of:
Name and address of attorney, law firm or plaintiff if self-represented (Number, street, town and zip code)
Juris number (if attorney or law firm)
Telephone number
Signature of plaintiff (if self-represented)
(
)
E-mail address for delivery of papers under Section 10-13 of the
The attorney or law firm appearing for the plaintiff, or the plaintiff if
Connecticut Practice Book (if agreed)
self-represented, agrees to accept papers (service) electronically
Yes
No
in this case under Section 10-13 of the Connecticut Practice Book.
Parties
Name (Last, First, Middle Initial) and Address of Each party (Number; Street; P.O. Box; Town; State; Zip; Country, if not USA)
P-01
First
Name:
Address:
Plaintiff
P-02
Additional
Name:
Address:
Plaintiff
D-01
First
Name:
Defendant
Address:
D-02
Additional
Name:
Address:
Defendant
D-03
Additional
Name:
Address:
Defendant
Form JD-CV-2 attached for additional parties
Total number of plaintiffs:
Total number of defendants:
Notice to each defendant
1. The Plaintiff will file the attached Appeal of a final administrative decision. The Appeal attached to these papers states the claims that the
Plaintiff is making.
2. To receive further notices, you or your attorney must file an Appearance (form JD-CL-12) with the clerk at the address above within thirty
(30) days of the mailing of the Appeal. You do not have to come to court on that date unless you receive a separate notice telling you to
come to court.
3. If you do not file an Appearance on time, the Court may enter sanctions against you.
4. You can get an Appearance form at the Court address above or on-line at https://jud.ct.gov/webforms/.
5. If you have questions about the Notice of Filing and the Appeal, you should talk to an attorney.
The court staff is not allowed to give advice on legal matters.
*
Name of person signing at left
Date
Signed (Sign and "x" proper box)
Commissioner of the Superior Court
*
Assistant Clerk
If this Citation is signed by a Clerk:
For Court Use Only
File Date
a. The signing has been done so that the plaintiff(s) will not be denied access to the courts.
b. It is the responsibility of the plaintiff(s) to ensure that service is made in the manner provided by law.
c. The court staff is not permitted to give any legal advice in connection with any lawsuit.
d. The Clerk signing this Citation at the request of the plaintiff(s) is not responsible in any way for any
errors or omissions in the Citation, any allegations contained in the Appeal, or the service of the
Citation or Appeal.
Date
Signed (Self-Represented Plaintiff)
Docket number
I certify I have read and
understand the above:
Print Form
Reset Form
STATE OF CONNECTICUT JUDICIAL BRANCH
CASE TYPE CODES
January, 2020
CODE
MAJOR
MINOR DESCRIPTION
Major/
DESCRIPTION
Minor
Appeals from
A 00
Zoning
Administrative
A 05
Affordable Housing Appeals
Boards
A 10
Taxation
A 20
Liquor
A 30
Motor Vehicle Commissioner
A 40
Unemployment
A 50
Worker's Compensation
A 60
Labor Relations Board
A 61
Environmental Protection Commissioner - State
A 62
Commission on Hospitals/Healthcare
A 63
Employees Review Board
A 64
Social Services Commission
A 65
Freedom of Information Commission
A 66
Inland Wetlands & Conservation Commission - Local
A 67
Retirement Commission
A 68
Housing and Building Code Enforcement
A 69
Human Rights and Opportunities Commission
A 70
Department of Children and Families
A 90
All other
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