Form JD-FM-154 "Affidavit of Noncompliance With License Suspension Order" - Connecticut

What Is Form JD-FM-154?

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, 2006;
  • 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-FM-154 by clicking the link below or browse more documents and templates provided by the Connecticut Superior Court.

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Download Form JD-FM-154 "Affidavit of Noncompliance With License Suspension Order" - Connecticut

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AFFIDAVIT OF NONCOMPLIANCE
STATE OF CONNECTICUT
WITH LICENSE SUSPENSION ORDER
SUPERIOR COURT
www.jud.ct.gov
JD-FM-154 Rev. 2-06
C.G.S. § 46b-220
INSTRUCTIONS TO PREPARER
1. Complete affidavit and file original and two copies with the clerk.
2. Provide the obligor with a file-stamped copy of the completed affidavit.
NOTICE
The obligor must comply with the conditions of the suspension order within thirty (30) days of the issuance of
the order. If the obligor fails to comply within the thirty-day period, this affidavit must be filed with the Court or
assistant clerk of the Family Support Magistrate Division within forty-five (45) days after the expiration of the
thirty-day period. The suspension order shall be effective upon the filing of this affidavit.
FOR THE JUDICIAL DISTRICT OF
AT (Address of court)
DOCKET NO.
NAME OF CASE
NAME OF OBLIGOR
I, the undersigned, duly depose and state that:
1. On
, the Court or Family Support Magistrate ordered the suspension of the
(date)
following license(s) held by the obligor:
2. The conditions to avoid license suspension were:
3. The conditions to avoid license suspension were not met within thirty days of the issuance of the license
suspension order.
SIGNED (Affiant)
DATE SIGNED
I hereby certify that the foregoing statements
are true to the best of my knowledge and belief.
SIGNED (Clerk, Notary, Comm. Sup. Ct )
DATE SIGNED
Subscribed and sworn to before me:
For Court Use Only
FILE DATE
DISTRIBUTION:
ORIGINAL - Court
COPY1 - IVD Agency/Obligee
COPY2 - Obligor
PRINT
RESET
AFFIDAVIT OF NONCOMPLIANCE
STATE OF CONNECTICUT
WITH LICENSE SUSPENSION ORDER
SUPERIOR COURT
www.jud.ct.gov
JD-FM-154 Rev. 2-06
C.G.S. § 46b-220
INSTRUCTIONS TO PREPARER
1. Complete affidavit and file original and two copies with the clerk.
2. Provide the obligor with a file-stamped copy of the completed affidavit.
NOTICE
The obligor must comply with the conditions of the suspension order within thirty (30) days of the issuance of
the order. If the obligor fails to comply within the thirty-day period, this affidavit must be filed with the Court or
assistant clerk of the Family Support Magistrate Division within forty-five (45) days after the expiration of the
thirty-day period. The suspension order shall be effective upon the filing of this affidavit.
FOR THE JUDICIAL DISTRICT OF
AT (Address of court)
DOCKET NO.
NAME OF CASE
NAME OF OBLIGOR
I, the undersigned, duly depose and state that:
1. On
, the Court or Family Support Magistrate ordered the suspension of the
(date)
following license(s) held by the obligor:
2. The conditions to avoid license suspension were:
3. The conditions to avoid license suspension were not met within thirty days of the issuance of the license
suspension order.
SIGNED (Affiant)
DATE SIGNED
I hereby certify that the foregoing statements
are true to the best of my knowledge and belief.
SIGNED (Clerk, Notary, Comm. Sup. Ct )
DATE SIGNED
Subscribed and sworn to before me:
For Court Use Only
FILE DATE
DISTRIBUTION:
ORIGINAL - Court
COPY1 - IVD Agency/Obligee
COPY2 - Obligor
PRINT
RESET