Form JD-CL-54 "Request and Stipulation for Referral to a Private Alternative Dispute Resolution (Adr) Provider" - Connecticut

What Is Form JD-CL-54?

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 March 1, 2015;
  • 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-CL-54 by clicking the link below or browse more documents and templates provided by the Connecticut Superior Court.

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Download Form JD-CL-54 "Request and Stipulation for Referral to a Private Alternative Dispute Resolution (Adr) Provider" - Connecticut

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REQUEST AND STIPULATION FOR
Court Use Only
STATE OF CONNECTICUT
ADRPREF
REFERRAL TO A PRIVATE ALTERNATIVE
SUPERIOR COURT
DISPUTE RESOLUTION (ADR) PROVIDER
*ADRPREF*
www.jud.ct.gov
JD-CL-54
Rev. 3-15
P.B. § 23-67 C.G.S. § 52-235C
Instructions for Applicants
1. All counsel or self-represented parties must sign fully completed form.
ADA NOTICE
2. All parties should make and keep a copy for their records.
3. File both parts of this form in the Superior Court Clerk's Office in which
The Judicial Branch of the State of Connecticut complies with the
your case is pending.
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.
Instructions for Clerk
1. Bring this completed form and the file to the civil/family presiding judge.
2. Notify counsel and self-represented parties of record of the court's decision.
Name of case
Docket number
Judicial District
Address of court (Number, street, town, state and zip code)
Housing Session
Claim date:
Trial date:
Return date
Type of case (Check one)
Trial list claim filed
Civil
Family
Housing
No
Yes
If yes:
Request And Stipulation
All parties request and stipulate that this case shall be submitted to a private Alternative Dispute Resolution provider as follows:
. Type Of ADR:
1
Non-Binding Mediation
Binding Arbitration
Other
2. ADR Provider:
Provider Number (See Clerk for List)
(Specify Name of ADR Provider Selected By Parties)
3. Scope Of ADR:
All issues
Liability only
Damages only
Discovery disputes
4. Requested Referral Period:
(Not to Exceed Ninety Days)
5. Special Conditions If Any:
Plaintiff Counsel/Self-represented party
Defendant Counsel/Self-represented party
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
Order
The request and stipulation has been reviewed by this court and it is ORDERED that:
the above-entitled case is referred to Alternative Dispute Resolution, and all court proceedings are stayed through
or until the ADR process is completed, whichever occurs first.
(Specify date - Not to exceed ninety days)
the above-entitled case is not referred to Alternative Dispute Resolution.
The parties are ordered to file an ADR Result Report with the clerk's office no later than five days after the expiration of the
above stay.
Special Conditions of Order:
By the court:
(Judge/Clerk)
(Date)
Distribution:
White - Clerk's Office
Yellow - Caseflow
Print Form
Reset Form
REQUEST AND STIPULATION FOR
Court Use Only
STATE OF CONNECTICUT
ADRPREF
REFERRAL TO A PRIVATE ALTERNATIVE
SUPERIOR COURT
DISPUTE RESOLUTION (ADR) PROVIDER
*ADRPREF*
www.jud.ct.gov
JD-CL-54
Rev. 3-15
P.B. § 23-67 C.G.S. § 52-235C
Instructions for Applicants
1. All counsel or self-represented parties must sign fully completed form.
ADA NOTICE
2. All parties should make and keep a copy for their records.
3. File both parts of this form in the Superior Court Clerk's Office in which
The Judicial Branch of the State of Connecticut complies with the
your case is pending.
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.
Instructions for Clerk
1. Bring this completed form and the file to the civil/family presiding judge.
2. Notify counsel and self-represented parties of record of the court's decision.
Name of case
Docket number
Judicial District
Address of court (Number, street, town, state and zip code)
Housing Session
Claim date:
Trial date:
Return date
Type of case (Check one)
Trial list claim filed
Civil
Family
Housing
No
Yes
If yes:
Request And Stipulation
All parties request and stipulate that this case shall be submitted to a private Alternative Dispute Resolution provider as follows:
. Type Of ADR:
1
Non-Binding Mediation
Binding Arbitration
Other
2. ADR Provider:
Provider Number (See Clerk for List)
(Specify Name of ADR Provider Selected By Parties)
3. Scope Of ADR:
All issues
Liability only
Damages only
Discovery disputes
4. Requested Referral Period:
(Not to Exceed Ninety Days)
5. Special Conditions If Any:
Plaintiff Counsel/Self-represented party
Defendant Counsel/Self-represented party
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
(Signature)
(Date)
Order
The request and stipulation has been reviewed by this court and it is ORDERED that:
the above-entitled case is referred to Alternative Dispute Resolution, and all court proceedings are stayed through
or until the ADR process is completed, whichever occurs first.
(Specify date - Not to exceed ninety days)
the above-entitled case is not referred to Alternative Dispute Resolution.
The parties are ordered to file an ADR Result Report with the clerk's office no later than five days after the expiration of the
above stay.
Special Conditions of Order:
By the court:
(Judge/Clerk)
(Date)
Distribution:
White - Clerk's Office
Yellow - Caseflow
Print Form
Reset Form