Form JD-FM-177A "Dissolution of Civil Union Judgment" - Connecticut

What Is Form JD-FM-177A?

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 October 1, 2018;
  • 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-177A 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-177A "Dissolution of Civil Union Judgment" - Connecticut

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DISSOLUTION OF
COURT USE ONLY
STATE OF CONNECTICUT
JFILE
CIVIL UNION JUDGMENT
SUPERIOR COURT
JD-FM-177A Rev. 10-18
www.jud.ct.gov
*JFILE*
C.G.S § 46b-38tt;
P.A. 18-14; P.B. §§ 6-2 through 6-5, 17-4, 17-9, 17-43, 25-38
INSTRUCTIONS: Type or print with black ink and file with Court Clerk within 60 days of the judgment.
Judicial District of
At (Town)
Docket number
Name of Judge
Date of judgment
Plaintiff's name (Last, first, middle initial)
Defendant's name (Last, first, middle initial)
Plaintiff's address
Defendant's address
1. A complaint asking for a dissolution of civil union and
Return date
other relief was filed in this court with a return date of:
2. Status of case ("X" one):
Defendant filed an Appearance.
Defendant failed to file an appearance (defaulted) and the Court finds that: (a) the complaint was properly served
on the defendant, and (b) the defendant is not now, nor within the past thirty days has been, in the military service.
3. "X" one:
The Court in this case heard the evidence and finds the following:
The plaintiff has attested, under oath, that the necessary conditions required for the entry of a judgment without a
hearing have been met. The Court has considered the evidence without a hearing and finds the following:
The plaintiff,
, and defendant,
,
(Name before civil union)
(Name before civil union)
entered a civil union on
at
.
(Month, day, year)
(Town and state)
4. "X" one:
The ("X" one)
plaintiff
defendant
has lived in Connecticut for at least twelve months before the filing
of the dissolution of civil union complaint or before the dissolution of civil union will become final.
The ("X" one)
plaintiff
defendant
lived in Connecticut at the time of the civil union, moved away, and
then returned to Connecticut, planning to live here permanently.
The civil union broke down after the ("X" one)
plaintiff
defendant
moved to Connecticut.
5. A dissolution of civil union is granted based on the
complaint
cross complaint
because ("X" one):
This civil union has broken down irretrievably and there is no possibility of getting back together.
Other (must be reason(s) listed in Connecticut General Statutes section 46b-40(c)):
6. "X" all that apply:
No children were born to either the plaintiff or defendant after the date of this civil union.
There are no children of this civil union.
The following children have been born to the
plaintiff
defendant or have been adopted before,
on, or after the date of this civil union and the other party to this civil union is the parent/adoptive parent.
Name of child (First, middle, last)
Date of birth (Month, day, year)
The following children were born after the date of this civil union to the ("X" all that apply)
plaintiff
defendant
and are not the children of the other party to this civil union.
Name of child (First, middle, last)
Date of birth (Month, day, year)
7.
("X" if it applies) The Court finds that the agreement between the parties is fair and equitable.
(Continued on page 2)
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DISSOLUTION OF
COURT USE ONLY
STATE OF CONNECTICUT
JFILE
CIVIL UNION JUDGMENT
SUPERIOR COURT
JD-FM-177A Rev. 10-18
www.jud.ct.gov
*JFILE*
C.G.S § 46b-38tt;
P.A. 18-14; P.B. §§ 6-2 through 6-5, 17-4, 17-9, 17-43, 25-38
INSTRUCTIONS: Type or print with black ink and file with Court Clerk within 60 days of the judgment.
Judicial District of
At (Town)
Docket number
Name of Judge
Date of judgment
Plaintiff's name (Last, first, middle initial)
Defendant's name (Last, first, middle initial)
Plaintiff's address
Defendant's address
1. A complaint asking for a dissolution of civil union and
Return date
other relief was filed in this court with a return date of:
2. Status of case ("X" one):
Defendant filed an Appearance.
Defendant failed to file an appearance (defaulted) and the Court finds that: (a) the complaint was properly served
on the defendant, and (b) the defendant is not now, nor within the past thirty days has been, in the military service.
3. "X" one:
The Court in this case heard the evidence and finds the following:
The plaintiff has attested, under oath, that the necessary conditions required for the entry of a judgment without a
hearing have been met. The Court has considered the evidence without a hearing and finds the following:
The plaintiff,
, and defendant,
,
(Name before civil union)
(Name before civil union)
entered a civil union on
at
.
(Month, day, year)
(Town and state)
4. "X" one:
The ("X" one)
plaintiff
defendant
has lived in Connecticut for at least twelve months before the filing
of the dissolution of civil union complaint or before the dissolution of civil union will become final.
The ("X" one)
plaintiff
defendant
lived in Connecticut at the time of the civil union, moved away, and
then returned to Connecticut, planning to live here permanently.
The civil union broke down after the ("X" one)
plaintiff
defendant
moved to Connecticut.
5. A dissolution of civil union is granted based on the
complaint
cross complaint
because ("X" one):
This civil union has broken down irretrievably and there is no possibility of getting back together.
Other (must be reason(s) listed in Connecticut General Statutes section 46b-40(c)):
6. "X" all that apply:
No children were born to either the plaintiff or defendant after the date of this civil union.
There are no children of this civil union.
The following children have been born to the
plaintiff
defendant or have been adopted before,
on, or after the date of this civil union and the other party to this civil union is the parent/adoptive parent.
Name of child (First, middle, last)
Date of birth (Month, day, year)
The following children were born after the date of this civil union to the ("X" all that apply)
plaintiff
defendant
and are not the children of the other party to this civil union.
Name of child (First, middle, last)
Date of birth (Month, day, year)
7.
("X" if it applies) The Court finds that the agreement between the parties is fair and equitable.
(Continued on page 2)
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Based on these facts, the Court enters a judgment of dissolution of civil union
Docket number
and declares each party to be single. The Court further orders:
The agreement between the parties is attached and its terms are incorporated by reference.
Sole custody to
Joint legal custody to
and
Primary residence with:
Visitation as follows:
Alimony payable to:
Amount: $
to terminate at
Child support as follows:
Payable through the State of Connecticut.
Medical insurance coverage as follows:
Immediate income withholding (See Notice to Nonappearing Obligor of Income Withholding Order, JD-FM-70,
if defendant has not filed an appearance)
Contingent income withholding
Regarding educational support orders, pursuant to Connecticut General Statues § 46b-56c:
The Court finds that the parties have made a knowing and intelligent waiver of their right to request a educational
support order; or
The Court reserves jurisdiction to determine educational support orders; or
The Court enters an educational support order (Attach additional sheets if necessary).
Name change from
to
Other:
Notice as directed by the judicial authority must be given to parties who have not filed an appearance, of any
order for support or alimony. No such order shall be effective until the order of notice has been complied with or
the nonappearing party has actually received notice of such order. (Practice Book section 25-29)
Date of judgment
Print name of person signing at left
By the Court (Full name of Judge)
Signed (Judge/Assistant Clerk)
,J.
Attorney Certification:
(Completed by attorneys only if both the plaintiff and defendant were represented by attorneys)
I certify that the foregoing judgment file conforms to the judgment entered by the court.
Print name
Date signed
Plaintiff's attorney
Print name
Date signed
Defendant's attorney
(Page 2 of 2)
JD-FM-177A Rev. 10-18
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