Form JD-CV-163CO "Request for Nondisclosure of Location Information - Civil Protection Order" - Connecticut

What Is Form JD-CV-163CO?

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 April 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-163CO 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-163CO "Request for Nondisclosure of Location Information - Civil Protection Order" - Connecticut

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REQUEST FOR NONDISCLOSURE
Court Use Only
STATE OF CONNECTICUT
OF LOCATION INFORMATION -
REQNON
SUPERIOR COURT
CIVIL PROTECTION ORDER
www.jud.ct.gov
*REQNON*
JD-CV-163CO New 4-20
C.G.S. § 46b-16a(b); E.O. 7T
Instructions to Party
Instructions to Clerk
For information on ADA
1. Complete the information below if you believe that disclosure of location
1. Seal any location information except
accommodations,
information would jeopardize you and/or your child(ren)'s health, safety
disclosable mailing address.
contact a court clerk or go to:
or liberty.
2. Do not disclose the location
www.jud.ct.gov/ADA.
2. You must say that your statement is true under penalty of false statement.
information to the public, including
3. Keep a copy for your records.
anyone involved in the case, except
4. Do not file anything further with the court containing location information
by order of the court after hearing.
other than to report a change in your mailing address.
Name of Case
Docket number (If known)
Plaintiff's name (First, middle initial, last)
Defendant's name (First, middle initial, last)
1. I, the above-named
plaintiff
defendant believe that the health, safety or liberty of
(check one)
(check one or both)
myself
my child(ren)
(Specify name(s))
would be jeopardized by disclosure of location information. I therefore request that no location information contained in this
case pertaining to
(check one or both)
myself
my child(ren)
be disclosed to anyone including parties to this case and that this information be sealed.
2. (Select one)
Attorney's name (First, middle initial, last)
I have an attorney representing me in this case. My attorney is:
I do not have an attorney representing me in this case. Therefore, I am providing my mailing address below.
I understand that this address will be public information.
Full mailing address for
your attorney or your
mailing address if you
are self-represented.
(Public Information)
3. (Select one)
There have been no documents previously filed with the court that contain location information that poses the risk.
There is location information posing the risk contained in documents previously filed with the court. The location
information can be found in the following documents (Attach additional sheet if necessary).
(Do not indicate what the location information is.)
NOTICE TO APPLICANT:
DO NOT FILE ANY PAPERWORK WITH THE COURT THAT CONTAINS ANY LOCATION INFORMATION
IN ANY FURTHER PLEADINGS OTHER THAN TO REPORT A CHANGE IN YOUR MAILING ADDRESS.
Enter your name as your signature
Date signed
The representations made in this document are
made under the penalty of false statement.
Print Form
Reset Form
REQUEST FOR NONDISCLOSURE
Court Use Only
STATE OF CONNECTICUT
OF LOCATION INFORMATION -
REQNON
SUPERIOR COURT
CIVIL PROTECTION ORDER
www.jud.ct.gov
*REQNON*
JD-CV-163CO New 4-20
C.G.S. § 46b-16a(b); E.O. 7T
Instructions to Party
Instructions to Clerk
For information on ADA
1. Complete the information below if you believe that disclosure of location
1. Seal any location information except
accommodations,
information would jeopardize you and/or your child(ren)'s health, safety
disclosable mailing address.
contact a court clerk or go to:
or liberty.
2. Do not disclose the location
www.jud.ct.gov/ADA.
2. You must say that your statement is true under penalty of false statement.
information to the public, including
3. Keep a copy for your records.
anyone involved in the case, except
4. Do not file anything further with the court containing location information
by order of the court after hearing.
other than to report a change in your mailing address.
Name of Case
Docket number (If known)
Plaintiff's name (First, middle initial, last)
Defendant's name (First, middle initial, last)
1. I, the above-named
plaintiff
defendant believe that the health, safety or liberty of
(check one)
(check one or both)
myself
my child(ren)
(Specify name(s))
would be jeopardized by disclosure of location information. I therefore request that no location information contained in this
case pertaining to
(check one or both)
myself
my child(ren)
be disclosed to anyone including parties to this case and that this information be sealed.
2. (Select one)
Attorney's name (First, middle initial, last)
I have an attorney representing me in this case. My attorney is:
I do not have an attorney representing me in this case. Therefore, I am providing my mailing address below.
I understand that this address will be public information.
Full mailing address for
your attorney or your
mailing address if you
are self-represented.
(Public Information)
3. (Select one)
There have been no documents previously filed with the court that contain location information that poses the risk.
There is location information posing the risk contained in documents previously filed with the court. The location
information can be found in the following documents (Attach additional sheet if necessary).
(Do not indicate what the location information is.)
NOTICE TO APPLICANT:
DO NOT FILE ANY PAPERWORK WITH THE COURT THAT CONTAINS ANY LOCATION INFORMATION
IN ANY FURTHER PLEADINGS OTHER THAN TO REPORT A CHANGE IN YOUR MAILING ADDRESS.
Enter your name as your signature
Date signed
The representations made in this document are
made under the penalty of false statement.
Print Form
Reset Form