JD-FM-231 New 9-14
STATE OF CONNECTICUT
Court Use Only
Name of case
Address of courtJudicial District of
This agreement applies to the following motions: (number or name)
Matter continued to
Agreement of the parties
Pendente Lite Dissolution Post Judgment Dissolution Never Married Final Judgment Temporary Restraining Order Hearing
Monetary orders comply with the Child Support and Arrearage Guidelines:
If the orders differ from the guidelines, state the reason(s) for the deviation:
Signed (Plaintiff/Plaintiff's attorney)
We hereby certify that the above conforms with the agreement of the parties.
Signed (Defendant/Defendant's attorney)
Signed (Guardian ad Litem/Attorney for the Minor Child)
Approved and so ordered (Judge/Family Support Magistrate)
Complete form, make copies for yourself
and give the original to the Court Clerk.
The Judicial Branch of the State of Connecticut complies with the 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.