Time of court hearing
The original Application or Petition and Notice of Automatic Court Orders are attached.
I left a true and attested copy of the Application or Petition, Notice of Automatic Court
Orders, and Order to Attend Hearing
Return of Service
personally with the respondent.
at the current home of the respondent at (Number, street, town or city):
Signed (State Marshal, proper officer)
Title of signer
Date of serviceCounty
,J.
The attached Application or Petition asks for custody of, or visitation with, a child or children. It has been reviewed by the
Court. Based on the Application or Petition, you are ordered to attend a court hearing to explain why the applicant's or
petitioner's requests should not be granted. If you do not come to the court hearing, a civil arrest order (capias) may be
issued against you and the court may enter custody or visitation orders that affect you.
ORDER TO ATTEND HEARING
AND NOTICE TO THE RESPONDENT
JD-FM-162 Rev. 5-15
P.B. §§ 25-3, 25-4
TO ANY PROPER OFFICER:
By Authority of the State of Connecticut, you must serve a true and attested copy of the court orders above, the
Application or Petition and Notice of Automatic Court Orders on the respondent at least twelve days before the scheduled
hearing date listed above and return it to court at least six days before the scheduled hearing date.
Instructions to the Applicant/Petitioner (the person starting this case):
1. Fill out the top part of this form with the court information and the name and address
information for the Applicant/Petitioner and the Respondent.
2. Attach this form to a completed Custody/Visitation Application – Parent (JD-FM-161) or
Verified Petition for Visitation – Grandparents & Third Parties (JD-FM-221).
3. Bring both completed forms to the Court Clerk’s Office to get a hearing date.
.m.
Order
Notice to the Respondent
1. The Application or Petition attached to these papers states what the applicant or petitioner is asking the Court to
order in this case.
2. The Court has ordered you to come to a hearing on this Application or Petition at the date and time shown below.
If you do not come to the hearing on this Application or Petition, the Court may issue a civil arrest order against
you and/or enter temporary or permanent orders, which may include judgment against you for what is asked for in
the Application or Petition.
3. If you want to get notices about your case, you or your attorney must file a form called an "Appearance" with the
clerk of the above-named Court at the above Court address.
4. You can get the "Appearance" form (JD-CL-12) at the Court address above or at the Judicial Branch web site
at www.jud.ct.gov.
5. If you have questions about the Application or Petition, Hearing or Notice of Automatic Court Orders (JD-FM-158),
you should talk to an attorney. The Clerk of Court is not allowed to give advice on legal questions.
STATE OF CONNECTICUT
SUPERIOR COURT
www.jud.ct.gov
Judicial District of
At (Town)
Address of court (Number, street, city)
Docket number
Applicant's or Petitioner's name (Last, first, middle initial) Address (Number, street, town, zip code)
Respondent's name (Last, first, middle initial) Address (Number, street, town, zip code)
Date of court hearing
Address of court (Number, street, town)
Room number
By the court
Date signed
Fees
Copy
Endorsement
Service
Travel
Total
Signed (Assistant Clerk)
ADA NOTICE
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.
- Read this carefully if you are the Respondent and have been served with these papers.
