SIGNED (Assistant Clerk)
DATE OF SERVICE OF EXECUTION OR
APPLICATION FOR TURNOVER ORDER
PROPERTY EXECUTION PROCEEDINGS
CLAIM FOR DETERMINATION OF
INTERESTS IN DISPUTED PROPERTY
ADDRESS OF COURT
JD-CV-5c Rev. 3-02.
C.G.S. 52-356c
DATE OF JUDGMENT
DOCKET NO.
ORDER FOR HEARING AND NOTICE
SIGNED (Assistant Clerk)
HOUSING
SESSION
SIGNED (Note: Signing this document constitutes the appearance of any third person claimant)
G.A.
JUDICIAL
DISTRICT
The foregoing claim having been presented to the court, it is hereby ordered that a hearing be held thereon at a session of this court to be
held within and for the above-named Court Location shown above on the Date and Time shown above, and that the applicant give notice
to all persons known to claim an interest in the disputed property of the pendency of such claim and of the time and place where it will be
heard, by having a true and attested copy of the claim and of this order served upon the interested persons in the manner prescribed by
law, at least six days before the date of the hearing.
1. Complete application in triplicate.
2. Present original and one copy to the clerk of court.
3. Retain copy for your file.
1. Upon filing of claim set down for hearing on date certain.
2. Complete and sign order of notice.
3. Retain copy for file.
JUDGMENT CREDITOR OR ATTORNEY, OR
PERSON CLAIMING INTEREST IN PROPERTY
NAME(S) AND ADDRESS(ES) OF JUDGMENT DEBTOR(S)
NAME(S) AND ADDRESS(ES) OF JUDGMENT CREDITOR(S)
ON (Date)
www.jud.ct.gov
STATE OF CONNECTICUT
SUPERIOR COURT
* C L M *
PROPERTY EXECUTION PROCEEDINGS
INSTRUCTIONS
CLERK
ORIGINAL CASE CAPTION
NAME(S) AND ADDRESS(ES) OF PERSON(S) CLAIMING INTEREST N PROPERTY DESCRIPTION OF PROPERTY N WHICH INTEREST IS CLAIMED
STATEMENT OF BASIS OF CLAIM, SUPERIOR INTEREST OR NATURE OF DISPUTE (Attach additional sheets if more room is needed)
TYPE IN NAME OF PERSON SIGNING AT LEFTDATE SIGNED
X
FOR THE JUDGMENT CREDITOR OR PERSON CLAIMING INTEREST: (Name and address of Attorney or Pro Se Movant)
TEL. NO. JURIS NO. (If attorney or firm)
DATE OF HEARING TIME OF HEARING (am/pm) COURTROOM
FOR COURT USE ONLY
DATED AT (Town)
BY THE COURT
TO ANY PROPER OFFICER
By authority of the State of Connecticut you are hereby commanded to serve a true and
attested copy of the above claim upon the judgment creditor(s), judgment debtor(s) and
person(s) claiming an interest in property named above by leaving in their hands or at their usual
place of abode on or before six days before the hearing date shown above.
Hereof fail not but due service and return make.
DATED AT (Town)
(NOTE: A claim concerning an interest in personal property sought to be levied on or a claim that the execution will prejudice
the superior interest of a third person may be made by the third person or the judgment creditor within 20 days of the service
of execution or upon application by the judgment creditor for a turnover order )
SMALL CLAIMS
AREA AT
ADDRESS OF COURT (If different from above)
