NOTICE OF APPLICATION FOR STATE OF CONNECTICUT PREJUDGMENT REMEDY/CLAIM FOR ‘SUPERIOR COURT HEARING TO CONTEST APPLICATION ‘www jud.ct.gov OR CLAIM EXEMPTION INSTRUCTIONS TO PLAINTIFF/APPLICANT JO-CV.53 Rv. 7.01 1. Complete section 1 i connection wih all rejudgmont remedies EXCEPT ox pate prejudgment se ‘omcles and submit fo th Clerk along with your application and aber required document, Snes cestasiae 2 Upon rece o ned odor fr hes on cork sore ts far on Cotas) wh ator rogue documents TESECTIONISGASE INFORMATION (To be completed by Plaintif/Applicant). = ‘luda! Housing ‘COURT ADDRESS Bl oistict 1) sossion [) G.A No. 20 FRANKLIN SQUARE NE BRITAIN, CT 06051 ‘AHQUNT,LEGALINTEREST, OR PROPERTY IN DEMAND, EXCLUBVE OF ——Has.a temporary restraining onder been cequested? {7} yes f@}-No—| INTER ‘NAME OF CASE (First-named plaintif va First-named Gelendant) 1 Less Tan s2s00 Sar SRR Tem (15,000 on MORE: CLP JRA Craermerenmvernacomonoammes —| tema ‘CASE TYPE (From Joi ranch code a) [ NO, COUNTS LAIMING OTHER RELIEF iN ADDITION WORT. MINOR. 90. 4 ‘TOOR INLIEU OF MONEY DAMAGES. NAVE AND ADDRESS OF PLAINTIFF/APPLIGANT (Paton maling alain for Prehdgment Remedy (No, set, fo and a oe) CHARLES L BURBY 75 FIRST STREET NEW BRITAIN, CT 06051 "NAME(S ADDRESS(ES) AND TELEPHONE NO(S), OF DEFENDANT(S) AGAINST WHOM PRE JUDGMENT RENEGY 1S SOUGHT (a, aot town and pede) Tach esstonal sheet recess") ROBERT PRIMS 38 HAVILAND STREET BRISTOL, CT 06010 "WAVE A ADDRESS OF AY THIRD PERSON HOLDING PROPERTY OF DEFENDANT WHO ISTO BE MADE A GARNISHEE BY PROGESS PREVENTING DISSIPATION 7D BANK 414 BROAD STREET BRISTOL, CT. NAME AND ADDRESS OF ATTORNEY, LAW FIR OR PLAINTIFF IF PRO SE (Na, aot fon and a Coo] FORTHE PLAMIFF(s) | JOSEPHINE S MILLER 152 DEER HILL AVE SUITE 302 DANBURY, CT 06810 ENTER THE JORIS NO. (iat. orlaw fm) apraanance: |422896 SECTION IL ‘You have rights specified in the Connecticut General Statutes, including Chapter 903 this application for a prejudgment remedy. These rights include the right to a hearing: (1) to object to the proposed prejudgment remedy because you have a defense to or setoff against the action or @ counterclaim ‘against the plaintiff or because the amount sought in the application forthe prejudgment remedy is unreasonably high or becaisse payment of any judgment that may be rendered against you is covered by any insurance that may be available to you; (2) to request that the plaintif post a bond in accordance with section 52-276d of the General Statutes to secure you against ‘any damages that may result from the prejudgment remedy, (3) to request that you be allowed to substitute a bond forthe prejudgment remedy sought; and (4) to show thatthe property sought to be subjected to the prejudgment remedy is exempt from such a prejudgment remedy. that you may wish to exercise concerning ‘You may request a hearing to contest the application fora prejudgment remedy, assert any exemption or make a request conceming {he posting or substitution of a bond In connection withthe projudgrent remedy. The Rearing may be requostod by any proper motion ‘or by completing section Il below and returning this form tothe superior court atthe Gour Address listed above. ‘You havea ight to appear and be heard at the hearing onthe application to be held atthe above cout location on: TATE Te TCO 8-29.20\ 2:00 Pu. “TED ~SECTION Ill DEFENDANT'S CLAIM AND REQUEST FOR HEARING. ‘(To be completed by Defendant) |, the defendant named below, request a hearing to contest the application for prejudgment remedy; clei an jption or request the posting or substitution of a bond. | claim: ("X" the appropriate boxes) el i) ll I C1 that the amount sought in the application for [[] a defense, counterclaim, - pryngameraacart mespesctentor Cl ager, cata Crees es DD that any judgment that may be rendered is (1 that | be allowed to substitute a t abamaarenasin eye suinemiaseies, (Ee 2a re tah atv rated post bond seare me apna 238 para lat rea a sea a Pao 5S | certify that a copy of the above claim was mailed/delivered to the Plaintiff — a Ee or the Plaintiff's attorney on the Date Mailed/Delivered shown below. sup ne ‘DATE COPY{ES) MALEDIDELIVERED | SIGNED (Defendant) ‘DATE SIGNED a AT TE CTT TRENT a a mart SOI 7G FAR aT eee “if necessary, attach addtional sheet wilh names ofeach party served and the address al which service was made.