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Case type (From code list above)
1. Type or print legibly; sign summons.
2. Attach the original summons to the original complaint, and Notice of Automatic Court Orders (JD-FM-158) and attach a copy of the summons and a
copy of the Notice of Automatic Court Orders to each copy of the complaint.
3. After service has been made by proper officer, file original papers and officer's return with the clerk of the court at least six days before the return date.
4. Do not use this form for actions in which an attachment or garnishment is being sought or for petitions for paternity or for support orders, or for actions in
which an application for relief from abuse is being sought.
JD-FM-3 Rev. 9-12
C.G.S. § 52-45a, Pr. Bk. § 8-1
STATE OF CONNECTICUT
To: Any proper officer
By Authority of the State of Connecticut, you are hereby commanded to make due and legal service of this Summons and
attached Complaint and Notice of Automatic Orders.
Notice To The Defendant Named Above
1. You are being sued.
2. This paper is a Summons in a lawsuit.
3. The Complaint attached to these papers states the
claims that the Plaintiff is making against you in this
4. To respond to this Summons, or to be informed of
further proceedings, you or your attorney must file a
form called an "Appearance" with the Clerk of the above-
named Court at the above Court address on or before
the second day after the above Return Date. The Return
Date is the date your case is officially in court. It is
not a date you have to come to court unless another notice
says that you have to be in court that day.
5. If you or your attorney do not file a written "Appearance"
form on time, the Court may enter judgment against you for
the relief requested in the Complaint, which may result in
temporary or permanent orders without further notice.
6. The "Appearance" form may be obtained at the Court
address above or at www.jud.ct.gov under "Forms."
7. If you have questions about the Summons, Complaint, or
Notice of Automatic Court Orders (JD-FM-158), you should
talk to an attorney quickly. The Clerk of Court is not
allowed to give advice on legal questions.
Signed (Comm. of Superior Court or Ass't Clerk sign and "X" proper box)
For The Plaintiff
Please enter the appearance of:
Signed (Plaintiff, if self-represented party or attorney for plaintiff)
FOR COURT USE
Signed (Plaintiff, if self-represented party)
I certify I have read and
understand the above.
If this summons is signed by a clerk:
a. The signing has been done so that the Plaintiff will not be denied access to the courts.
b. It is the responsibility of the Plaintiff to see that service is made in the manner provided by law.
c.The clerk is not permitted to give any legal advice in connection with any lawsuit.
d. The clerk signing this summons at the request of the Plaintiff is not responsible in any way forany errors
or omissions in the Summons, any allegations contained in the Complaint, or theservice of the
Summons or Complaint.
Case Type Minor Codes
00 Dissolution of Marriage
10 Legal Separation
50 Civil Union - Dissolution, Legal
90 All Other
SUMMONS, Family Actions
The Judicial Branch complies with the Americans with Disabilities Act (ADA). If you need a reason-
able accommodation in accordance with the ADA, contact the clerk's office indicated above.
* See Form JD-FM-165A - C
Judicial district of
At (Town)Return date (Month, day, year)
Address of Court (Number, street, city)
Case management date*
Plaintiff's name (Last, first, middle initial)Plaintiff's address (Number, street, town, zip code)
Defendant's name (Last, first, middle initial)Defendant's address (If known) (Number, street, town, zip code)
Comm. of Superior Court
Name of person signing at left
Name of attorney, law firm or self-represented party
Juris number (If attorney or law firm)
Mailing address (Number, street, town, zip code)Telephone number (Area code first)
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