Connecticut Appearance Form

In the case of wanting to represent yourself in front of a court of law in the State of Connecticut without using an attorney, the following form has to be completed and submitted.

Extracted Text for Proper Search

1. Type or print. 
2. For Criminal and Motor Vehicle cases: Fill out the form, 
including the certification section at the bottom of the 
form. File the original with the clerk. Mail or deliver a copy 
of the appearance to the prosecutor.  (Sections 3-4(d) and 
3-5 of the Connecticut Practice Book)  
 3. For Civil , Eviction  (Summary Process), and Small 
Claims cases : Fill out the form, including the certification 
section at the bottom of the form. File the original with the 
clerk. Mail or deliver a copy to all counsel and self-
represented parties of record. If a party who has been 
defaulted for failure to appear files an appearance before 
the entry of judgment after default, the default will 
automatically be set aside by the clerk.  (Sections 3-4(a), 
3-4(b), 3-5 and 17-20 of the Connecticut Practice Book)  
4. For Family cases: Fill out the form, including the  certification section at the bottom of the form. In addition      to selecting plaintiff or defendant, indicate the scope of 
your appearance. File the original with the clerk. Mail or 
deliver a copy to all counsel and self-represented parties 
of record. (Sections 3-4(a) and 3-5 of the Connecticut 
Practice Book) 
 5. For Juvenile cases: Do not use this form. Use form  JD-JM-13 Appearance, Juvenile Matters. 
6. For Self-represented parties who have changed their  address after filing an appearance: Check the box at 
the top of the other side or page 1 of this form. Fill out the 
form, including your new address in the Mailing Address 
section of this form. Fill out the certification section at the 
bottom of the form. File the original with the clerk. Mail or 
deliver a copy to all counsel and self-represented parties 
of record or, in a criminal case, to the prosecutor. 
Instructions
 JD-CL-12  (Back/Page 2)  Rev. 9-13	
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.

Note: If other counsel or a self-represented party has already filed an \
appearance for the party or parties "x'd" above,  put an "x" in box 1 or 2 below:
Please Enter the Appearance of 
Notice To Self-Represented Parties 
A self-represented party is a person who represents himself or herself. \
If you are a self-
represented party and you filed an appearance before and you have since \
changed your address, 
you must let the court and all attorneys and self-represented parties of\
 record know that you have 
changed your address by checking the box below:
I certify that a copy of this document was mailed or delivered electroni\
cally or non-electronically on  (date) to all attorneys
*If necessary, attach an additional sheet or sheets with the name of eac\
h party and the address which the copy was mailed or delivered to.	
STATE OF CONNECTICUT 
SUPERIOR COURT	 
www.jud.ct.gov
in the case named above for: 	
("x" one of the following parties; if this is a Family Matters case, al\
so indicate the scope of your appearance) 	
Housing  Session
Judicial 
District	
APPEARANCEJD-CL-12 Rev.  9-13 
P.B. §§ 3-1 thru 3-6, 3-8, 10-13, 25A-2
Mailing Address 	(Number, street) (Notice to attorneys and law firms - The address to \
which papers will be mailed from the 
court is the one registered or affiliated with your juris number. That a\
ddress cannot be changed in this form.) 	Telephone number  (Area code first)	
This appearance is in place of the appearance of the following attorney,\
 
firm or self-represented party on file  (P.B. Sec. 3-8):	
Certification	
Geographic 
Area number	
and self-represented parties of record and that written consent for elec\
tronic delivery was received from all attorneys and self-represented 
parties receiving electronic delivery.	
I am filing this appearance to let the court and all attorneys and self-\
represented 
parties of record know that I have changed my address. My new address is\
 below.	
Post office box	
Name of self-represented party  (See "Notice to Self-Represented Parties" at top),  or name of official, firm, professional corporation, or individual 
attorney Small 
Claims
I agree to accept papers (service) electronically in this case under P\
ractice Book Section 10-13 Instructions — 
See Back/Page 2 
ADA Notice — See Back/Page 2
Scheduled Court date  (Criminal/Motor Vehicle  Matters) 
Name of case 	(Full name of Plaintiff vs. Full name of Defendant)	
(Name and Juris Number)	
Docket number
Return date	
Address of Court (Number, street, town and zip code)	
Juris number of attorney or firm	
City/town	State	Zip code	Fax number (Area code first)	E-mail address	
Signed (Signature of filer)  
u
Signed (Individual attorney or self-represented party)  
u	
Name of person signing at left (Print or type)	Date signed	
Date signed	
For Court Use Only	
The Plaintiff (includes the person suing another person).
All Plaintiffs.
The following Plaintiff(s) only:
The Defendant (includes the person being sued or charged with a crime).
The Defendant for the purpose of the bail hearing only  (in criminal and motor vehicle cases only).
All Defendants. 
The following Defendant(s) only:
Other (Specify):
This is a Family Matters case and my appearance is for:  ("x" one or both) 	
matters in the Family Division of the Superior Court	Title IV-D Child Support matters	
Name and address of each party and attorney that copy was mailed or deli\
vered to*	
This appearance is in addition to an appearance already on file. 	
Yes	No	
Print or type name of person signing	Telephone number	
1.
2.