`APPEARANCE
`JD-CL-12 Rev. 1-12
`P.B. §§ 3-1 thru 3-6, 3-8, 10-13, 25A-2
`
`STATE OF CONNECTICUT
`SUPERIOR COURT
`www.jud.ct.gov
`
`Instructions — See Back/Page 2
`
`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 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.
`Name of case (Full name of Plaintiff vs. Full name of Defendant)
`
`Return date
`
`Docket number
`
`Small
`Geographic
`Judicial
`Housing
`Claims
`Area number
`District
`Session
`Scheduled Court date (Criminal/Motor Vehicle Matters)
`
`Address of Court (Number, street, town and zip code)
`
`Please Enter the Appearance of
`Name of self-represented party (See "Notice to Self-Represented Parties" at top), or name of official, firm, professional corporation, or individual
`attorney
`
`Juris number of attorney or firm
`
`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 address cannot be changed in this form.)
`
`Post office box
`
`Telephone number (Area code first)
`
`City/town
`
`State
`
`Zip code
`
`Fax number (Area code first) E-mail address
`
`in the case named above for: ("x" one of the following parties; if this is a Family Matters case, also indicate the scope of your appearance)
`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
`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:
`This appearance is in place of the appearance of the following attorney,
`firm or self-represented party on file (P.B. Sec. 3-8):
`2.
`This appearance is in addition to an appearance already on file.
`I agree to accept papers (service) electronically in this case under Practice Book Section 10-13
`Name of person signing at left (Print or type)
`Signed (Individual attorney or self-represented party)
`u
`Certification
`to all attorneys
`I certify that a copy of this document was mailed or delivered electronically or non-electronically on (date)
`and self-represented parties of record and that written consent for electronic delivery was received from all attorneys and self-represented
`parties receiving electronic delivery.
`Name and address of each party and attorney that copy was mailed or delivered to*
`
`Yes
`Date signed
`
`No
`
`For Court Use Only
`
`1.
`
`(Name and Juris Number)
`
`Signed (Signature of filer)
`u
`
`Print or type name of person signing
`
`Date signed
`
`Telephone number
`
`*If necessary, attach an additional sheet or sheets with the name of each party and the address which the copy was mailed or delivered to.
`
`COMM'R OF REVENUE SERVICES v. CHENEY JR., RICHARD A.
`
`JOHN AB LANGMAID
`
`AG-FINANCE 55 ELM ST PO BOX 120
`
`860-808-5270
`
`HHD-CV-16-5042803
`
`Sep-14-2016
`
`95 WASHINGTON STREET HARTFORD, CT 06106
`
`6
`
`434418
`
`HARTFORD
`
`CT
`
`06141
`
`860-808-5385
`
`john.langmaid@ct.gov
`
`JOHN AB LANGMAID
`
`Sep 26 2016
`
`Sep 26 2016
`
`6
`
`COMMISSIONER OF REVENUE SERVICES (Self Represented) - STE 2 25 SIGOURNEY ST HARTFORD, CT
`06106
`RICHARD A. CHENEY JR. (Self Represented) - 42 OAK DR MANSFIELD CENTER, CT 06250
`
`6
`
`6
`
`Sep 26 2016
`
`JOHN AB LANGMAID
`
`860-808-5270
`
`434418
`
`434418
`
`