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`4.
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`NBH-CV-25-6013456-S
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`accommodations, contactthe
`JUDICIAL BRANCH fpaNe
`AFFIDAVIT OF COMPLIANCE
`For Infarmation on ADA
`Shemale
`STATE OF CONNECTICUT
`CARES ACT
`«tonne.
`
`
`
`Centralized ADA Office at 860-706-5910
`SUPERIOR COURT “AG. Bf
`UD-HM-41 Rev. 10-23
`OF go to: Www.JudchowADAl
`www.jud.ctgov “iss
`C.G.S. §§ 47a-23, 472-239; 15 USC § 9058
`
`
`
`
`
`~Judisial Distiet
`Address afcout
`
`New Britain
`
`20 Franklin Square, New Britain, CT 06061
`Nameofcase
`Dovket Number
`——~ _
`
`Robert Cohen vs. Noreida Rivera
`1. Did the notice to quitin this action give the tenants atleast 30 days to vacate?
`(may be completed by plaintiff orplaintiff's counsel)
`[_] Yes
`Complete Line 8 below.
`[x] No
`Go fo Question 2.
`2. 18 any part of the eviction complaint based upon non-paymentofrent for a residential property?
`(may be completed by plaintiff or plaintiff's counsel)
`[x] Yes
`Goto Question 3.
`[} No
`Complete Line 10 below.
`. Do you receive rent payments from Section 8 or similar federal rental assistance program, or any otherform of federal
`rental assistance on behalf of any occupants In the dwelling unit?
`C] Yes
`Complete Line 9 below,
`No
`Go to Question 4.
`Is the property receiving any form of federal financial assistance or financing (such as a Federal Housing Administration
`loan, or federal low-income housing tax credits) or is the proparty still subject to federal rules becauseit previously
`received federal financial assistance?
`(] Yes
`Complete Line 9 below.
`[x] No
`Go to Question §,
`Is there a mortgage on the property?
`(x] Yes
`Go to Question6.
`[} No
`Complete Line 10 below.
`Is the mortgage onthe property secured by Fannie Mae or Freddie Mac?
`Check both of the websites below to seeif the propertyis listed:
`Fannie Mae: hittpsi//www.knowyouroptions:cam/oanlookup
`Freddie Mac: hitps://myhome.freddiemac.com/resources/loanlookup
`
`
`||Yes i have checked these websites and my propertyIs listed there. Completa Line 9 below,
`[| No
`| have checked these websites and my property is natlisted there.
`Complete Line 10 below.
`! have not checked these wabsites.
`Go to Question 7.
`| contacted my mortgage servicer and asked the servicerto determine whether any mortgageon the property is currently
`ownedor securitized with any federalfinancing.If the servicers answeris:
`C] Yes
`Complete Line 9 befow.
`[x] No
`Complete Line 10 below.
`[_]
`t don’t know
`Complete Line 11 below.
`L_]
`| have not contacted my mortgage servicer, Complete Line 11 below.
`(_] The notice to quit provided at least 30 days to vacate. Please sign this affidavit,
`8.
`9, [] The property is covered by the CARESAct and a 30-day notice to quit is required. Please sign this affidavit.
`10. [x]
`
`@ property is not covered by the CARES Act. Please sign this affidavit.
`
`whether gr notthe property. i coveredby the CARESAct. Please sign this affidavit \ Ss: 7
`
`
`\ \
`Sr xorlype namieafparsonsigring
`:
`Oglesigned
`
` Cor Sslonerofthe SuperiorCourt)\_\ weaaahoesKoray;|SsMilos. Sloned(assistantClerk, Notary,
`
`
`
`
`sworn to before me—--~
`XD
`peat) HYLUGO j NYU Commiss00 £yjO. 7 las ]
`IMPORTANT NOTICE: Certification on page 2isrequired and must be completed
`Page 1 of 2
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`5.
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`8.
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`7.
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`

`Certification
`| certify that a copy of this document was orwill immediately be mailed or delivered electronically or non-slectronically on
`(date)
`to all attorneys and self-represarited parties of tecord and that written consentfor electronic delivery was
`recelved from all attorneys and self-represented partlesof record who received or will immediately be receiving electronic delivery.
`Name and address of each party and attorney that COpy was of will be mailad or delivered ta*
`Norelda Rivera, 46 Capitol Avenue, Unit 208, New Britain, CT 06051
`Norelda Rivera, 44-46 Capito! Avenue, Apt. #208, New Britain, CT 06053
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` 7S py
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`Page 2 of 2
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