www.jud.ci.gov
`
`STATE OF CONNECTICUT <g5eR
`SUPERIOR COURT &
`\)
`
`SUMMARY PROCESS EXECUTION FOR POSSESSION-
`DECEASED TENANT/IOCCUPANT
`JD-HM-40 New4-19
`C.G.S. § 47a-11d
` Docket number
`Court
`.
`
`
` Date of judgment
`NHHCV225005692S
`[_] Judicial District
`Housing Session
`
`Address of court location (number, street, town andzip code)
`
`11/23/2022
`121 Elm Street, New Haven, CT 06510
`
`
`
`Nameand mailing addressofplaintiff/landlord or attorne
`.
`ge
`a
`P
`¥
`Instructions to plaintifffandlord or attorney
`1. Completethis form.
`2. File this form with the clerk for the clerk.fo sign.
`
`ri.
`
`-
`Karen Baldwin Kravetz, Esq.
`Susman, Duffy & Segaloff, P.c.
`700 State Street, Suite 100
`New Haven, CT 06511
`
`q
`
`4
`L
`
`Name(s)of plaintiff(s) (Landlord)
`
` Name of defendant (Deceased tenantfoccupant)
`ThomasGillis
`Savin Rock, LLC
`
`200-204 Oak Street
`Ton. St edlarz _ next ot Kew
`
`
`
`West Haven, CT 06516
`Elaine Gilhs - next of kin
`
`
`
`Address of premises (number,street, town and apartment number)
`200 Oak Street, #112, West Haven, CT 06516
`
`retum within 60 days of the date hereof.
`
`Date signed
`
`
`Sa
`
`To: Any proper State Marshal
`Byauthority of the State of Connecticut, you are commandedto give the plaintiff(s)iandlord(s) possession of the above named premises.
`Possessions and personal effects of the deceased tenant/occupant may be.removedanddelivered to the place of storage designated by
`the chief executive officer of the municipality. First, use reasonableefforts to locate and notify the tenant's/occupant's emergencycontact,
`if any, and the next ofkin, if known, of the date, time and location of such removal andof the possibility of a sale pursuant Section
`47a-11d (e) of the Connecticut General Statutes. Second, give the chief executive officer of the municipality in which the premisesis
`located (1) 24-hours' written notice of the removal, stating the date, time and location of such removal as well as a general description,if
`known, of the types and amountof possessions and personaleffects to be removed from the premises and delivered to the designated
`‘place of storage, and (2) a copyof the inventory preparedbythe plaintiffflandlord pursuant to Section 47a-11d (d) of the Connecticut
`General Statutes, annotated to indicate any items that have been reclaimed.
`
`(JU -fs
`UA?
`Notice to deceased tenant's/occupant's next of kin and emergency contact
`(To be completed by State Marshal)
`
`
`
`
`
` The piaintiff/landiord for the property previously occupied by the deceased tenant/occupant named above has obtained
`
`judgment and may remove and disposeof the deceased tenant's/occupantS possessions and personaleffects. The
`
`
`plaintifflandiord is currently storing those items.
`You mustcontactthe plaintiff/landlord and removetheitems by:eCeS|
`At (Time)
`
`
`If you do not remove the-items by this date, the state marshal may remove the possessions and personaleffects from the
`
`premisesor their place of storage and deliver them fo a place of storage designated by the chief executive officer of the
`municipality in which the premisesis located.
`.
`
`
`
`You maycall the municipality at_ss —ss—C‘“‘CSNUCOCofo make arrangements to claim the items.
`
`
`if the possessions and personal effects are not reclaimed within 15 days after removal and storage with the municipality, they
`may be sold pursuant Section 47a-11d (e) of the Connecticut General Statutes.
`
`
`
`
`At any time before the sale of such possessions and personal effects, an executor or administrator appointed by the Probate
`Court, or an individual designated by the Probate Court in accordance with Section 45a-273 of the Connecticut General
`
`Statutes, may reclaim such possessions and personaleffects after paying for the expenseof storage.
`
`
`ADA NOTICE
`
`
`
`The Judicial Branch ofthe 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 ADAcontact personlisted at wwwjud.ctgov/ADA.
`
`
`
`The state marshal will move the items to:
`
`Page 1 of 2
`
`:ii i
`
`
`
`
`
`
`

`

`Docket number
`NHHCV225005692S
`
`.
`
`Return of Service
`
`By virtue of the foregoing execution, on (dafe)
`
`__.
`
`_at (time)
`
`__M.
`
`[] | notified the deceased tenant's/occupant's next of kin:
`
`-
`[] | notified the deceased tenant's/occupant's emergency contact:
`C1 I used reasonableefforts to locate the deceased tenant's/occupant's next of kin and emergency contact, but was unable
`to notify the following:
`
`_ __.M., | notified the chief executive officer of the
`at (time)
`Thereafter, on (dafe)
`municipality wherethe premises is located that the evictionof the.deceased tenant's/occupant's possessions and personal
`effects would take place on(date)
`:
`at (time)
`__M.
`| further advised the chief executive
`officer, so far as known, of the general description, types, and amount of property to be removed from the premisesortheir
`place of storage.
`
`And afterwards, the deceased tenant's/occupant's possessions [1] had been removed.
`[_] were removed by me and delivered to the
`municipality for storage.
`~
`
`Signed (State Marshal)
`
`Fees;
`
`Date signed
`
`Page 2 of 2
`
`