Grievance Complaint (Supreme Court Or Appellate Court) Filed Under The Americans With Disabilities Act
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Grievance Complaint (Supreme Court Or Appellate Court) Filed Under The Americans With Disabilities Act Form. This is a Connecticut form and can be use in Administrative Statewide.
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Tags: Grievance Complaint (Supreme Court Or Appellate Court) Filed Under The Americans With Disabilities Act, JD-ES-280, Connecticut Statewide, Administrative
GRIEVANCE COMPLAINT (SUPREME
COURT OR APPELLATE COURT)
FILED UNDER THE AMERICANS WITH
DISABILITIES ACT
STATE OF CONNECTICUT
SUPERIOR COURT
www.jud.ct.gov
JD-ES-280 New 5-11
Instructions
File this form with the Chief Administrative Officer, Supreme Court Building, 231 Capitol
Avenue, Hartford, Connecticut 06106, (860) 757-2145, no later than ten (10) days after the
act or decision complained about. Attach additional documents, if necessary.
Name of person filing complaint
Telephone
Address (city)
(state)
(zip)
E-mail (optional)
Description of alleged discriminatory act or decision (include dates, locations, names and contact information of witnesses use additional page(s), if necessary.)
Remedy or solution requested
Date signed
Signature of complainant (person filing this complaint)
The complaint is dismissed.
The following resolution is offered and the matter is concluded:
The above resolution has been offered but the matter is not concluded.
The complainant has been told about the federal and state agencies that are available if he or she wants to pursue the
matter further.
Additional Comments:
By:
Title:
Date:
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/.
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