CASEFLOW REQUEST JD-CV-116 Rev. 1-16 STATE OF CONNECTICUT SUPERIOR COURT www.jud.ct.gov CSFLREQ *CSFLREQ* Instructions 1. Fill out all sections and file with the court. 2. File at least 3 days before the date of the scheduled event. Note: If the request is granted, the court will try to schedule the event for the requested date. However, if that date is not available, it will be scheduled for the next available date. Name of case (First-named plaintiff v. First-named defendant) Judicial District of Name of Judge who scheduled the event (if applicable) Date of request Docket number Date of scheduled event (if applicable) CV - (S) Requested Action ("X" box(es) that apply and give reason(s) for request below) Date Status Conference on or about: . Event Client/adjuster to be available by phone for Pretrial on or about Party to be excused from Other: Reason(s) for request: Date scheduled on Date . . Event scheduled on Date . . I agree to notify my client and all counsel of record and self-represented parties whether the requested action is granted or denied, and if granted, the specific ruling of the court. I have told all counsel and self-represented parties of record that I would be asking for the requested action. All Counsel and Self-represented Parties: Consent Signed (Person making request) The person requesting the action is the: Do not consent to the action requested above Name of attorney and juris number or self-represented party (Print or type) Plaintiff Defendant Attorney for Plaintiff Address Attorney for Defendant Telephone number (with area code) Firm name (If applicable) I certify that a copy of the above was mailed or delivered on the date shown below to all counsel and self-represented parties of record. A sheet is attached listing the name and address of each party the copy was mailed or delivered to. Signed (Individual attorney or self-represented party) Date Order Request is Signed (Judge) Date Granted Denied 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/ American LegalNet, Inc. www.FormsWorkFlow.com