WITHDRAWAL STATE OF CONNECTICUT SUPERIOR COURT SMALL CLAIMS AND HOUSING MATTERS www.jud.ct.gov JD-CV-70 Rev. 7-12 Docket number Return date Answer date Name of case (First-named Plaintiff vs. first-named Defendant) Judicial District at: Housing Session at: Geographical Area number Small Claims at: or at: Centralized Small Claims 80 Washington Street Hartford, CT 06106 Fax number: 860-756-7805 ("X" All that apply) The Plaintiff's action is withdrawn against all defendants and no costs will be paid to any party. The Plaintiff's action is withdrawn against defendant(s) only, and no costs will be paid. The: Complaint Counterclaim Cross complaint in this action is withdrawn. Signed (Plaintiff/Plaintiff's attorney) Signature Required Signed (Defendant/Defendant's attorney) Name, address and telephone number of person signing above Certification I certify that a copy of this document was mailed or delivered electronically or non-electronically on (date) to all attorneys 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* *If necessary, attach additional sheet or sheets with name and address which the copy was mailed or delivered to. Print or type name of person signing Signed (Signature of filer) Date signed X Telephone number Mailing address (Number, street, town, state and zip code) For Court Use Only 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. WITHDRAWAL - SMALL CLAIMS AND HOUSING MATTERS American LegalNet, Inc. www.FormsWorkFlow.com