NOTICE OF JUDGMENT AND ORDER FOR WEEKLY PAYMENTS JD-CV-50 Rev. 9-09 P.B. § 17-23 et seq. Instructions to Clerk STATE OF CONNECTICUT Mail a copy of this notice and order to plaintiff/plaintiff's attorney and keep the original in the court file. Instructions to Plaintiff/Plaintiff's Attorney SUPERIOR COURT www.jud.ct.gov Court Use Only 1. Complete Section I. 2. Complete "Payable to" line in Section lI by filling in the name and address of the person who is to receive payments. 3. After notification of judgment send a copy of this notice to the Defendant(s) and return the original to Clerk's Office with the certification below completed (Section III). Geographic Area Number Address of court (Number, street, town, and zip code) RETJGOR Docket number Section l (To be completed by Plaintiff/Plaintiff's Attorney) Judicial District Housing Session Name of case (Plaintiff v. Defendant) Name(s) of Defendant's who must pay the judgment Section II -- Notice To All Parties (To be completed by clerk) The following judgment may be enforced 21 (twenty-one) days after the clerk receives a certification that a copy of this notice was served on each judgment debtor (defendant). Judgment After reviewing the affidavits filed in this matter, the court finds that the defendant(s) named above is/are not in the military or naval service and that the following are owed to the Plaintiff(s): 1. Amount Due On Claims . . . . . . . . . . . . . . 2. Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Reasonable Attorney's Fees . . . . . . . . . . 4. Other Lawful Charges . . . . . . . . . . . . . . . 5. Total Amount Of Judgment . . . . . . . . . . . (Total of lines 1-4) 6. Plaintiff's Costs . . . . . . . . . . . . . . . . . . . . 7. Total Amount Of Judgment And Costs (Total of lines 5 and 6) $ $ $ $ $ $ $ Judgment is rendered for the Plaintiff(s) and the Defendant(s) named above must pay the Total Amount of Judgment and costs to the Plaintiff(s). It is also ordered that the Defendant(s) who must pay the judgment must make weekly payments as follows: Amount of weekly payment Date first payment is due Weekly Payments $ Payable to (Name and address of person who is to receive payments) Signed (Judge/Assistant clerk) Date signed By the Court (Name of Judge) Section III -- Certification Of Service Of Notice And Judgment To All Parties I certify that a copy of this Notice and Judgment has been delivered or mailed by U.S. Mail, to the Defendants named below and that I paid the postage for that mailing. (Enter name(s) and address(es) of Defendant(s)): Signed (Plaintiff/Attorney for Plaintiff) Date signed Date delivered/mailed American LegalNet, Inc. www.FormsWorkFlow.com