APPLICATION FOR EXAMINATION OF JUDGMENT DEBTOR AND NOTICE OF HEARING JD-CV-54 Rev. 6-19 C.G.S. 247 52-397STATE OF CONNECTICUT SUPERIOR COURT www.jud.ct.govA judgment was recovered against the judgment debtor named above in the Superior Court on the date and for the amount of damages and costs indicated above. ("X" one or both)The judgment creditor(s) requests that the judgment debtor be ordered to come to the Superior Court where the judgment was entered, to be examined under oath concerning any property and means of paying this judgment.The Application for Examination of Judgment Debtor having been presented to the court, it is ordered that the judgment debtor named above come to the Superior Court at the court location shown above, to be examined under oath concerning the judgment debtor's property and means of paying the judgment described in the above Application for Examination of Judgment Debtor on the date and time set for the hearing shown below. To Any Proper Officer:To: The Superior CourtInstructions to Judgment Creditor 1. Fill out and give the original and 2 copies to the clerk to review and sign. 2. Attach a completed Subpoena (form JD-CL-43), if one is needed. 3. Give the original and 1 copy of the signed application to a proper officer for service (delivery). 4. Make a copy for your file. 5. The original application must be returned to court after it is served at least 6 days before the court hearing. 6. Come to the court hearing and be prepared to examine the judgment debtor on the debtor's property and the means of paying the judgment.By authority of the State of Connecticut, you are commanded to give notice of the pendency of this Application and to summon the judgment debtor to appear at the place, date, and time set for the examination by serving on said judgment debtor, as prescribed by law for the service of civil process, a true and attested copy of the foregoing Application and of this order at least twelve days prior to the hearing date shown above. Make service and return this Application to the court at least six days prior to the hearing date shown above. Docket number Judicial District Housing SessionAt Address of Court (Number, street, town and zip code) Name(s) of judgment creditor(s) Address(es) (Number, street, town, state and zip code) Name of judgment debtor Address (Number, street, town, state and zip code) Date of judgment Amount of damages awarded Amount of costs awarded Total damages and costs awarded Name and address of judgment creditor's attorney (If applicable)Application for Examination of Judgment Debtor An execution was issued on this judgment which has been returned unsatisfied in whole or in part. Postjudgment interrogatories were served on the judgment debtor in accordance with the Connecticut General Statutes, but the judgment debtor did not to respond within 30 days of the date of service. Signed (Judgment creditor or attorney) Date signed Telephone numberOrder for Examination and Notice of Hearing Court Hearing Date And Time Date of hearing Time of hearing Courtroom .m.Signed (Judge/Clerk)Date signed 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. COURT USE ONLY PAEJD *PAEJD* American LegalNet, Inc. www.FormsWorkFlow.com