PROCEEDINGS FOR ENFORCEMENT OF MUNICIPAL REGULATIONS AND ORDINANCES (Including Parking) JD-CV-20 Rev. 12-07 C.G.S. §§ 7-152b, 7-152c INSTRUCTIONS TO TOWN STATE OF CONNECTICUT SUPERIOR COURT www.jud.ct.gov 1. Complete section I only. Prepare in duplicate, keep copy for file. 2. Attach a certified copy of each Notice of Assessment to the original. 3. File original with clerk for the superior court facility designated by the Chief Court Administrator along with the court entry fee. I. REQUEST FOR JUDGMENT (To be completed by town) NAME OF TOWN DATE OF REQUEST TOWN CODE SIGNED (Hearing Officer) JUDICIAL DISTRICT OF ADDRESS OF COURT TELEPHONE NO. WEEKLY ORDER REQUESTED YES NO TO: ENTER COMPLETE NAME AND ADDRESS OF PERSON FOUND LIABLE ON THE LEFT. VIOLATIONS OF MUNICIPAL REGULATIONS AND ORDINANCES (Including Parking) Fold TICKET NUMBER DATE OF VIOLATION DATE NOTICE OF ASSESSMENT MAILED FINES, PENALITIES COSTS OR FEES DUE 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Number of certified copies of Notice of Assessment attached: TOTAL AMOUNT DUE: II. JUDGMENT (To be completed by court clerk) Pursuant to Section 7-152b or Section 7-152c of the Connecticut General Statutes judgment hereby enters in favor of the above-named town, city borough or other municipality as defined in C.G.S. § 7-148 against such above-named person in the amount of The court further orders weekly payments of the Date of Judgment indicated below. SIGNED (Assistant Clerk) AMOUNT OF JUDGMENT $ WEEKLY PAYMENTS and court costs of eight dollars. per week commencing 3 weeks from $ DATE OF JUDGMENT RECEIPT NO. DOCKET NO. American LegalNet, Inc. www.FormsWorkflow.com