REQUEST FOR ACTION - ADMINISTRATIVE AND TAX APPEALS - NOT FOR USE IN LAND USE APPEALS JD-CV-114 Rev. 6-18 P.B. 24714-5 et seq.STATE OF CONNECTICUT SUPERIOR COURT www.jud.ct.gov Instructions 1.File this form immediately after filing an Appearance or motion in anadministrative or tax appeal; not for use in land use appeals. 2.If you are filing this form because you have filed a motion, fill out andfile one form for each motion that you want decided. COURT USE ONLY REQACTA *REQACTA* Judicial district Name of case (Plaintiff v. Defendant) Docket number Title of motion that you want decided Date of motion Motion entry number1.Are you filing this form because you have filed an Appearance? No YesIf you checked "No", answer 2-5.2.Is oral argument requested? No Yes3.Is testimony required? No Yes4.Does the opposing party object to this motion? No Yes5.Has an objection already been filed? No YesIf you checked "Yes", please provide the date of objection: and the entry number: CertificationI certify that a copy of this document was or will immediately be 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 of record who received or will immediately be receiving electronic delivery. Name and address of each party and attorney that copy was or will be mailed or delivered to**If necessary, attach additional sheet or sheets with name and address which the copy was or will be mailed or delivered to. Signed (Signature of filer) u Print or type name of person signing Date signed Mailing address (Number, street, town, state and zip code) Telephone number 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