Request For Exclusion From Electronic Services Requirements
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Request For Exclusion From Electronic Services Requirements Form. This is a Connecticut form and can be use in Grievance Statewide.
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Tags: Request For Exclusion From Electronic Services Requirements, JD-CL-92, Connecticut Statewide, Grievance
REQUEST FOR EXCLUSION FROM
ELECTRONIC SERVICES REQUIREMENTS
STATE OF CONNECTICUT
SUPERIOR COURT
JUDICIAL BRANCH
www.jud.ct.gov
JD-CL-92 New 6-08
Instructions
1. Type or print clearly.
2. File the exclusion request form with the Statewide Grievance
Committee at the below address.
3. Keep a copy of this form for your records.
To: Statewide Grievance Committee, 287 Main Street, 2nd Floor, Suite 2, East Hartford, CT 06118-1885
Telephone (860) 568-5157
From (Name of Attorney/Law Firm requesting exclusion)
Juris Number
Address of Attorney/Law Firm
Telephone Number (with area code)
E-mail address
Reason for Exclusion Request
I request an exclusion from electronic services requirements for me or on behalf of the firm named above for the following
reason(s):
I do not have Internet Access
The firm does not have Internet Access
Other (explanation required)
Signed (Attorney making request)
Name of Attorney Signing at left
Date
Juris Number of Attorney
Do not write below this line
The request is hereby ordered:
FILE DATE
Granted.
Denied.
Signed
Name/Title of Person Signing
Date
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