Application For Referral Of Case To The Individual Calendaring Program {JD-CV-132}

APPLICATION FOR REFERRAL OF CASE TO THE INDIVIDUAL CALENDARING PROGRAM JD-CV-132 New 1-13 STATE OF CONNECTICUT SUPERIOR COURT - CIVIL DIVISION www.jud.ct.gov COURT USE ONLY INDICAL *INDICAL* Instructions 1. Counsel and self-represented parties who want to have a case referred to the individual calendaring program (IndiCal) must supply all of the information requested below. (Not supplying complete and accurate information may disqualify a case.) 2. Information that does not fit on this form should be attached on a separate sheet and numbered to correspond to the questions on the form. 3. Self-represented parties and attorneys excluded from e-filing must file the form with the clerk in the judicial district where the case is pending. Attorneys not excluded from e-filing must e-file this form and select "IndiCal Program Referral Application" when naming the form in e-filing. 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. Name and address of applicant 1. Case name (First-named Plaintiff vs. First-named Defendant) 3. Judicial District where case is pending 4. Case type Juris number (if applicant has one) 2. Docket number Telephone number 5. Return date of original complaint 6. List all plaintiffs and their counsel: Plaintiff's name Counsel's name and address Counsel's phone number 7. List all defendants and their counsel: Defendant's name Counsel's name and address Counsel's phone number 8. Do self-represented parties or opposing counsel agree to the referral? 9. Status of Litigation a. pleadings closed.......................................................................................... b. discovery completed .................................................................................... c. trial date assigned........................................................................................ if so, when d. trial list claim filed (Date) Yes Yes No No Don't know Estimated length of trial Jury Court None 10. Briefly describe the nature of the case: 11. Reasons why this case should be referred to the IndiCal Program (Continued...) American LegalNet, Inc. www.FormsWorkFlow.com Certification to all attorneys I certify that a copy of this document was mailed or delivered electronically or non-electronically on (date) and self-represented parties of record and that written consent for electronic delivery was received from all attorneys and self-represented parties receiving electronic delivery. Name and address of each party and attorney that copy was mailed or delivered to* *If necessary, attach additional sheet or sheets with name and address which the copy was mailed or delivered to. Signed (Signature of filer) Print or type name of person signing Date signed Telephone number u Mailing address (Number, street, town, state and zip code) JD-CV-132 (Page 2 of 2) New 1-13www.FormsWorkFlow.com