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Get CT JD-FM-185 2010

MOTION FOR INTERVENTION IN FAMILY MATTERS JD-FM-185 Rev. 10-10 C. G.S. 46b-57 STATE OF CONNECTICUT SUPERIOR COURT COURT USE ONLY MTI www. jud. ct. gov Instructions Fill out the form below to intervene in an existing case and file it with the Court Clerk. You must also file an Appearance form JD-CL-12. Judicial District of Docket number At Town Name of case Return date Month day year if applicable Intervenor s name Last first middle initial Intervenor s address Number street town state zip code 1. I am the State relationship to child ren for example grandparent aunt uncle etc* 2. I have a relationship with the child ren that is similar in nature to a parent-child relationship* State specifically how your relationship is similar to a parent-child relationship Check if asking for visitation Denial of visitation will cause real and significant harm to the child ren. State specifically what harm would be caused to the child ren Or the child ren s best interests. custody of the child ren listed below 3. I want X one Child s Age Child s Name First middle last visitation rights with the child ren listed below Name s Of Parent s Or Guardian s First middle initial last X here if additional children are listed on a separate sheet. 4. Briefly explain why you are asking to intervene in this case I request the Court s permission to intervene in this case. I certify that a copy of the above was mailed/delivered to all counsel and self-represented parties of record on Signed Attorney or self-represented party Date mailed or delivered Address Number street town and zip code u Name of each party that copy was mailed or delivered to Address that copy was mailed or delivered to If necessary attach additional sheet with name and address of each party the form was mailed or delivered to. Print Form Reset Form Order To be completed by the court The court has heard this motion and orders it This Court further orders the appointment of Attorney Granted Denied of as counsel for the child ren in this case under the provisions of section 46b-54 of the Connecticut General Statutes. By the Court Name of Judge Signed Judge/Assistant Clerk Print name of person signing at left J* Date signed. jud. ct. gov Instructions Fill out the form below to intervene in an existing case and file it with the Court Clerk. You must also file an Appearance form JD-CL-12. Judicial District of Docket number At Town Name of case Return date Month day year if applicable Intervenor s name Last first middle initial Intervenor s address Number street town state zip code 1. You must also file an Appearance form JD-CL-12. Judicial District of Docket number At Town Name of case Return date Month day year if applicable Intervenor s name Last first middle initial Intervenor s address Number street town state zip code 1. I am the State relationship to child ren for example grandparent aunt uncle etc* 2. I have a relationship with the child ren that is similar in nature to a parent-child relationship* State specifically how your relationship is similar to a parent-child relationship Check if asking for visitation Denial of visitation will cause real and significant harm to the child ren.

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