1 REPLY TO SPECIAL STATE OF CONNECTICUT DEFENSES SUPERIOR COURT JD-HM-16 Rev. 11-15 Docket number Geographical Judicial Housing Area District at Session at number Name of case Reply To Special Defenses Certification I certify that a copy of this document was or will immediately be mailed or delivered electronically or non-electronically on to all attorneys and self-represented parties of record and that written consent for electronic (date) 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. (You may use JD-CV-67.) Print or type name of person signing Date signed Signed (Signature of filer) u Telephone number Mailing address (Number, street, town, state and zip code) REPLY TO SPECIAL DEFENSES 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

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