INSTRUCTIONS: ALABAMA REFUND REQUEST (Form PEEHIP RR)

In Alabama, a request for a refund from the state administered public education employees' health insurance plan is submitted using a form PEEHIP RR. This document can be obtained from the website of the retirement systems of Alabama.

Alabama Refund Request PEEHIP RR Step 1: Enter the employee's name on the first blank line.

Alabama Refund Request PEEHIP RR Step 2: Enter the employee's Social Security number on the third blank line.

Alabama Refund Request PEEHIP RR Step 3: Enter the employee's system on the third blank line.

Alabama Refund Request PEEHIP RR Step 4: On the fourth blank line, enter the amount of the insurance premium you wish to be refunded to the member.

Alabama Refund Request PEEHIP RR Step 5: On the fifth blank line, enter the amount of the insurance premium you wish to be refunded to the system.

Alabama Refund Request PEEHIP RR Step 6: On the sixth blank line, enter the month or months to which the refund applies.

Alabama Refund Request PEEHIP RR Step 7: On the seventh blank line, detail your coverages.

Alabama Refund Request PEEHIP RR Step 8: On the eighth blank line, provide the reason for your request.

Alabama Refund Request PEEHIP RR Step 9: On the ninth blank line, enter the name of the member to whom the refund should be mailed.

Alabama Refund Request PEEHIP RR Step 10: On the tenth blank line, enter the member's street address or P.O. box number.

Alabama Refund Request PEEHIP RR Step 11: On the eleventh blank line, enter the member's city, state and zip code.

Alabama Refund Request PEEHIP RR Step 12: On the twelfth blank line, enter the system name.

Alabama Refund Request PEEHIP RR Step 13: On the thirteenth blank line, enter the system street address or P.O. box number.

Alabama Refund Request PEEHIP RR Step 14: On the fourteenth blank line, enter the system city, state and zip code.

Alabama Refund Request PEEHIP RR Step 15: On the fifteenth blank line, enter the name of the school system.

Alabama Refund Request PEEHIP RR Step 16: On the sixteenth blank line, enter the date.

Alabama Refund Request PEEHIP RR Step 17: The applicable official should enter their signature on the last blank line.

INSTRUCTIONS: CONNECTICUT MEDICAL DISCOUNT PLAN (MDP) LICENSE APPLICATION

To apply for a medical discount plan (MDP) license in Connecticut, use the form discussed in this article. This document can be obtained from the website of the government of Connecticut.

Connecticut Medical Discount Plan (MDP) License Application Step 1: The first page contains general instructions for filing this application.

Connecticut Medical Discount Plan (MDP) License Application Step 2: Enter the calendar year for which you are filing on the first blank line of the second page.

Connecticut Medical Discount Plan (MDP) License Application Step 3: Enter the name of the MDP on the second blank line.

Connecticut Medical Discount Plan (MDP) License Application Step 4: Enter the email address of the MDP on the third blank line.

Connecticut Medical Discount Plan (MDP) License Application Step 5: List all names used to market your MDP card on the fourth blank line.

Connecticut Medical Discount Plan (MDP) License Application Step 6: Enter your MDP tax identification number or federal employer identification number on the fifth blank line.

Connecticut Medical Discount Plan (MDP) License Application Step 7: Enter your MDP business address on the next three blank lines.

Connecticut Medical Discount Plan (MDP) License Application Step 8: If your MDP mailing address is different from your business address, enter it on the next two blank lines.

Connecticut Medical Discount Plan (MDP) License Application Step 9: Enter your MDP phone number on the next blank line.

Connecticut Medical Discount Plan (MDP) License Application Step 10: The next section concerns contact information to be used for all future related correspondence. On the first two blank lines, enter the name and title of a contact person.

Connecticut Medical Discount Plan (MDP) License Application Step 11: Enter the contact person's mailing address on the next two blank lines.

Connecticut Medical Discount Plan (MDP) License Application Step 12: Enter the contact person's phone number and fax number on the next two blank lines.

Connecticut Medical Discount Plan (MDP) License Application Step 13: Enter the name and a description of your controlling company and organization.

Connecticut Medical Discount Plan (MDP) License Application Step 14: Enter a contact name for the controlling company or organization.

Connecticut Medical Discount Plan (MDP) License Application Step 15: Complete the remainder of the application as instructed.

INSTRUCTIONS: CONNECTICUT CITIZENS' ELECTION PROGRAM – DECLARATION OF JOINT CAMPAIGN BY PARTICIPATING CANDIDATES FOR GOVERNOR AND LT. GOVERNOR (SEEC Form CEP 18)

Two people running a joint campaign for governor and lieutenant governor in Connecticut use an  SEEC form CEP 18 to document this. This form can be obtained from the website of the government of Connecticut.

Connecticut Citizens' Election Program – Declaration Of Joint Campaign By Participating Candidates For Governor And Lt. Governor SEEC Form CEP 18 Step 1: In box 1, enter the election date.

Connecticut Citizens' Election Program – Declaration Of Joint Campaign By Participating Candidates For Governor And Lt. Governor SEEC Form CEP 18 Step 2: In box 2, enter the name of the governor candidate's candidate committee.

Connecticut Citizens' Election Program – Declaration Of Joint Campaign By Participating Candidates For Governor And Lt. Governor SEEC Form CEP 18 Step 3: In box 3, enter the name of the candidate for governor.

Connecticut Citizens' Election Program – Declaration Of Joint Campaign By Participating Candidates For Governor And Lt. Governor SEEC Form CEP 18 Step 4: In box 4, enter the name of the governor candidate committee's treasurer.

Connecticut Citizens' Election Program – Declaration Of Joint Campaign By Participating Candidates For Governor And Lt. Governor SEEC Form CEP 18 Step 5: In box 5, enter the name of the governor candidate committee's deputy treasurer, if applicable.

Connecticut Citizens' Election Program – Declaration Of Joint Campaign By Participating Candidates For Governor And Lt. Governor SEEC Form CEP 18 Step 6: In box 6, enter the name of the lieutenant governor candidate's candidate committee.

Connecticut Citizens' Election Program – Declaration Of Joint Campaign By Participating Candidates For Governor And Lt. Governor SEEC Form CEP 18 Step 7: In box 7, enter the name of the candidate for lieutenant governor.

Connecticut Citizens' Election Program – Declaration Of Joint Campaign By Participating Candidates For Governor And Lt. Governor SEEC Form CEP 18 Step 8: In box 8, enter the name of the lieutenant governor candidate committee's treasurer. 

Connecticut Citizens' Election Program – Declaration Of Joint Campaign By Participating Candidates For Governor And Lt. Governor SEEC Form CEP 18 Step 9: In box 9, enter the name of the lieutenant governor candidate committee's deputy treasurer, if applicable. Both candidates should sign and date the second page.

INSTRUCTIONS: CONNECTICUT EXEMPTION AND MODIFICATION CLAIM FORM, WAGE EXECUTION (Form JD-CV-3a)

In Connecticut debt cases, a form JD-CV-3a is sent to the debtor's employer as part of the wage garnishing process. This document can be obtained from the website of the Connecticut Judicial Branch.

Connecticut Exemption And Modification Claim Form, Wage Execution JD-CV-3a Step 1: In the blank section at the top of the first page, enter the name and address of the judgment debtor.

Connecticut Exemption And Modification Claim Form, Wage Execution JD-CV-3a Step 2: Section I must be completed by the judgment creditor. In the first blank box, indicate with a check mark whether this case is being processed by a judicial district court, a housing session court or a geographical area court. If the latter, give its number.

Connecticut Exemption And Modification Claim Form, Wage Execution JD-CV-3a Step 3: In the second blank box, enter the name and address of the court.

Connecticut Exemption And Modification Claim Form, Wage Execution JD-CV-3a Step 4: In the third blank box, enter the name of the case.

Connecticut Exemption And Modification Claim Form, Wage Execution JD-CV-3a Step 5: In the fourth blank box, enter the case docket number.

Connecticut Exemption And Modification Claim Form, Wage Execution JD-CV-3a Step 6: In the fifth blank box, enter the name of the judgment debtor.

Connecticut Exemption And Modification Claim Form, Wage Execution JD-CV-3a Step 7: Section II should be completed by the proper officer. In the first blank box, they should enter their name.

Connecticut Exemption And Modification Claim Form, Wage Execution JD-CV-3a Step 8: In the second blank box, they should enter the date of service of wage execution upon the employer.

Connecticut Exemption And Modification Claim Form, Wage Execution JD-CV-3a Step 9: Section III must be completed by the employer. In the first blank box, enter your name and address.

Connecticut Exemption And Modification Claim Form, Wage Execution JD-CV-3a Step 10: In the second blank box, enter the telephone number of your payroll department.

Connecticut Exemption And Modification Claim Form, Wage Execution JD-CV-3a Step 11: In the next three blank boxes, enter the date of mailing or delivery of the judgment order, the total amount of wage execution and the amount to be taken out from weekly earnings. The debtor may apply for an exemption or modification using sections V and VI.

INSTRUCTIONS: CONNECTICUT CERTIFICATE OF JUDGMENT FORECLOSURE BY SALE (Form JD-CV-46)

When a Connecticut Superior Court finds a judgment of foreclosure and authorizes the sale of the property in question at public option, a form JD-CV-46 will be completed. This document will take effect unless the defendant pays their debt, interest and expenses. This document can be obtained from the website of the Connecticut Judicial Branch.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 1: Enter the name of the case in the first blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 2: Enter the docket number in the second blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 3: Enter the judicial district in the third blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 4: Enter the address of the court in the fourth blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 5: Enter the return date in the fifth blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 6: Enter the property location in the sixth blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 7: Enter the judgment date in the seventh blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 8: Enter the amount of debt, including attorney's fees, in the eighth blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 9: Enter costs, if taxed, in the ninth blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 10: Enter the name of the judge in the tenth blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 11: Enter the judge's name in the eleventh blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 12: Enter the redemption date for the defendant in the twelfth blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 13: Enter the defendant's name in the thirteenth blank box.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 14: Where indicated, enter a legal description of the property. If additional space is required, place an "X" in the box where indicated and continue on the second page.

Connecticut Certificate Of Judgment Foreclosure By Sale JD-CV-46 Step 15: The clerk of the superior court will sign and date the first page where indicated.

INSTRUCTIONS: CONNECTICUT AFFIDAVIT OF SERVICE PETITION FOR ORDER RE: COMMISSION ON HUMAN RIGHTS AND OPPORTUNITIES AND NOTICE OF HEARING (Form JD-CV-69)

When you file a form JC-CV-68 requesting a ruling of cause or no cause from the Connecticut Commission On Human Rights And Opportunities after two years from the ordered date of finding has passed, you must also file a form JD-CV-69. This document certifies all defendants have been served with a copy of form JD-CV-68. Both forms can be found on the website of the Connecticut Judicial Branch.

Connecticut Affidavit Of Service Petition For Order Re: Commission On Human Rights And Opportunities And Notice Of Hearing JD-CV-69 Step 1: Enter the docket number in the first blank box.

Connecticut Affidavit Of Service Petition For Order Re: Commission On Human Rights And Opportunities And Notice Of Hearing JD-CV-69 Step 2: Enter the name and address of the petitioner in the next two blank boxes.

Connecticut Affidavit Of Service Petition For Order Re: Commission On Human Rights And Opportunities And Notice Of Hearing JD-CV-69 Step 3: Enter the name and address of the Commission On Human Rights And Opportunities in the next two blank boxes.

Connecticut Affidavit Of Service Petition For Order Re: Commission On Human Rights And Opportunities And Notice Of Hearing JD-CV-69 Step 4: In the next two blank boxes, enter the names and addresses of all respondents named in the original complaint.

Connecticut Affidavit Of Service Petition For Order Re: Commission On Human Rights And Opportunities And Notice Of Hearing JD-CV-69 Step 5: In the next two blank boxes, enter the Commission On Human Rights and Opportunities case name and number.

Connecticut Affidavit Of Service Petition For Order Re: Commission On Human Rights And Opportunities And Notice Of Hearing JD-CV-69 Step 6: In the table provided below, you must list all respondents who were served with a copy of your petition. Enter their names in the first column, the method by which service was certified or registered in the second column, the date of service in the third column, and the return receipt number in the fourth column.

Connecticut Affidavit Of Service Petition For Order Re: Commission On Human Rights And Opportunities And Notice Of Hearing JD-CV-69 Step 7: Enter the town where you signed this document, the date and your signature in the presence of a commissioner of the Superior Court or a notary public.