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STATE OF CONNECTICUT
JD-FM-6-LONG Rev. 2-16
P.B. §§ 25-30, 25a-15
Use this long version if either your gross annual income is more than $75,000 (see
Section I. Income) or your total net assets are more than $75,000 (see Section IV. Assets),
or if both are more than $75,000. Otherwise, use the short version, form JD-FM-6-SHORT.
Court Use Only
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.
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