INSTRUCTIONS: CONNECTICUT EXEMPTION CLAIM FORM FINANCIAL INSTITUTION EXECUTION (Form JD-CV-24A)

When a financial institution receives a Connecticut form JD-CV-24N requiring them to withhold moneys owed by a member who is a debtor, they may file a form JD-CV-24A if they are exempt from this order. This document can be obtained from the website of the Connecticut Judicial Branch.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 1: Section I is to be completed by the plaintiff creditor. Indicate whether the case was processed by judicial district, housing sessions or geographical area court. If the latter, enter its number.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 2: Enter the name and address of the court.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 3: Enter the name of the case.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 4: Enter the name of the judgment debtor.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 5: Enter the docket number.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 6: Section II is to be completed by the financial institution. Enter the name and address of the financial institution to which the exemption claim should be returned.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 7: Enter the date of mailing to the judgment debtor.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 8: Enter the last four digits of all of the debtor's account numbers.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 9: Enter the amount removed pursuant to execution.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 10: Enter the amount and type of readily identifiable funds not removed.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 11: Section IV requires the financial institution to indicate the basis for the claimed execution by checking the box next to the applicable statement.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 12: If the amount claimed to be exempt is less than the entire amount, enter it where indicated.

Connecticut Exemption Claim Form Financial Institution Execution JD-CV-24A Step 13: An authorized representative of the institution should sign and date the form, as well as providing a contact telephone number, and the complete mailing address of the debtor. This should be done before a notary public or a commissioner of the Superior Court.