Foreclosure Mediation Certificate — JD-CV-108
This form gives the court information to determine eligibility for the Foreclosure Mediation Program. Explore an illustrative example across both pages, including signatures and certification, or switch to the untouched blank form.
On a phone the form is wider than the screen so the sample stays readable. Slide it sideways to see the whole page.
What the sample shows
Jane Q. Homeowner, Example Bank and attorney Alex Sample are fictional. The sample shows where names, contact details, signatures, printed names, signing dates, mailing dates and recipient details go.
All checkbox questions and consent choices are unselected. These sections still need to be completed as directed by the official form; blank choices in this illustration do not mean they can be skipped.
The italic names illustrate signatures. They are not actual signatures or instructions about an acceptable signing method. The sample is not a completed filing.
A request to be considered for mediation
The Foreclosure Mediation Certificate asks about the property, the borrower and certain ownership situations. The court uses these answers to assess eligibility. Completing a sample or viewing this page does not enroll anyone in mediation.
| Form | Purpose |
|---|---|
| Appearance Form JD-CL-12 | Identifies who is appearing in the case and provides contact information. |
| Foreclosure Mediation Certificate JD-CV-108 | Provides information for the court to determine mediation eligibility. |
They serve different purposes. The Certificate’s instructions also call for an Appearance.
Source: Foreclosure Mediation Certificate, page 1What does the return date mean here?
The return date is printed on the summons. It is a reference date for case deadlines. It is not the date the papers arrived or, by itself, a hearing date.
Certificate instruction: 15 days
JD-CV-108 says to file the Certificate and an Appearance no more than 15 days after the return date on the summons.
General Appearance instruction: earlier
The civil summons says an Appearance is generally due by the second day after the return date.
These documents give different timing instructions. The Certificate’s 15-day instruction should not be read as permission to disregard the earlier general Appearance deadline on the summons. A lawyer can explain the requirements for a particular case.
The summons says attendance on the return date is not required unless a separate notice directs it. Mediation appointments and hearings have their own notices. This page does not calculate your deadlines.
Certificate instructions · Civil Summons: notice to each defendantDistrict name or courthouse address?
This Certificate asks for the judicial district from the summons. The Appearance form asks for the court’s address. These are different fields.
| Detail | Meaning | Example |
|---|---|---|
| Homeowner’s address | Your contact address in the personal-information area. | The fictional address here is in Hamden. |
| Judicial district | The court district identified on the summons. | New Haven |
| Court location | A location within that district. | New Haven or Meriden |
Connecticut law provides New Haven and Meriden locations for civil cases brought to New Haven Judicial District. The actual summons and later court notices identify the relevant location; the example does not select a courthouse for your case.
Source: Connecticut General Statutes §§ 51-346 and 51-347Why are questions and choices blank?
This guide explains the questions without answering them. Complete applicable sections using the actual facts and the official instructions. Court-use-only fields remain for court staff. Some conditional sections may not apply; their instructions explain when they are used.
Illustrative names, signatures and dates are included to show field placement. They are not information to copy into a real filing.
Official form and sources
Foreclosure Mediation Certificate — JD-CV-108
Appearance Form — JD-CL-12
Civil Summons — JD-CV-1
Judicial districts and court locations — Chapter 890
Certificate snapshot: Rev. 1-26. Reviewed September 15, 2026. The official link provides the current downloadable form.
General information only, not legal advice. The form images above are pictures of the official blank form; the official PDF at jud.ct.gov is the accessible, fillable version and the only one to file. Foreclosure Clarity is a guide, not a law firm. This viewer does not accept or submit case information.
EDUCATIONAL VIEWER — FICTIONAL SAMPLE — NOT FOR FILING