On October 28, 2016 a
APPEARANCE Appearance
was filed
involving a dispute between
Charlotte Hungerford Hospital,
and
Shana E Goldberg,
for S05 - Small Claims - Small Claims - Collection - Hospital
in the District Court of Litchfield County.
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APPEARANCE STATE OF CONNECTICUT
JD-CL-12 Rev. 1-12 Instructions — See Back/Page 2
P.B. §§ 3-1 thru 3-6, 3-8, 10-13, 25A-2 SUPERIOR COURT
www.jud.ct.gov
Notice To Self-Represented Parties
A self-represented party is a person who represents himself or herself. If you are a self-
represented party and you filed an appearance before and you have since changed your address,
you must let the court and all attorneys and self-represented parties of record know that you have Return date
changed your address by checking the box below: Oct-28-2016
I am filing this appearance to let the court and all attorneys and self-represented Docket number
parties of record know that I have changed my address. My new address is below. LLI-CV-16-5014044-S
Name of case (Full name of Plaintiff vs. Full name of Defendant)
CHARLOTTE HUNGERFORD HOSPITAL v. GOLDBERG, SHANA E
✖ Address of Court (Number, street, town and zip code)
JudicialHousing Small Geographic
DistrictSession Claims Area number
50 FIELD STREET TORRINGTON, CT 06790
Scheduled Court date (Criminal/Motor Vehicle Matters)
Please Enter the Appearance of
Juris number of attorney or firm
Name of self-represented party (See "Notice to Self-Represented Parties" at top), or name of official, firm, professional corporation, or individual
attorney
438749
MONAGAN PHILIP H LAW OFFICES OF
Mailing Address (Number, street) (Notice to attorneys and law firms - The address to which papers will be mailed from the
Post office box Telephone number (Area code first)
court is the one registered or affiliated with your juris number. That address cannot be changed in this form.)
61 HOLMES AVENUE PO BOX 2390 2037533374
City/town State Zip code E-mail address
Fax number (Area code first)
WATERBURY CT 06722 2035751364 phm@monaganlaw.com
in the case named above for: ("x" one of the following parties; if this is a Family Matters case, also indicate the scope of your appearance)
✖ The Plaintiff (includes the person suing another person).
All Plaintiffs.
The following Plaintiff(s) only:
The Defendant (includes the person being sued or charged with a crime).
The Defendant for the purpose of the bail hearing only (in criminal and motor vehicle cases only).
All Defendants.
The following Defendant(s) only:
Other (Specify):
This is a Family Matters case and my appearance is for: ("x" one or both)
matters in the Family Division of the Superior Court Title IV-D Child Support matters
Note: If other counsel or a self-represented party has already filed an appearance for the party or parties "x'd" above, put
an "x" in box 1 or 2 below:
1. ✖ This appearance is in place of the appearance of the following attorney,
firm or self-represented party on file (P.B. Sec. 3-8): HERTZMARK CREAN & LAHEY LLP 027309
(Name and Juris Number)
2. This appearance is in addition to an appearance already on file.
I agree to accept papers (service) electronically in this case under Practice Book Section 10-13 ✖ Yes No
Signed (Individual attorney or self-represented party) Name of person signing at left (Print or type) Date signed
u 305987 PHILIP H MONAGAN Dec 06 2021
Certification
I certify that a copy of this document was mailed or delivered electronically or non-electronically on (date)
Dec 06 2021 to all attorneys
and self-represented parties of record and that written consent for electronic 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* For Court Use Only
HERTZMARK CREAN & LAHEY LLP - 61 HOLMES AVENUE/P.O. BOX 2390/WATERBURY, CT 06722
SHANA E GOLDBERG (Self Represented) - 350 HEIGHTS DR. TORRINGTON, CT 06790
Signed (Signature of filer) Print or type name of person signing Date signed Telephone number
u 305987 PHILIP H MONAGAN Dec 06 2021 2037533374
*If necessary, attach an additional sheet or sheets with the name of each party and the address which the copy was mailed or delivered to.
Document Filed Date
December 06, 2021
Case Filing Date
October 28, 2016
Category
S05 - Small Claims - Small Claims - Collection - Hospital
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