# Conn. Practice Book Form 207: Form 207 > Connecticut · Court rules · In force URL: https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R207 ## Section - **Citation:** Conn. Practice Book Form 207 - **Heading:** Form 207 - **Jurisdiction:** Connecticut - **Kind:** Court rules - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Connecticut Court Rules / Connecticut Practice Book Appendix of Forms / Conn. Practice Book Form 207 ## Text (f) Is your disability the result of an automobile accident, an accident at work, an accident at home or otherwise? Please give the date and details of the incident and state whether you have filed a lawsuit or workers’ compensation claim as a result. (g) Have you had any children since the incident? If so, list their dates of birth. (7) Have you applied for Social Security Disability (SSD) or Supplemental Security Income (SSI)? (a) If you did, when did you apply and where are you in the application process? (b) Have you been told if or when you will receive benefits? If so, who told you and what is the date they gave you? (c) If your application for SSD and/or SSI has been denied, did you appeal? If you appealed, what is the status of the appeal and what lawyer, if any, represents you? (d) Have you applied for or are you receiving state assistance? (e) Are you a recipient of the state supplement program, medical assistance program, temporary family assistance program or state-administered general assistance program (SAGA medical or cash)? If so, state the source of the benefit, the effective date of the benefit and the date when your eligibility for benefits will be redetermined by the Department of Social Services. (8) Do you have any lawsuits pending? (a) If you do, what type of case is it? (b) Give the name, address, email address and phone number of the lawyer handling the case for you. (c) What amount do you expect to recover and when do you expect to receive it? (d) If you have already settled the case, please provide a copy of the settlement statement. (9) Do you expect to inherit any money or property in the next six months? (a) If you do, who do you expect to inherit from and where do they or where did they live? (b) What do you expect to inherit, what is its value and when do you expect to inherit it? t to recover and when do you expect to receive it? (d) If you have already settled the case, please provide a copy of the settlement statement. (9) Do you expect to inherit any money or property in the next six months? (a) If you do, who do you expect to inherit from and where do they or where did they live? (b) What do you expect to inherit, what is its value and when do you expect to inherit it? (c) What is the name and address of the person or lawyer handling the estate and where is the Probate Court in which the action is filed? (10) Is anyone holding any money for you? If so, name the person, their relationship to you, their address and the amount of money they are holding. (11) Do you own any rental properties, by yourself, with someone else or in trust? If the answer is yes: (a) Is the property residential or commercial? (b) Please identify the location of the property or properties, include the address and identify your ownership interest. (c) Do you derive any income from the property? Do you calculate your net income from the property on a weekly, monthly or yearly basis? ## Nearby sections - [Conn. Practice Book Form 101 Form 101. Heading of Pleadings, Motions and Requests](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R101.md) - [Conn. Practice Book Form 201 Form 201](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R201.md) - [Conn. Practice Book Form 202 Form 202](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R202.md) - [Conn. Practice Book Form 203 Form 203](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R203.md) - [Conn. Practice Book Form 204 Form 204. Plaintiff’s Requests for Production](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R204.md) - [Conn. Practice Book Form 205 Form 205. Defendant’s Requests for Production](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R205.md) - [Conn. Practice Book Form 206 Form 206. Plaintiff’s Requests for Production—Premises Liability](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R206.md) - [Conn. Practice Book Form 207 Form 207](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R207.md) - [Conn. Practice Book Form 208 Form 208. Defendant’s Supplemental Interrogatories—](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R208.md) - [Conn. Practice Book Form 209 Form 209. Defendant’s Supplemental Requests for Production—](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R209.md) - [Conn. Practice Book Form 210 Form 210. Defendant’s Interrogatories—](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R210.md) - [Conn. Practice Book Form 211 Form 211. Defendant’s Requests for Production—](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R211.md) - [Conn. Practice Book Form 212 Form 212. Defendant’s Interrogatories—Loss of Consortium](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R212.md) - [Conn. Practice Book Form 213 Form 213](https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R213.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/SRULES_CT_FORMS_R207. Check the current official text before relying on it. Not legal advice.