Fillable /2020 (NJ Judiciary)

Fill Online, Printable, Fillable, Blank /2020 (NJ Judiciary) Form

Use Fill to complete blank online NJ JUDICIARY (NJ) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

/2020 (NJ Judiciary)

On average this form takes 11 minutes to complete

The /2020 (NJ Judiciary) form is 5 pages long and contains:

  • 0 signatures
  • 3 check-boxes
  • 41 other fields

Country of origin: US
File type: PDF

U.S.A. forms for NJ Judiciary

BROWSE NJ JUDICIARY (NJ) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Revised Form Promulgated by 12/23/2020 Notice to the Bar, CN 10517_ps page 1 of 5
Civil – Law
Case Information Statement
12/23
/2020
How to Complete the Civil Case Information Statement
(CIS)
These instructions are intended to guide individuals who are either plaintiffs or defendants in
civil cases and who are
not represented by an attorney in completing the Civil Case Information
Statement (Civil CIS) required by court rules. The Civil CIS must be included with each party’s
first pleading in the Civil part of the Law Division. That is, the plaintiff must file
it with the
complaint and the defendant must file it with the answer. If it is not included, the papers will be
returned.
The CIS summarizes your case and alerts the court to any special needs you may have such as
the need for an interpreter or the need
for a quick trial date because one of your witnesses is
expected to be unavailable. The numbers for the various case types are located on the back of the
form. Enter the number which best describes your complaint. For example, if you are suing the
defend
ant for a breach of contract, your case number would be 599.
After you have completed the CIS, keep it with the other papers you are planning to file.
Note: These materials have been prepared by the New Jersey Administrative Office of the
Courts for use by self-represented litigants. The guides, instructions, and forms will be
periodically updated as necessary to reflect current New Jersey statutes and court rules. The
most recent version of the forms will be available at the county courthouse or on the
Judiciary’s Internet site njcourts.gov. However, you are ultimately responsible for the content
of your court papers.
Revised Form Promulgated by 12/23/2020 Notice to the Bar, CN 10517_ps page 2 of 5
Instructions for Parties Not Represented by an Attorney for Completing the
Civil Case Information Statement (CIS)
Box# Instruction
1.
Print your name.
2.
List a telephone number, including area code, where you can be reached during the day.
3.
Insert the name of the county where the complaint or answer is being filed.
4.
Leave the box blank.
5.
If you know the docket number of your case, insert it in the docket number box. If the CIS is
being filed with a complaint, the court will assign the docket number before it returns the
filed complaint.
6.
Enter an address where you wish to receive mail concerning this matter.
7.
Document type means the type of paper you are filing. If you are filing the complaint, print
complaint; if you are filing an answer, print answer.
8.
Check the box marked “yes” if you have requested that the matter be heard by a jury.
Otherwise, check “no.”
9.
Enter your name and indicate whether you are the plaintiff or defendant.
10.
The caption is the name of the case - the name of the plaintiff(s) v. the name of the
defendant(s). For example: John Doe, Plaintiff v. Mary Smith, Defendant. Print the name of
your case.
11.
The Case Type Number identifies the type of case. On the back of the CIS form is a list of
case types. Sometimes it is difficult to pick the number of your case, but you must fill in this
section in order for your case to proceed. Choose the one that best describes what your case
is about and enter that number. For example, if you are the plaintiff or defendant in a dispute
over fulfilling the terms of a contract, the case type is 599; if your case concerns a personal
injury, the case type number is 605.
12.
Are you alleging claims of sexual abuse? If yes, check the box marked “yes.” Otherwise,
check “no.”
13.
If you believe that your case is a professional malpractice case, check the box marked “yes”
and see N.J.S.A. 2A:53A-27 and applicable case law regarding your obligation to file an
affidavit of merit.
14.
If you believe that you have any other cases involving the same adversary or arising from the
same set of circumstances (related cases pending), check the box marked “yes.” Otherwise,
check “no.”
15.
If you checked “yes” to the previous question, enter the docket number(s) of any related
cases.
16.
If you believe you will be adding more parties to the case, check “yes.” Otherwise, check
“no.”
17.
If you are the plaintiff and know the name of the defendant’s primary insurance company
enter it in the box. Otherwise check “unknown.” If you are the defendant and you have
Revised Form Promulgated by 12/23/2020 Notice to the Bar, CN 10517_ps page 3 of 5
insurance that might cover or partially cover the damages complained of, enter the name of
your insurance company.
18.
If you and your adversary knew each other before the event giving rise to the law suit
occurred, check “yes.” Otherwise, check “no.”
If the answer was “yes”, check the box next to the word(s) that best describe the relationship
between the parties.
19.
If you believe that the statute governing your case provides for payment of fees by the losing
party, (for example, the Law Against Discrimination), check “yes.” Otherwise, check “no.”
20.
If you believe that your case has some unusual circumstance which would require special
attention, indicate the problem in the space provided. For example, if there is a witness who
is ill or who may be unavailable, you should let the court staff know.
21.
If you are requesting any accommodation for a disability, check “yes” and indicate what is
needed. Otherwise, check “no.”
22.
If you are requesting an interpreter, check “yes” and indicate the language for which it is
needed. Otherwise, check “no.”
23.
This box contains the statement by which you certify that you have removed any confidential
personal identifiers from any document you have already submitted to the court and that you
will continue to remove such identifiers in any future submission, unless such confidential
personal identifiers are required by statute, court rule or court order. If you are filing a name
change complaint, N.J.S.A. 2A:52-1 (the applicable New Jersey statute) requires that the
social security number be listed on your complaint. Once a name change judgment is entered,
your social security number will be removed by the court before the judgment is published in
the newspaper.
24.
The person whose name appears in Box 1 must sign the CIS in the space marked “Attorney
Signature.”
Civil Case Information Statement
(CIS)
Use for initial Law Division
Civil Part pleadings (not motions) under Rule 4:5-1
Pleading will be rejected for filing, under Rule 1:5-6(c),
if information above the black bar is not completed
or attorney’s signature is not affixed
For Use by Clerk’s Office Only
Payment type: ck cg ca
Chg/Ck Number:
Amount:
Overpayment:
Batch Number:
Attorney/Pro Se Name
Telephone Number
Firm Name (if applicable)
Office Address
Jury Demand Yes No
Name of Party (e.g., John Doe, Plaintiff)
Caption
Case Type Number
(See reverse side for listing)
Are sexual abuse claims
alleged?
Is this a professional malpractice case? Yes No
Yes No
If you have checked “Yes,” see N.J.S.A. 2A:53A-27 and applicable case law
regarding your obligation to file an affidavit of merit.
Related Cases Pending?
If “Yes,” list docket numbers
Yes No
Do you anticipate adding any parties
Name of defendant’s primary insurance company (if known)
(arising out of same transaction or occurrence)?
None
Yes No Unknown
The Information Provided on This Form Cannot be Introduced into Evidence.
Case Characteristics for Purposes of Determining if Case is Appropriate for Mediation
Do parties have a current, past or recurrent relationship?
If “Yes,” is that relationship:
Yes No
Employer/Employee
Friend/Neighbor
Other (explain)
Familial Business
Does the statute governing this case provide for payment of fees by the losing party? Yes No
Use this space to alert the court to any special case characteristics that may warrant individual management or accelerated disposition
Do you or your client need any disability accommodations?
If yes, please identify the requested accommodation:
Yes
No
Will an interpreter be needed?
If yes, for what language?
Yes No
I certify that confidential personal identifiers have been redacted from documents now submitted to the court and will be
redacted from all documents submitted in the future in accordance with Rule 1:38-7(b).
Attorney Signature:
Revised Form Promulgated by 12/23/2020 Notice to the Bar, CN 10517_ps page 4 of 5
Save
Print
Clear
Side 2
Civil Case Information Statement
(CIS)
Use for initial pleadings (not motions) under Rule 4:5-1
CASE TYPES (Choose one and enter number of case type in appropriate space on the reverse side.)
Track I - 150 days discovery
151
Name Change
506
PIP Coverage
175
Forfeiture
510
UM or UIM Claim (coverage issues only)
302
Tenancy
511
Action on Negotiable Instrument
399
Real Property (other than Tenancy, Contract, Condemnation, Complex
Commercial or Construction)
512
Lemon Law
801
Summary Action
502
Book Account (debt collection matters only)
802
Open Public Records Act (summary action)
505
Other Insurance Claim (including declaratory judgment actions)
999
Other (briefly describe nature of action)
Track II - 300 days discovery
305
Construction
603Y
Auto Negligence – Personal Injury (verbal threshold)
509
Employment (other than Conscientious Employees Protection Act (CEPA)
or Law Against Discrimination (LAD))
605
Personal Injury
610
Auto Negligence – Property Damage
599
Contract/Commercial Transaction
621
UM or UIM Claim (includes bodily injury)
603N
Auto Negligence – Personal Injury (non-verbal threshold)
699
Tort – Other
Track III - 450 days discovery
005
Civil Rights
608
Toxic Tort
301
Condemnation
609
Defamation
602
Assault and Battery
616
Whistleblower / Conscientious Employee Protection Act
(CEPA) Cases
604
Medical Malpractice
606
Product Liability
617
Inverse Condemnation
607
Professional Malpractice
618
Law Against Discrimination (LAD) Cases
Track IV - Active Case Management by Individual Judge / 450 days discovery
156
Environmental/Environmental Coverage Litigation
514
Insurance Fraud
303
Mt. Laurel
620
False Claims Act
508
Complex Commercial
701
Actions in Lieu of Prerogative Writs
513
Complex Construction
Multicounty Litigation (Track IV)
271
Accutane/Isotretinoin
601
Asbestos
274
Risperdal/Seroquel/Zyprexa
623
Propecia
281
Bristol-Myers Squibb Environmental
624
Stryker LFIT CoCr V40 Femoral Heads
282
Fosamax
625
Firefighter Hearing Loss Litigation
285
Stryker Trident Hip Implants
626
Abilify
286
Levaquin
627
Physiomesh Flexible Composite Mesh
289
Reglan
628
Taxotere/Docetaxel
291
Pelvic Mesh/Gynecare
629
Zostavax
292
Pelvic Mesh/Bard
630
Proceed Mesh/Patch
293
DePuy ASR Hip Implant Litigation
631
Proton-Pump Inhibitors
295
AlloDerm Regenerative Tissue Matrix
632
HealthPlus Surgery Center
296
Stryker Rejuvenate/ABG II Modular Hip Stem Components
633
Prolene Hernia System Mesh
297
Mirena Contraceptive Device
634
Allergan Biocell Textured Breast Implants
299
Olmesartan Medoxomil Medications/Benicar
300
Talc-Based Body Powders
If you believe this case requires a track other than that provided above, please indicate the reason on Side 1,
in the space under "Case Characteristics.
Please check off each applicable category
Putative Class Action Title 59 Consumer Fraud
Revised Form Promulgated by 12/23/2020 Notice to the Bar, CN 10517_ps page 5 of 5
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

2020 (NJ Judiciary)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 26 January 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document