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Revised 09/03/2019, CN 11487 page 1 of 15
Family – Chancery
How to File a Request to Modify a Non
-Dissolution “FD” Court Order Previously Issued By the Court
Updated 09/03/2019
How to File a Request to Modify a Non-Dissolution “FD” Court Order
Previously Issued by the Court
Superior Court of New Jersey - Chancery Division - Family Part
Who Should Use This Packet?
You can use this packet if your
docket number starts with the letters FD, and you have an order from the court that
you want to change.
You can also use this packet if you want to respond to the modification request filed by the other
party.
You must include a $25.00 filing fee with the completed packet. Some types of modifications you can request
with this packet are
:
• Establish or Change an existing Child/Spousal Support Order
• Enforce the Current Support Order
• Change an existing Custody/Parenting Time Court Order
• Request to Relocate the Child(ren)/Oppose to Relocation
• Request to have a Bench Warrant/Detainer lifted (Incarcerated Defendants Only)
ONLY use this packet if your case begins with letters FD.
Do NOT use this packet if:
•
You want to file an appeal of a court order that was already issued. To file an appeal use 10837- How to Appeal a
Trial Court, Tax Court or State Agency Decision found on our website at njcourts.gov.
•
Your case is an emergency (Emergent Application Order to Show Cause). An emergent hearing in family court is
designed to protect children from substantial and irreparable harm if someone is not restrained for doing something
right now. You must file for an emergent hearing at the courthouse. You cannot file for an emergent hearing
through the mail. Only a judge can determine if your case will qualify as an emergency. If you are denied an
emergency hearing, your case will continue under the normal case process.
•
Your case begins with letters other than “FD”.
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.
Completed forms are to be submitted to the Family Division where the case is filed. A list of Family Division
Offices can be found on njcourts.gov
How to File a Request to Modify a Non-Dissolution “FD” Court Order Previously Issued By the Court
Revised 09/03/2019, CN 11487 page 2 of 15
Things to Think About Before You Represent Yourself in Court
Try to Get a Lawyer
The law, the proofs necessary to present your
case, and the procedural rules governing cases
in the Family Division are complex. It is
recommended that you make every effort to
obtain the assistance of a lawyer. If you cannot
afford a lawyer, you may contact the legal
services program in your county to see if you
qualify for free legal services. Their telephone
number can be found online under “Legal Aid”
or “Legal Services.”
If you do not qualify for free legal services and
need help in locating an attorney, you can
contact the bar association in your county. The
telephone number can also be found in your
local yellow pages. Most county bar
associations have a Lawyer Referral Service.
The County Bar Lawyer Referral Service can
supply you with the names of attorneys in your
area willing to handle your particular type of
case and sometimes consult with you for a
reduced fee.
There are a variety of organizations of minority
lawyers throughout New Jersey, as well as
organizations of lawyers who handle specialized
types of cases. Ask the Family court staff in
your county for a list of lawyer referral services
that include these organizations.
What You Should Expect If You
Represent Yourself
While you have the right to represent yourself in
court, you should not expect special treatment,
help or attention from the court. The following
is a list of some things court staff can and
cannot do for you. Please read it carefully
before asking court staff for help.
• We can explain and answer questions about
how the court works.
• We can tell you what the requirements are to
have your case considered by the court.
• We can give you some information from
your case file.
• We can provide you with samples of court
forms that are available.
• We can provide you with guidance on how
to fill out forms.
• We can usually answer questions about
court deadlines.
• We cannot give you legal advice. Only your
lawyer can give you legal advice.
• We cannot tell you whether or not you
should bring your case to court.
• We cannot give you an opinion about what
will happen if you bring your case to court.
• We cannot recommend a lawyer, but we can
provide you with the telephone number of a
local lawyer referral service.
• We can cannot not talk to the judge for you
about what will happen in your case.
• We cannot let you talk to the judge outside
of court.
• We cannot change an order issued by a
judge.
Keep Copies of All Papers
Make and keep copies for yourself, written
agreements, Case Information Statements, and
other important papers that relate to your case.
How to File a Request to Modify a Non-Dissolution “FD” Court Order Previously Issued By the Court
Revised 09/03/2019, CN 11487 page 3 of 15
Definitions of Court Terms Used in FD Cases
Arrears - Arrears are unpaid or overdue child support, alimony, or spousal support payments.
Application - An application is a written request in which you ask the court to issue an order or to change an
order that has already been issued.
Bench Warrant - A bench warrant is an order from the court giving legal authority to law enforcement to
arrest a person for failure to appear for a court hearing or failure to comply with a court order.
Certification - A certification is a written statement made to the court when you file papers with the court,
swearing that the information contained in the filed papers is true.
Child Support Number (also referred to as “CS Number”) - The Child Support Number is the identifying
number assigned to your child, spousal, or alimony support case.
Complaint - A complaint is a formal document filed in court that starts a case. It typically includes the names
of the parties and the issues you are asking the court to decide.
Custodial Parent - the custodial parent is the person with whom the child(ren) live with and has the primary
day-to-day responsibility.
Counterclaim - A counterclaim is a document in which the Defendant states their opposition to the original
claim and may additionally relay to the court why you think you are entitled to relief in the case.
Court Order - A court order is the written decision issued by a court of law. For example, a child support
court order sets forth how often, how much, and what kind of support is to be paid.
Custody - refers to the right to make decisions for the child. Joint, sole, physical custody, refers to where and
by whom the child’s needs are met. Sole custody refers to one person and joint custody refers to sharing by the
parties in the case.
Diligent Search - A diligent search means you made a serious effort to find information about the location of
the other party named in your case, and that you have followed up on any information you have received about
their whereabouts.
Docket Number - The docket number is the identifying number assigned to every case filed in the court.
Exhibits - Exhibits are documents or objects you provide to the court to support what you want the court to
decide.
FD - The letters the court uses to identify a non-dissolution case that involves parents who are not legally
married or other adults filing for court relief on behalf of minor children. FD cases can also include married
people who are separated but need financial support.
File - To file means to give the appropriate forms to the court to begin the court’s consideration of your request.
Income Withholding/Wage Garnishment - Income Withholding/Wage Garnishment is a process where
automatic deductions are made from wages or other income, to pay your support obligation. Income
withholding has been mandatory since the enactment of the Family Support Act of 1988.
How to File a Request to Modify a Non-Dissolution “FD” Court Order Previously Issued By the Court
Revised 09/03/2019, CN 11487 page 4 of 15
Definitions of Court Terms Used in FD Cases (continued)
New Jersey Child Support Guidelines - Both parents are responsible for the financial and emotional support
of their children. New Jersey has developed a standard method for calculating child support based on the
income of both parents and other factors. The full set of NJ Child Support Guidelines is contained in Rule
5:6A of the New Jersey Court Rules.
NJKiDS (New Jersey Kids Deserve Support) - NJKiDS is the New Jersey Child Support automated computer
system that tracks child support accounts.
Non-Custodial Parent - the non-custodial parent is the parent with whom the child(ren) do not live the
majority of the time with.
Obligor/Payor - An obligor/payor is the person ordered by the court to pay support, also known as the non-
custodial parent (NCP).
Obligee/Payee - An obligee/payee is the person, agency, or institution who receives support, also known as the
custodial parent (CP).
Party - A party is a person, business, or governmental agency involved in a court action.
Petitioner - Petitioner is another name for the person starting the court action by filing the appropriate papers
the court will consider.
Respondent - Respondent is the person who is named as the other party in the court action filed by the
petitioner. This person can respond to the complaint or application filed by the petitioner by filing a cross
application or written response with the court.
Relief - To ask for relief is to ask the court to grant something such as custody, parenting time, or support.
Support Obligation - Support Obligation is the amount of support that the court orders the obligor to pay.
The court order includes how much and how often support has to be paid (i.e., per week, per month, bi-weekly,
etc.).
Child Support Enforcement - The Child Support Enforcement Division is required to enforce court orders
that call for the payment of child support, health care coverage, and/or spousal support/alimony. If support is
not being paid timely, the Child Support Enforcement has many state and federal tools available to enforce
child support orders. These can include, but are not limited to:
• Income withholding
• Court hearing
• Bench warrant
• Tax offset - federal and state
• Judgment (liens attached to property & assets)
• Credit bureau notification
• Financial Institution Data Match (FIDM) - seizure of bank accounts
• Child Support Lien Network (CSLN) - seizure of proceeds from law suits
• Passport denial
• License suspension
• Lottery interception
How to File a Request to Modify a Non-Dissolution “FD” Court Order Previously Issued By the Court
Revised 09/03/2019, CN 11487 page 5 of 15
The numbered steps listed below tell you what forms you will need to fill out and what to do with them. Each form should be
typed or printed clearly on 8 ½ “x 11” white paper only. Forms cannot be filed on a different size or color paper. Use only
the forms included in this packet. Be sure to keep a copy for your records.
Steps for Filing a Complaint
STEP 1: Fill out the Application/Cross
Application to Modify a Court Order (Form A)
The Application/Cross Application to Modify a
Court Order is a written request in which you ask
the court to change or enforce an existing court
order. The court will change an order only if
important facts or circumstances have changed from
the time the order was issued.
STEP 2: Provide the court with the most
recent address of the other party(ies)
The court will send a Notice to Appear to the
plaintiff, defendant, all listed parties, and attorney(s)
connected to your case when the case is scheduled
for court. Your appearance is mandatory.
Note: The other party will receive copies of all of
the papers you attach to your modification
application with the Notice to Appear, unless court
rules prohibit this information from being shared.
You must provide the court with the most current
address (that you know of) for the other party and
the name of their attorney (if you know it) when you
file your modification application. Failure to do so
may result in your case being dismissed by the court
or delayed because the other party could not be
served with a Notice to Appear.
STEP 3: Fill out the Certification of Diligent
Search (if necessary)
Every person named in a court action must be given
the opportunity to respond. They must be provided
notice so that they can exercise their right to answer
the complaint. If you are filing this application to
modify an order the court requires that you provide
the address of the other legal parent/guardian, so
they can be served with the modification application
and have the opportunity to respond.
If you do not know the current address of the other
party, you must complete the Certification of
Diligent Search (CN 11490). This packet provides
proof to the court of your efforts to find the other
party. The packet must be completed in its entirety
and mailed or delivered to the court. If you are
unable to send a letter as directed, you must tell the
court why by putting your reason on the letter and
including it in the completed packet you mail or
deliver to the court. Once you have mailed or
delivered your packet to the court, your case will be
filed and scheduled for a hearing. The judge will
decide if your search was sufficient at the hearing.
This process must be completed before your case
can proceed in court. You can find this kit on
njcourts.gov.
Important Note: If you are filing to establish
paternity or child support, a diligent search might
not be required. You can go to your local County
Welfare Office (CWA) and request locate services.
Federal locate services are used only for the purpose
of establishing paternity or child support.
STEP 4: Fill out the Confidential Litigant
Information Sheet
The Confidential Litigant Information Sheet (CN
10486) is to ensure accuracy of court records and
must be completed by the person filing this
application to modify a court order. You must
complete the entire form and submit it with your
papers to the court. Do NOT leave any blank
spaces. If something does not apply to you, enter
“N/A”. This form is confidential and will not be
shared with the other party. Each party is
required to complete their own Confidential Litigant
Information Sheet and file it with the court. You can
find this form on njcourts.gov.
Note: Failure to complete the Confidential Litigant
Information Sheet will result in your papers being
returned to you marked “deficient” and will cause a
delay in your case being scheduled for court.
STEP 5: Fill out the Financial Statement for
Summary Support Actions (if applicable)
The Financial Statement for Summary Support
Actions (CN 11223) must be completed if you are
requesting to establish or modify a child support
order in an FD case. You must complete the entire
form. Do NOT leave any blank spaces. If
something does not apply to you, enter “N/A”. This
completed form must be included in your packet
submitted to the court. This form will be shared
with the other party pursuant to Court Rule 5:5-
3. The other party must complete this same form
and file it with the court. The court will share this
How to File a Request to Modify a Non-Dissolution “FD” Court Order Previously Issued By the Court
Revised 09/03/2019, CN 11487 page 6 of 15
information with the filing party at the court hearing.
You can find this form on njcourts.gov.
STEP 6: Fill out the Family Case Information
Statement (CIS) (if applicable)
The Family Case Information Statement
(CN 10482)
must be completed only if you are married but
separated and want to establish or modify spousal
support. Spousal support can only be established or
modified under FD when there is no active divorce
case.
Pursuant to Court Rule 5:5-2, a spousal support
determination and/or modification requires the
parties to submit a Case Information Statement to
the court. You must complete the entire form. Do
NOT leave any blank spaces. If something does not
apply to you, enter “N/A”. This completed form
must be included in your packet submitted to the
court. This form will be shared with the other
party. The other party must complete this same
form, file it with the court and send a copy to you.
The court will provide instructions to the other party
about sharing this information with the filing party
prior to the court hearing. This document is
confidential pursuant to Court Rule 1:38-3 and is not
available for review by any other people besides the
two parties involved in the case, their attorneys, and
the court. You can find this form on njcourts.gov.
STEP 7: Fill out the Additional Information
Sheet (if needed)
Use this form if you need additional space to explain
to the court what you want the court to consider or
your position on a particular issue stated in the
complaint. Type or write legibly and be as specific
as possible.
STEP 8: Check your completed forms
Check your forms and make sure they are complete.
Remove all instruction sheets. Make sure you have
signed all the forms wherever necessary.
In Step 9 you will be directed to mail or deliver your
documents to the court. The following checklist will
help insure your package is complete:
Checklist
Make sure you have all the following items:
Verified Complaint or Counterclaim (Form
A)
Confidential Litigant Information Sheet
Additional forms if applicable:
Certification of Diligent Search (CN
11490)
Financial Statement for Summary
Support Actions (CN 11223)
Family Case Information Statement
(CIS) (CN 10482)
Federal Child Support Services
Application (IV-D Child Support
Program)
Certification in Support of Establishing
Paternity
Certificate of Parentage (COP)
Additional Information Sheet
Filing fee of $25.00 in the form of a
check or money order made payable to
the Treasurer, State of New Jersey. Do
not mail cash. You may use cash if you
pay in person, but you should keep the
receipt you get from the court staff for
your records.
STEP 9: Mail or deliver your completed
paperwork
Mail or deliver your completed packet to the
courthouse in the county where the child of the
custodial parent resides. You must include a
$25.00 filing fee with the completed packet.
When mailing, make sure you specify the “Family
Division” and “Non-dissolution Intake” in your
address to insure your papers arrive at the correct
department in the court.
Sample Address:
(Name of County) Courthouse Family Division
Non-Dissolution Intake 1234 Street
PO Box #
City, State, Zip code
All courthouse addresses can be found on
njcourts.gov.
How to File a Request to Modify a Non-Dissolution “FD” Court Order Previously Issued By the Court
Revised 09/03/2019, CN 11487 page 7 of 15
Instructions for Completing the Application/Cross Application to Modify a Court Order
Important Notice: This form can be used to request multiple reliefs from the court. Make sure to check the boxes for all
the reliefs you are requesting, as only the ones you check will be considered on the day of your hearing.
A. Enter the names of the parties in the correct order on the “Plaintiff” and “Defendant” lines. You can find the correct
case title at the top of the order you want to modify. Copy the information exactly as it appears on that order.
B. On the right side of the form, enter the County where you are filing the application.
C. Enter the Docket Number that has been issued in your case. You can find that number on the court order you want to
modify.
D. Type or print the CS Number that has been issued in your case. You can find that number on the court order you want
to modify.
E. Select whether you are filing an Application for Modification or Cross-Application for Modification.
F. Enter your name on the line between the words “I … of full age,” On the second line (at the end of the sentence) fill in
the date of the original order (if known).
G. In item #1, select whether you are the Plaintiff, Defendant or the Attorney (for either the Plaintiff or Defendant) filing
this application. Enter your maiden name, if applicable.
H. In item #2, enter the Plaintiff’s address on the lines provided. Make sure to include the apartment number or floor, if
applicable. Enter the plaintiff’s relationship to the child(ren) in this matter.
I. In item #3, enter the Defendant’s address on the lines provided. Make sure to include the apartment number if
applicable. Enter the defendant’s relationship to the child(ren) in this matter.
J. In item #4, enter the attorney’s name, attorney ID number and firm address that is representing a party in this matter.
K. In item #5, enter each child’s name, date of birth, gender and the relationship of the person with whom the child
currently resides, for all those listed on the support order that you want to modify. Do not list children who do not
appear on the original order.
L. In item #6, list other interested parties that should be noticed to appear in court if it applies to your case.
M. For item #7, select whether you have had previous Family Court activity related to any of the parties listed in this
modification. Check only one box. If you select “Yes”, enter the title of the case, the docket number and the state or
country that has jurisdiction of that case.
Select whether (to your knowledge) a child protection agency (i.e., DCP&P or similar agency in another state) has
been involved with the child(ren) or listed parties.
Select whether (to your knowledge) the children are recipients of public assistance.
N. For item #8, select the appropriate checkboxes for all the reliefs you want the court to consider in your case. Select all
that apply. Note that only those that are selected will be considered during your court hearing.
O. For item #9, if you are requesting to terminate your child support order, enter the name(s) and date(s) of birth of the
child(ren) on the lines provided.
Select the reason(s) why the child support should be terminated. Select all that apply.
How to File a Request to Modify a Non-Dissolution “FD” Court Order Previously Issued By the Court
Revised 09/03/2019, CN 11487 page 8 of 15
P. For item #10, if you are requesting NOT to terminate your child support order, enter the name(s) and date(s) of birth
of the child(ren) on the lines provided.
Select the reason(s) why the child support should be not terminated. Select all that apply and give explanations where
indicated.
Q. For item #11, select whether you are requesting enforcement of a current support order (because someone is not
paying as they have been ordered) or if you have already requested enforcement of your child support order through
Probation
Note: If your child support order is payable through the Child Support Enforcement Division, you should
contact them first for enforcement services.
R. For item #12, select all responses that apply to your modification of Existing Custody/Parenting Time Court Order,
and give explanations where indicated.
S. For item #13, select the checkbox if you are applying to relocate the children out-of-state. Make sure to enter where
you want to move and the reason you want to move.
Select the checkbox if you are opposed to the children moving out-of-state and explain why you are opposed in the
space provided. Use Additional Information form if necessary.
T. For item #14, if you are requesting to change from the county with current jurisdiction to another county in New
Jersey, enter the county where the court originally heard the case on the first line, and the county where you are
requesting the court to take jurisdiction of the case on the second line. Enter the reason why you are requesting the
change.
U. For item #15, check this box only if you are incarcerated and you want a detainer or bench warrant lifted so that you
may apply for a work release or half way house program. You must provide the name of the facility where you are
now and your inmate number.
V. Only fill out item #16 if the relief you are seeking is not contained in any of the numbered items in the form. Write in
your own words the relief you are seeking for the court in the space provided. Be as specific as possible. Use
Additional Information form if necessary.
W. For item #17, write whatever you feel the court should know to support your request. Write the date of the court order
you want changed; if you have the order, make a copy and attach it to the application.
X. In the Required Attachments section, select the appropriate box(es) for those forms that you have attached to your
packet.
Select the box if you are attaching any additional information to your packet.
Select the box if you are presently incarcerated.
Y. Select whether you will need Interpreting services or ADA accommodations, and list the language and/or
accommodation.
Z. The form must have the signature of the party filing the application to modify along with the signature of the attorney
that is filing the application to modify on behalf of the party.
Note: Both the person filing this modification and the attorney (if any) must sign above.
Mail or deliver the completed application with a $25.00 filing fee to the correct court house.
Revised Form Promulgated by Directive #20-19 (09/03/2019), CN 11487 page 9 of 15
Superior Court of New Jersey
Chancery Division - Family Part
Plaintiff
Docket Number: FD -
vs.
CS Number
: CS-
CIVIL ACTION
Application for
Modification of Court Order
Cross-Application for
Modification of Court Order
Defendant
I,
of full age, hereby certify the following in support of this Application/Cross-
application to modify the court order of
(date if known) .
1.
I am the Plaintiff Defendant Attorney for .
Maiden Name (if applicable) .
2.
Plaintiff resides OR is incarcerated at:
Address
City/Town
County
State
Zip Code
Relationship to the child(ren)
Plaintiff resides OR is incarcerated at:
Address
City/Town
County
State
Zip Code
Relationship to the child(ren)
3.
Defendant resides OR is incarcerated at:
Address
City/Town
County
State
Zip Code
Relationship to the child(ren)
Defendant resides OR is incarcerated at:
Address
City/Town
County
State
Zip Code
Relationship to the child(ren)
4.
Attorney
Name
Firm Name
ID Number
Address
City/Town
State
Zip Code
Save
Print
Clear
Revised Form Promulgated by Directive #20-19 (09/03/2019), CN 11487 page 10 of 15
5.
The child(ren) involved in this order are:
Name
Date of Birth
M/F
Residing with (relationship)
6.
Other interested parties’ name(s) and address(es):
7.
I have been previously been involved in the following New Jersey family court actions or other
State/Country litigation with regard to any of the parties or children listed above. (If yes, give
the title of case and docket number.)
Yes
No
Title of Case
Docket Number
State/Country
a.
vs.
b.
vs.
c.
vs.
A Child Protection Agency (i.e. the Division of Child Protection and Permanency or a similar
agency in another State) has been involved
or is currently involved with the with the child(ren)
or listed parties.
Yes
No
Is any party in this case currently receiving public assistance? (Governed by 41 U.S.C.A. 602
(A)(26),
N.J.S.A. 44:10-1.1, et seq.)
Yes
No
8.
I request the following:
Paternity (Certification in Support of Establishing Paternity required when requesting Paternity)
Were parents of the child married at the time of birth?
Yes
No
Disestablishment of Paternity
Were parents of the child married at the time of birth?
Yes
No
Maternity
Establish/Modify Child Support (A Certificate of Parentage is required if available when filing for Child Support)
I am requesting (check one) an increase decrease in child support payments.
(Pursuant to Court Rule 5:5-3, you are required to complete a Financial Statement for Summary Support Actions to
serve upon the other party. At the hearing you must have your most recent federal income tax return or your three most
recent pay stubs.)
Establish/Modify Spousal Support
I am requesting (check one) an increase decrease in spousal support payments.
(Pursuant to Court Rule 5:5-2, you are required to complete a Case Information Statement to serve upon the other
party. At the hearing you must have your most recent federal income tax return or your three most recent pay stubs)
Establish/Modify Financial Maintenance order
Revised Form Promulgated by Directive #20-19 (09/03/2019), CN 11487 page 11 of 15
Medical Support Requested
Health benefits for myself
Health benefits for the child (ren) named in this complaint
Reasons for your request: (explain in detail)
9.
I am requesting the Court to terminate the child support for the following child(ren)
Name
Date of Birth
Please check all the following that apply:
I have physical custody of the child(ren) specified above.
My child turned 18 years of age on
.
To the best of my knowledge my child is not physically or mentally disabled.
My child is not attending high school or any other special education programs.
My child is married.
Date of the marriage: .
My child is not attending college or a post
-secondary education program.
My child is in the military.
Date enrolled: . Branch: .
I am requesting that child/spousal support be paid directly to me without court
involvement.
10.
I am requesting the Court NOT terminate the child support for the following child(ren)
Name
Date of Birth
Please check all the following that apply:
I have physical custody of the child(ren) specified above.
My child is disabled. Describe disability:
My child is attending high school or special education program. Provide the name of the school and most recent
date(s) attended:
My child is not married
.
Revised Form Promulgated by Directive #20-19 (09/03/2019), CN 11487 page 12 of 15
My child is attending college or a post
-secondary education program. Provide the name of the school and the
most recent date(s) attended.
My child is not
in the military.
I am requesting that child/spousal support be made payable through the Probation Division.
11.
Enforcement of the Current Support Order
I am requesting enforcement of the current support order of (date if known) . Attach a copy of the
order you want enforced.
I have already requested enforcement through Probation.
12.
Establish or Change of Existing Custody/Parenting Time Court Order (check all that apply)
Establish custody
Establish visitation/parenting time arrangements
Parenting Time
Grandparent Visitation
Sibling Visitation
I am requesting to change the custody/parenting time terms of the current order.
Reasons for your request: (explain in detail)
13.
Request to Relocate the Child(ren)/Opposition to Relocation
I am applying to relocate the child(ren) listed above to another state or country. I want to relocate the child(ren)
by
(date) .
New location:
Reason for relocation:
Attached is the additional information form.
I am opposed to the relocation of the children listed above. I believe this move is not in the best interest of the
child(ren). Explain:
Attached is the additional information form.
Revised Form Promulgated by Directive #20-19 (09/03/2019), CN 11487 page 13 of 15
14.
Change of Venue (Request to change from the county with current jurisdiction to another county in New Jersey)
I am requesting that venue of my case in county be changed to county.
Explain:
15.
Request to have a Bench Warrant/Detainer lifted (Incarcerated Defendants Only)
I am currently incarcerated and am filing an application to have a child support bench warrant/detainer lifted so
that I may participate in a rehabilitation program. I understand that I must rep
ort to the court 30 days after my
release.
Facility:
Inmate Number:
16.
The relief I am requesting is not listed above. I am requesting the following from the court. (Use additional information
sheet if necessary.)
17.
Explain anything else the court should know about this Application or Cross Application to modify the court order of
(date if known)
.
Revised Form Promulgated by Directive #20-19 (09/03/2019), CN 11487 page 14 of 15
Required Attachments (Check all applicable boxes)
Confidential Litigant Information Statement.
Certificate of Parentage (if available). (Please note that this is not the Birth Certificate.)
Certification to Establish Paternity (when requesting establishment of paternity).
Financial Statement for Summary Support Actions (when requesting child support).
Case Information Statement (when requesting spousal support).
Check this box if you are attaching any additional information (a certification, exhibits)
I am presently incarcerated and would like to appear; however, I understand that unless a judge orders my
appearance through a court order to the facility of my incarceration, my request will be decided on the papers that I
filed.
At
the hearing:
Will you require an interpreter?
Yes
No
If yes, indicate language:
Will you require an accommodation for a disability?
Yes
No
If yes, indicate requested accommodation:
I/we certify that the foregoing statements made by me/us are true. I am/We are aware that if any of the
foregoing statements made by me/us are willfully false, I am/We are subject to punishment.
Date
Signature
Plaintiff
Defendant
Date
Signature
Plaintiff
Defendant
Date
Signature
Plaintiff Attorney
Defendant Attorney
Note: Both the person filing this modification and the attorney (if any) must sign above.
Your appearance is mandatory. You should bring to court any other documentation or proof that supports your case. If you are filing
for child or spousal support, bring any information about your finances with you such as your last three pay stubs and your most recent
W-2 statement. You may bring an attorney, although an attorney is not required. If you require assistance in selecting an attorney,
you may contact your County Bar Association. If you cannot afford an attorney, you may contact Legal Services of New Jersey at
www.lsnj.org.
COURT APPEARANCE INFORMATION FOR THE PERSON RECEIVING THIS APPLICATION:
Your appearance is mandatory. If you fail to appear at the hearing an order granting the relief requested by the filing party may be
granted. If the filing party’s request is for child or spousal support, bring any information about your finances with you such as your
last three pay stubs and your most recent W-2 statement. You may bring an attorney, although an attorney is not required. If you
require assistance in selecting an attorney, you may contact your County Bar Association. If you cannot afford an attorney, you may
contact Legal Services of New Jersey at www.lsnj.org.
Revised Form Promulgated by Directive #20-19 (09/03/2019), CN 11487 page 15 of 15
Additional Information Sheet
Use this sheet (if necessary) to tell the court anything else you want the court to know about why you filed your application.
Full Name
Date
Docket Number
CS Number
I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements
made by me are willfully false, I am subject to punishment.
Date
Signature of Applicant/Cross-applicant
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-Dissolution FD Court Order Previously Issued By the (NJ Judiciary)

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Completed 11 February 2022

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