Revised: 10/28/2015, CN: 11933 page 1 of 1
Supreme Court of New Jersey
Request for Exception from
Electronic Attorney Registration and Payment
For Office Use Only
Received Date
Reviewed By and Date
____/____/_______
Approved
Denied
The Supreme Court of New Jersey has directed that New Jersey attorneys with a plenary license or a limited, in-
house counsel (IHC) license must complete their annual attorney registration electronically. Although attorneys
may qualify for an exception, the Judiciary encourages all attorneys to register electronically. For assistance or
questions related to the annual attorney registration and billing, contact the NJ Lawyers’ Fund for Client
Protection at 855-533-FUND (3863) (select option 2); or CPF.Mailbox@judiciary.state.nj.us.
For a copy of an approved request, include a self-addressed stamped envelope (SASE). Without a SASE,
only notifications of denied requests will be mailed. Attorneys whose requests are approved will receive a
paper registration and payment form when forms are available, approximately 3 weeks after electronic
registration opens.
INSTRUCTIONS
1. Please return the completed form no later than December 15 to request an exception.
2. Please type or print clearly. An asterisk (*) indicates a required field.
3. Approved exceptions carry forward until you either register electronically or are no longer entitled to
the exception.
4. These exceptions do not apply to requirements for Continuing Legal Education (CLE) and/or pro bono.
5. Please do not make any changes to this form. Incomplete or altered forms will be returned to the
attorney.
6. Mail the completed form to: NJ Lawyers’ Fund for Client Protection
PO Box 961
Trenton, NJ 08625-0961
*
Attorney: Last Name
*
First Name
*
MI
*
NJ Attorney ID Number
*
Billing Address: Street
*
PO Box or Apt.
*
City
*
State
*
Zip Code
*
Email Address (up to 60 characters)
*
Telephone Number (including area code)
* I hereby request exception from the requirement that I complete my annual attorney registration electronically
for the following reason(s)
(select all that apply):
I was admitted to the practice of law in New Jersey on or before December 31, 1965.
I have a good standing status of Disability Inactive (Rule 1:20-12).
I have a verifiable medical condition or disability that causes me to be unable to use or have access to
a computer. (Please do not send any supporting documentation.)
I am located in a geographic area or facility where no internet access is possible or allowed.
Identify location:
I hereby 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 attorney discipline.
*
Signature of Attorney
*
Date
