Municipal Court
Incarcerated Defendant Request for Relief Form
Form Published: 08/2016, CN: 11870 1 of 3
This form is for use by unrepresented defendants incarcerated in a New Jersey State or County
correctional facility who are asking that a Municipal Court grant relief or in some way modify
the status of the defendant’s case. Send this form only to the particular Municipal Court that
has jurisdiction over the matter(s) in question. When submitting this completed form to that
Municipal Court, you must enclose the original, for the court’s use, and one copy, for the
Municipal Prosecutor. Please also retain a copy for your records.
The Rules of Court (Rule 7:7-2(d)) require that the Municipal Court respond to a request for
relief submitted by an unrepresented incarcerated defendant using this form within 45 days of
receipt of the completed form. If at the end of 45 days after submitting the form you have not
received a response from the Municipal Court (taking into account mail delivery times), you may
seek further relief from the Municipal Presiding Judge of the county within which the particular
Municipal Court is located. The addresses for the Municipal Presiding Judges are included on
page 3 of this form. When seeking such further relief from the Municipal Presiding Judge, please
include a copy of the completed form that you earlier submitted to the particular Municipal Court
requesting relief.
Requestor Information
(Also Known As)
Date of Birth U.S. Citizen
Correctional Institution: Name and Address Inmate Number
Projected Release Date
Home Address
(or expected address after release)
Complaint(s) Information
Provide as much information as possible to enable the court to identify the complaint(s)
I am not represented by an attorney on any of the following charges.
Complaint Number(s) Date of Offense Charges
Date of Conviction
(if appropriate)
Additional page(s) attached if needed.
South Brunswick Township
Municipal Incarcerated Defendant Request for Relief Form
Published: 08/2016, CN: 11870 2 of 3
Relief Sought (check all that apply)
I wish to apply for a municipal public defender.
I request that my warrant be recalled.
(cite reason)
I request that my bail amount/conditions of release be modified.
(cite reason)
I request that the fines/penalties I owe be converted to jail time.
(cite reason)
I request that the court grant me credit for time served.
(cite reason)
I request that all or a portion of the monies I owe be vacated.
(cite reason)
Other relief sought (describe)
I would like my matter(s) scheduled for a court hearing.
Additional page(s) attached if needed.
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 Requestor’s Signature
For Court Use Only
Date Received:
Partially Granted:
Date Signed Judge’s Signature
Vicinage Municipal Presiding Judges
(for Further Relief if No Response to the Completed Form Received within 45 Days)
Form Published: 08/2016, CN: 11870 (Municipal Incarcerated Defendant Request for Relief Form) 3 of 3
List Updated: 08/2016
As indicated on page 1 of this form, if the Municipal Court to which you submit this completed form does
not respond within 45 days, under the Court Rules you may seek further relief from the Municipal
Presiding Judge who oversees that and the other Municipal Courts in the county. The addresses of the
Municipal Presiding Judges by county/counties are as follows. (Reminder: Initial submission of the
completed forms does not go to the Municipal Presiding Judge, but rather to the particular Municipal
Court having jurisdiction over the matter(s).)
Atlantic/Cape May Vicinage
Municipal Presiding Judge
Mays Landing Criminal Courts Complex
4997 Unami Boulevard
Mays Landing, NJ 08330
Middlesex Vicinage
Municipal Presiding Judge
Middlesex County Courthouse
56 Paterson Street
ew Brunswick, NJ 08903
Bergen Vicinage
Municipal Presiding Judge
Bergen County Justice Center
10 Main Street, Suite 309
Hackensack, NJ 07601
Monmouth Vicinage
Municipal Presiding Judge
Monmouth County Courthouse
71 Monument Park – Rm. 322 S
Freehold, NJ 07728
Burlington Vicinage
Municipal Presiding Judge
Burlington County Courts Facility
49 Rancocas Road
Mount Holly, New Jersey 08060
Morris/Sussex Vicinage
Municipal Presiding Judge
Morris County Courthouse
Washington & Court Streets
Morristown, NJ 07963
Camden Vicinage
Municipal Presiding Judge
6 Executive Campus
Suite 300
Cherry Hill, NJ 08002
Ocean Vicinage
Municipal Presiding Judge
Ocean County Justice Complex
120 Hooper Ave
Toms River, NJ 08754
Essex Vicinage
Municipal Presiding Judge
Essex County Veterans Courthouse
50 West Market Street
ewark, New Jersey 07102
Passaic Vicinage
Municipal Presiding Judge
Passaic County Courthouse
77 Hamilton Street – Room 648
Paterson, NJ 07505
Hudson Vicinage
Municipal Presiding Judge
Administration Building
595 Newark Ave. – Rm. 406
Jersey City, NJ 07306
Union Vicinage
Municipal Presiding Judge
Union County Courthouse
2 Broad Street
Elizabeth, NJ 07207
Mercer Vicinage
Municipal Presiding Judge
Mercer County Courthouse
209 South Broad Street
Trenton, NJ 08650
Somerset/Hunterdon/Warren Vicinage
Municipal Presiding Judge
Somerset County Courthouse
20 North Bridge Street
Somerville, NJ 08876
Gloucester/Cumberland/Salem Vicinage
Municipal Presiding Judge
Municipal Division Office
19 North Broad Street
Woodbury, NJ 08096