Revised: 06/2017, CN; 10328, State Tax Complaint Packet page 1 of 5
Revised 11/2013, CN 10326, (CIS-State)
Tax Court of New Jersey
State Tax Case Information Statement (CIS-State)
INSTRUCTIONS: TO BE ATTACHED TO FACE OF COMPLAINT (TYPE OR PRINT)
Attorney Name (List your information if you are not represented by an attorney)
Attorney ID Number
Street
E-mail Address
City
Zip
Telephone Number
PART A. PLEASE FILL IN THE FOLLOWING:
1.
Name of Plaintiff
2.
Name of Defendant
3.
Tax Contested:
a.
Tax Type:
b.
Statutory Citation(s):
N.J.S.A.
4.
Amount of Tax in dispute:
$
5. Have the tax, interest and penalty been paid? Yes No
6. Is the amount of the tax in dispute (not including interest and penalty) $5,000 or less? Yes No
7. Is any action in a related matter pending before the Tax Court for prior years? Yes No
8.
Select one:
A copy of the final determination is attached.
If there is no final determination, a copy of the notice of assessment or denial of claim is attached.
Do you or your client have any needs under the Americans with Disabilities Act? If yes,
please identify any requirements or accommodations you may require.
Yes No
Will an interpreter be needed?
Yes
No
If yes, for what language
PLEASE NOTE: Only an interpreter registered with the Administrative Office of the Courts may be used during a court
proceeding.
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).
Dated
Signed
Make Filing Fee checks payable to: Treasurer, State of New Jersey
Mailing Address: Tax Court Management Office, P.O. Box 972, Trenton, NJ 08625-0972
Print
Clear
Revised: 06/2017, CN; 10328, State Tax Complaint Packet page 2 of 5
Revised: 06/2017, CN; 10325, State Tax Complaint
Plaintiff or Filing Attorney Information:
Name
NJ Attorney ID Number
Address
Telephone Number
Email Address
Tax Court of New Jersey
Docket No.
Plaintiff,
Civil Action
Complaint
(State Tax)
v.
Defendant.
1. Plaintiff contests (check one):
a.
Tax assessment(s) made by the Director of the Division of Taxation, as shown on the
attached information schedules which is/are made a part of this complaint.
b.
The denial of plaintiff's claim for refund(s) by the Director of the Division of Taxation, as
shown on the attached information schedule(s) which is/are made a part of this complaint.
2.
This complaint contests separate assessment(s) or refund denial(s) under different tax
statutes. Each tax is included as a separate count and each is shown on a separate information
schedule attached to the face of this complaint.
3. The facts and contentions upon which the plaintiff relies are:
Wherefore, Plaintiff demands that said assessment, penalty and interest be set aside or reduced, or taxes
previously paid be refunded, together with such other relief as may be appropriate.
Date
Signature of Plaintiff or Attorney for Plaintiff
Revised: 06/2017, CN; 10328, State Tax Complaint Packet page 3 of 5
Revised: 06/2017, CN; 10325, State Tax Complaint
NOTE:
1. The use of this printed form is optional. Any complaint submitted for filing shall set forth the claim
for relief and a statement of the facts on which the claim is based, and shall conform to the rules of
court. The wording in this sample form may be modified to conform to the claim made and relief
sought in a particular case. However, the applicable State Tax Case Information Statement must be
attached to the face of the complaint.
2. A complaint for review of a State tax assessment or the denial of a claim for refund must be received
in the Tax Court Administrator's Office within the 90-day time period provided by the rules of court
together with proof of service as required and the correct filing fee.
3. If you are contesting a State tax administered by an agency other than the Division of Taxation, this
form must be modified so that the defendant will be the Director of the State agency administering
the tax in contest.
4. A copy of the notice or determination in controversy must be attached to the complaint. Rule
8:3-5(b)(1).
5. A complaint by a taxpayer seeking review of a certification of debt issued by the Director of the
Division of Taxation pursuant to N.J.S.A. 54:49-12 shall have attached thereto, where available,
copies of the Certificate of Debt and the underlying assessment. The complaint shall state whether
the issuance of the Certificate of Debt or the underlying assessment is being challenged. A
challenge to the assessment may be reviewed only if the applicable period for filing a complaint to
challenge this assessment had not previously expired.
Please note:
Rule 1:38-7(b) requires attorneys and self-represented litigants to redact (remove) confidential personal
identifiers from all documents prior to filing, unless required by statute, court rule, administrative
directive or court order.
Rule 1:38-7(a) defines a confidential personal identifier as a Social Security number, driver's license
number, vehicle plate number, insurance policy number, active financial account number, or active
credit card number. An active financial account number may be identified by the last four digits when
the account is the subject of litigation and cannot otherwise be identified.
It is not the responsibility of court staff to redact (remove) confidential personal identifiers when
included in pleadings or other documents submitted to the court.
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Revised: 06/2017, CN; 10325, State Tax Complaint
PROOF OF SERVICE
1. On , I, the undersigned, served upon the Director of the Division of
Taxation personally or by registered or certified mail, return receipt requested (strike out one), a
copy of the within complaint.
2. On , I, the undersigned, served upon the Attorney General of the State
of New Jersey personally or by registered or certified mail, return receipt requested (strike out one),
a copy of the within complaint.
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 Plaintiff or Attorney for Plaintiff
Revised: 06/2017, CN; 10328, State Tax Complaint Packet page 5 of 5
Revised: 06/2017, CN; 10325, State Tax Complaint
TAX COURT OF NEW JERSEY
TAX COURT MANAGEMENT OFFICE
(609) 815-2922
P. O. Box 972
TRENTON, NEW JERSEY
08625-0972
The original documents and your filing fee must be mailed to the Tax Court Management
Office at the above address.
Service must also be made on the following:
Director, Division of Taxation
50 Barrack Street
P. O. Box 240
Trenton, NJ 08695
and
Office of the Attorney General
Hughes Justice Complex
P.O. Box 112
Trenton, NJ 08625