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Case Information Statement (CIS-LP) 11004 - New Jersey
| Case Information Statement (CIS-LP) Form. This is a New Jersey form and can be used in Tax Court Statewide . |
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Tax Court of New Jersey Case Information Statement (CIS-LP) INSTRUCTIONS: TO BE ATTACHED TO FACE OF COMPLAINT (TYPE OR PRINT) Attorney Name (List your information if you are not represented by an attorney) Street City State Zip Telephone Number PART A. PLEASE CHECK ONE OF THE FOLLOWING CASE TYPES AND THE FILING FEE Direct Appeal Appeal from County Tax Board Judgment Correction of Error Exemption Added or Omitted Assessment Farmland Qualification Farmland Rollback Other NOTE: In order to proceed in the Small Claims Division, the property at issue must be a class 2 property (1-4 family residence) or a class 3A farm residence or prior year's taxes were less than $25,000. See Rule 8:11-(2). Check for Small Claims Division Filing Fee Submitted $ Check / other Attorney Charge Account # PART B. FILL IN THE FOLLOWING FOR ALL CASES 1. Plaintiff 2. County 3. Assessment year(s) in contest 4. Property Address 5. Property Type (check one) Industrial 1-4 Family Residence (class 2) Farm Residence (class 3A) Commercial Vacant land used as part of a 1-4 family residence 6. Is plaintiff the Owner 7. Is an exemption claimed? Yes Tenant No Other Type Multi-Unit Residential (over 4 Units) Vacant Land Farmland Other Block Defendant Lot Unit If more than one assessed property is included in the complaint, are they contiguous and in common ownership? Yes No Attach individual Case Information Statements for each separately assessed parcel. If multiple condominium units, attach the Condominium / Multiple Assessment Schedule. Revised 09/2010, CN 11004-English, (CIS-LP) page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com PART C. FILL IN THE FOLLOWING FOR ALL CASE TYPES EXCEPT FARMLAND ROLLBACK Assessment for the year set forth in No. 3 above Land Exemption Total Original Assessment $ $ $ $ County Tax Board Assessment $ Land $ Improvements Exemption Total $ $ Improvements PART D. FILL IN THE FOLLOWING ONLY FOR FARMLAND ROLLBACK Year Non Qualified Assessed Value Qualified Assessed Value Assessment Subject to Rollback $ $ $ PART E. FILL IN THE FOLLOWING: $ $ $ $ $ $ FOR ADDED ASSESSMENT ONLY Said property is the subject of an added assessment for the assessment year Improvements for Original Assessment $ $ Improvements for as follows: County Tax Board Judgment $ $ Prorated Assmt. months Prorated Assmt. months FOR OMITTED OR OMITTED/ADDED ASSESSMENT ONLY Said property is the subject of an added assessment for the assessment year Land Original Assessment $ $ $ as follows: County Tax Board Judgment $ Land $ Improvements Prorated Assmt. for months Yes No $ Improvements Prorated Assmt. for months 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. 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 Revised 09/2010, CN 11004-English, (CIS-LP) page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com
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