Civil Court Rules and Jury Charges

Kenneth Vercammen & Associates, P.C.
2053 Woodbridge Avenue - Edison, NJ 08817

Monday, August 24, 2009

How to File an Answer to a Complaint in the Superior Court of New Jersey - Law Division - Civil Part 10554

CIVIL – LAW
Answer
Updated April 2008





HOW TO USE THIS ONLINE


You may fill in the information required in this packet on
your screen, save it to your local drive and print it out on
your local printer OR you may print out the packet and
complete the forms by hand or typewriter.


The information you enter is NOT
submitted electronically.
Answer



HOW TO FILE AN ANSWER TO A COMPLAINT IN
THE SUPERIOR COURT OF NEW JERSEY - LAW
DIVISION – CIVIL PART

WHO SHOULD USE THIS PACKAGE

You may use this package if you have received a summons, complaint, civil case information
statement (CIS), and track assignment notice (TAN) notifying you that you are being sued in the
Law Division of the Superior Court of New Jersey. In order to avoid having the other party win
the case against you automatically, you must file an answer to the complaint along with a CIS
and the appropriate fee within 35 days from the date that you receive the summons. Your answer
should contain any defenses you have to the claims made in the complaint and any dispute you
have with the facts as stated in the complaint. If you do not file your answer and CIS within the
35 days, a default judgment can be entered against you and the County Sheriff may seize your
money, wages or property to pay all or part of the judgment.
Note: If you believe you have a claim against the plaintiff and wish to countersue, you must file
a counterclaim with your answer and CIS. If you believe you have a claim against another
defendant, you must file a cross-claim with your answer and CIS. For information on the
procedure for filing a cross-claim or counterclaim, consult staff in the civil division clerk’s
office.

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 www.njcourtsonline.com.
However, you are ultimately responsible for the content of your court papers.


Completed forms are to be submitted to the county where you are filing your case. A list of
Superior Court Offices is provided at the customer counter or at www.njcourtsonline.com.

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THINGS TO THINK ABOUT BEFORE YOU TRY
TO REPRESENT YOURSELF IN COURT

TRY TO GET A LAWYER
The court system can be confusing and it is a
good idea to get a lawyer if you can. The law, the
proofs necessary to present your case, and the
procedural rules governing cases in the Law
Division, Civil Part are complex. Since valuable
claims or potentially heavy judgments may be at
stake, most litigants appearing in the Law
Division, Civil Part have a lawyer. If you are
being sued, please contact your insurance
company to see if they might provide a lawyer for
you. Most likely your opponent will be
represented by a lawyer. 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 in your local
yellow pages 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. That 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 will sometimes consult with you at a
reduced fee. There are also organizations of
minority lawyers throughout New Jersey, as well
as organizations of lawyers who handle
specialized types of cases. Ask your county court
staff for a list of lawyer referral services that
include these organizations.

If you decide to proceed without an attorney, these
materials explain the procedures that must be
followed to have your papers properly filed and
considered by the court. These materials do not
provide information on the law governing your
claims or defenses; information on how to conduct
pretrial discovery; information on alternative
dispute resolution procedures, such as arbitration
or mediation, that may be available or required in
your case; information on the kinds of evidence
you need to prove your claims or defense at trial;
or information on other procedural and evidentiary
rules governing civil law suits.

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
the court staff can and cannot do for you.
Please read it carefully before asking the 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 cannot 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 of all completed
forms and documents related to your case.
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OVERVIEW

A civil suit begins with the filing of a complaint and civil case information statement with the
appropriate filing fee. Within 10 days of the filing of the complaint, the plaintiff will receive a
Track Assignment Notice. A case is assigned to one of four tracks depending on the type of case
and the length of tine it should take to complete discovery. The complaint, CIS and TAN must
be served with the summons on all parties. Defendant(s) must file an answer to the complaint
along with the appropriate filing fee within 35 days after service of the complaint. After the
complaint is served and an answer is filed, the discovery period begins. The time for discovery
depends on what track the case is assigned to. During the discovery period, the parties exchange
information about the case. At any time during the case, a party may make a motion to the court
for certain relief. Prior to a trial, cases may be sent to mediation (a meeting in which a neutral
third party facilitates discussion between the parties to reach a resolution of their differences)
and/or arbitration (a hearing in which parties present their positions to a neutral third party who
makes a recommendation for resolving the case which may be accepted or rejected by the
parties). If mediation and/or arbitration is unsuccessful, a case will be scheduled for trial. The
trial may take place before the judge alone or before a judge and a jury. At the trial, both sides
present evidence supporting their positions. The decision of the judge and/or jury is contained in
the final judgment. If a party wishes to appeal the final decision, a notice of appeal must be filed
in the Appellate Division within 45 days after the entry of the final judgment.

DEFINITIONS OF WORDS USED IN THIS PACKET
Affirmative Defense - An affirmative defense is what a defendant offers as a reason why there should
be no judgment against him/her. Examples of affirmative defenses include fraud, contributory
negligence, expiration of the statute of limitations.
Answer - An answer is the document filed by the defendant which contains the response to each of the
statements made by the plaintiff and the reasons or circumstances why the defendant is or is not
responsible for any harm claimed by the plaintiff.
Caption - A caption is the name of the case; it lists the name of the plaintiff(s) and the defendant(s).
For example, John Jones, Plaintiff v. Mary Smith, Defendant.
Cause of Action - A cause of action refers to the facts that give rise to the lawsuit or claim.
Certification - A certification is statement that certain facts are true to the best of the knowledge of
the person making the statement. It is like an affidavit, but is not sworn before a notary or other
authorized person.
Certification of No Other Actions - A certification of no other actions is a sworn written statement at
the end of the answer in which you state that, to the best of your knowledge, the action about which
you are complaining is not the subject of any other court matter or arbitration, that there are no other
parties that need to be added to this action and that you recognize the obligation to notify all parties
and the court if there are any changes.
Civil Case Information Statement (CIS) The CIS is a form that summarizes your case for the court.
Court rules require that each party file a CIS.
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Co-defendant - A co-defendant is another defendant who has been sued by the plaintiff in the
complaint.
Complaint - A complaint is a document in which the plaintiff tells the court the facts of a case and
states what relief is sought.
Counterclaim - A counterclaim is a complaint the defendant has against the plaintiff.
Cross-claim - A cross claim is a complaint that one defendant has against a co-defendant.
Defendant - The defendant is the person being sued.
Discovery – Discovery is the pretrial process by which one party learns of the evidence that will be
presented and relied upon in the trial by the opposing party.
Docket Number - A docket number is the number the court assigns to your case so that it may be
identified and located easily. Once you have a docket number, you must include it on all your
communications with the court.
File - To file means to give the appropriate forms and fee to the court to begin the court’s handling of
your case.
Jury - A jury in a civil matter is usually a group of six people selected according to law and sworn to
inquire into and decide the facts at issue in a trial.
Motion – A motion is an application to the court for a specific order or ruling to be made in favor of
the party making the motion.
Party - A party is any plaintiff or defendant in a case. You must send a copy of everything you send
to the court to every party.
Plaintiff -.The plaintiff is the person who files the first complaint in a lawsuit.
Proof of Mailing - Proof of mailing is the form in which you provide the dates and method you used
to give the other parties copies of the papers that you filed in court.
Pro se - Pro se is a Latin term that means “on one’s own behalf.” A plaintiff or defendant in a law
suit who does not have an attorney is said to be appearing pro se.
Service - Service refers to the delivery of the complaint or any other paper in a suit to the defendant
and other parties. Formal legal service requires that the service be made by an officially authorized
person or by mail.
Team - A team is made up of courthouse staff who are responsible for the processing of your case.
Each team is headed by a team leader who reports to the Civil Division Manager.
Track - Lawsuits in the Civil Division are assigned to one of four tracks. Which track a case is
assigned to usually depends on the type of case and how much time it should take to complete
discovery. On the back of the CIS is a listing of the tracks and the various case types that are included
in each one.
Track Assignment Notice (TAN) - The Track Assignment Notice (TAN) is a document prepared by
the court that tells you what judge and team will be handling your case. It also gives the telephone
number you should call whenever you need to reach the court about your case. The plaintiff is
required to send a copy of the TAN to everyone being sued.
Venue - Venue refers to the county where the court that has jurisdiction to hear your case is located.

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Answer

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 2 x 11" white paper only. Forms may
not be filed on a different size or color paper.

STEPS FOR FILING AN ANSWER

STEP 1: FILL IN ANSWER (FORM A).
The Answer tells the court in short and
simple terms whether you admit or deny the
statements made by the plaintiff in the
complaint and sets forth every defense you
may have to the plaintiff’s claims.
You must respond to each numbered
paragraph in the complaint and either admit
the allegation, deny the allegation, or state
that you do not have enough information to
know whether the statement is true.
In the area for Affirmative Defenses, you
can list the facts which defend your action or
inaction. You may state as many separate
defenses as you have and provide any reasons
you have why the plaintiff should not get the
relief requested. For example:
- the plaintiff was negligent (explain how)
- you, the defendant, fulfilled your
obligation(explain)
Sign and date the remaining statements
on the continuation of Form A. Do not sign
the demand for a trial by jury unless you
want to have a jury hear your case.

STEP 2: COMPLETE THE CIVIL CASE
INFORMATION STATEMENT (CIS).
The civil CIS form with instructions can
be found at the end of this packet. The
completed CIS must be filed with the answer.
Failure to file this required document may
result in your answer being returned to you.

STEP 3: MAKE A CHECK OR MONEY
ORDER PAYABLE TO TREASURER,
STATE OF NEW JERSEY.
The fee for filing an answer is $135.
Make a check payable to
Treasurer, State of New Jersey.

STEP 4: CHECK YOUR COMPLETED
FORMS AND MAKE COPIES.
Check your forms to make sure that they
are complete and that you have signed them
in the appropriate places. Make at least six
copies of the completed forms.
Checklist – In Steps 5 and 6 you will be
directed to mail your documents to the court
and other parties. The following checklist
will help insure that your package is
complete:
- The original and two copies of the
Answer and CIS.
- The filing fee in the amount of $135. It
must be a money order or check made out to
Treasurer, State of New Jersey.
- A stamped, self-addressed envelope.
- One copy of the CIS and Answer to serve
on each party or, if the party has an attorney,
on the attorney for that party.

STEP 5: MAIL OR DELIVER THE
FORMS TO THE COURT.
You may deliver your papers to the court
in person or you may mail them. The court
address can be found on the Judiciary’s
website, www.njcourtsonline.com.
If you mail the papers, we recommend
that you use certified mail, return receipt
requested.
Mail or deliver to the court the original
and 2 copies of the answer and CIS.

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STEP 6: MAIL CIS AND ANSWER TO ALL
PARTIES.
Within 35 days of the date that you
received the summons and complaint, you
must send a copy of your answer and CIS to
each party or, if the party has an attorney, to
the attorney for that party. You should use
certified mail, return receipt requested and
keep the green card when it is returned to you
as proof of service.
Revised 04/2008, CN 10554-English (How to File an Answer to a Complaint in the Superior Court) Page 7 of 15
FORM A
SUPERIOR COURT OF NEW
JERSEY
LAW DIVISION

County
Your Name (first, middle, last)
Docket Number

Street Address

Town, State, Zip Code


Telephone Number


Plaintiff

V.

Defendant

CIVIL ACTION



Answer


The defendant, , answers the
(your name)
plaintiff’s claim as follows:

(State whether you agree or disagree with each paragraph of the plaintiff’s complaint. If
additional room is needed, attach a separate sheet.)

1.



2.



3.



4.


Revised 04/2008, CN 10554-English (How to File an Answer to a Complaint in the Superior Court) Page 8 of 15
FORM A


5.




WHEREFORE, the defendant demands judgment dismissing the complaint with costs.

AFFIRMATIVE DEFENSE(S)

(State the reasons why you disagree with plaintiff’s complaint or why what you did or did
not do is not a matter for court. If additional room is needed, attached a separate
sheet.)

1.



2.



3.




CERTIFICATION OF NO OTHER ACTIONS

I certify that this dispute is not the subject of any other action pending in any
other court or a pending arbitration proceeding to the best of my knowledge and belief.
Also, to the best of my knowledge and belief, no other action or arbitration proceeding is
contemplated. Further, other than the parties set forth in this complaint, I know of no
other parties that should be made a part of this lawsuit. In addition, I recognize my
continuing obligation to file and serve on all parties and the court an amended
certification if there is a change in the facts stated in this original certification.

Dated: Signature:






Revised 04/2008, CN 10554-English (How to File an Answer to a Complaint in the Superior Court) Page 9 of 15
FORM A
CERTIFICATION REGARDING FILING AND SERVICE

The undersigned hereby certifies that a copy of this pleading was served and
filed within the time permitted by the court rules.

Dated: Signature:

OPTIONAL: If you would like to have a judge decide your case, do not include the
following paragraph in your complaint. If you would prefer to have a jury to
decide your case, please sign your name after the following paragraph.

DEMAND FOR TRIAL BY JURY

TAKE NOTICE that the defendant demands a trial by jury on all issues.

Dated: Signature:




Revised 04/2008, CN 10554-English (How to File an Answer to a Complaint in the Superior Court) Page 10 of 15




HOW TO COMPLETE THE CIVIL CASE INFORMATION
STATEMENT (CIS)

These instructions are intended to guide individuals who are either plaintiffs or
defendants in civil cases and who are not represented by an attorney in completing the Civil Case
Information Statement (Civil CIS) required by court rules. The Civil CIS must be included with
each party’s first pleading in the Civil part of the Law Division. That is, the plaintiff must file it
with the complaint and the defendant must file it with the answer. If it is not included, the papers
will be returned.
The CIS summarizes your case and alerts the court to any special needs you may have
such as the need for an interpreter or the need for a quick trial date because one of your witnesses
is expected to be unavailable. The numbers for the various case types are located on the back of
the form. Enter the number which best describes your complaint. For example, if you are suing
the defendant for a breach of contract, your case number would be 599.
After you have completed the CIS, keep it with the other papers you are planning to file.

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
(www.judiciary.state.nj.us). However, you are ultimately responsible for the
content of your court papers.
Revised 04/2008, CN 10554-English (How to File an Answer to a Complaint in the Superior Court) Page 11 of 15
INSTRUCTIONS FOR PARTIES NOT REPRESENTED BY AN
ATTORNEY FOR COMPLETING THE CIVIL CASE
INFORMATION STATEMENT (CIS)

BOX# INSTRUCTION
1. Print your name.
2. List a telephone number, including area code, where you can be reached during
the day.
3. Insert the name of the county where the complaint or answer is being filed.
4. Leave the box blank.
5. If you know the docket number of your case, insert it in the docket number box.
If the CIS is being filed with a complaint, the court will assign the docket
number before it returns the filed complaint.
6. Enter an address where you wish to receive mail concerning this matter.
7. Document type means the type of paper you are filing. If you are filing the
complaint, print complaint; if you are filing an answer, print answer.
8. Check the box marked “yes” if you have requested that the matter be heard by a
jury. Otherwise, check “no.”
9. Enter your name and indicate whether you are the plaintiff or defendant.
10. The caption is the name of the case - the name of the plaintiff(s) v. the name of
the defendant(s). For example: John Doe, Plaintiff v. Mary Smith, Defendant.
Print the name of your case.
11. The Case Type Number identifies the type of case. On the back of the CIS form
is a list of case types. Sometimes it is difficult to pick the number of your case,
but you must fill in this section in order for your case to proceed. Choose the
one that best describes what your case is about and enter that number. For
example, if you are the plaintiff or defendant in a dispute over fulfilling the
terms of a contract, the case type is 599; if your case concerns a personal injury,
the case type number is 605.
12. If you believe that your case is a professional malpractice case, check the box
marked “yes” and see N.J.S.A. 2A:53A-27 and applicable case law regarding
your obligation to file an affidavit of merit.
13. If you believe that you have any other cases involving the same adversary or
arising from the same set of circumstances, check the box marked “yes.”
Otherwise, check “no.”
14. If you checked “yes” to the previous question, enter the docket number(s) of any
related cases.
15. If you believe you will be adding more parties to the case, check “yes.”
Otherwise, check “no.”
16. If you are the plaintiff and know the name of the defendant’s primary insurance
company enter it in the box. Otherwise check “unknown.” If you are the
defendant and you have insurance that might cover or partially cover the
damages complained of, enter the name of your insurance company.
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17. If you and your adversary knew each other before the event giving rise to the
law suit occurred, check “yes.” Otherwise, check “no.”

If the answer was “yes”, check the box next to the word(s) that best describe the
relationship between the parties.
18. If you believe that the statute governing your case provides for payment of fees
by the losing party, (for example, the Law Against Discrimination), check “yes.”
Otherwise, check “no.”
19. If you believe that your case has some unusual circumstance which would
require special attention, indicate the problem in the space provided. For
example, if there is a witness who is ill or who may be unavailable, you should
let the court staff know.
20. If you are requesting any accommodation for a disability, check “yes” and
indicate what is needed. Otherwise, check “no.”
21. If you are requesting an interpreter, check “yes” and indicate the language for
which it is needed. Otherwise, check “no.”
22. The person whose name appears in Box 1 must sign the CIS in the space marked
“Attorney Signature.”

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CIVIL CASE INFORMATION STATEMENT FOR USE BY CLERK’S OFFICE ONLY
(CIS) PAYMENT TYPE: CK CG CA
CHG/CK NO.
AMOUNT:

OVERPAYMENT:




Use for initial Law Division
Civil Part pleadings (not motions) under Rule 4:5-1
Pleading will be rejected for filing, under Rule 1:5-6(c),
if information above the black bar is not completed or
if attorney’s signature is not affixed.
BATCH NUMBER:

1. ATTORNEY/PRO SE NAME


2. TELEPHONE NUMBER

( )
3. COUNTY OF VENUE
4. FIRM NAME (If applicable)


5. DOCKET NUMBER (When available)

7. DOCUMENT TYPE 6. OFFICE ADDRESS





8. JURY DEMAND
YES NO
9. NAME OF PARTY (e.g., John Doe, Plaintiff)






10. CAPTION

11. CASE TYPE NUMBER
(See reverse side for listing) 12. IS THIS A PROFESSIONAL MALPRACTICE CASE? YES NO
IF YOU HAVE CHECKED “YES,” SEE N.J.S.A. 2A:53A-27 AND APPLICABLE CASE LAW REGARDING
YOUR OBLIGATION TO FILE AN AFFIDAVIT OF MERIT.
13. RELATED CASES PENDING?

YES NO
14. IF YES, LIST DOCKET NUMBERS
15. DO YOU ANTICIPATE
ADDING ANY PARTIES (arising
out of same transaction or
occurrence)?


YES NO
16. NAME OF DEFENDANT’S PRIMARY INSURANCE COMPANY, IF KNOWN

ONE N
UNKNOWN
THE INFORMATION PROVIDED ON THIS FORM CANNOT BE INTRODUCED INTO EVIDENCE.
CASE CHARACTERISTICS FOR PURPOSES OF DETERMINING IF CASE IS APPROPRIATE FOR MEDIATION
17. A. DO PARTIES HAVE A CURRENT,
PAST OR RECURRENT
RELATIONSHIP? YES NO
IF YES, IS THAT
RELATIONSHIP EMPLOYER-EMPLOYEE FRIEND/NEIGHBOR OTHER (explain)
FAMILIAL BUSINESS
18. B. DOES THE STATUTE GOVERNING THIS
CASE PROVIDE FOR PAYMENT OF FEES
BY THE LOSING PARTY?

YES NO
19. USE THIS SPACE TO ALERT THE COURT TO ANY SPECIAL CASE CHARACTERISTICS THAT MAY WARRANT INDIVIDUAL MANAGEMENT OR ACCELERATED
DISPOSITION:













20. DO YOU OR YOUR CLIENT NEED
ANYDISABILITY ACCOMMODATIONS? YES NO IF YES, PLEASE IDENTIFY THE REQUESTED ACCOMMODATION:

21. WILL AN INTERPRETER BE NEEDED?



YES NO IF YES, FOR WHAT LANGUAGE:

22. ATTORNEY SIGNATURE




Revised 04/2008, CN 10554-English (How to File an Answer to a Complaint in the Superior Court) Page 14 of 15
Revised 03/2009, CN 10517-English



CIVIL CASE INFORMATION STATEMENT
(CIS)
Use for initial pleadings (not motions) under Rule 4:5-1

CASE TYPES (Choose one and enter number of case type in appropriate space on the reverse side.)

Track I — 150 days' discovery
151 NAME CHANGE
175 FORFEITURE
302 TENANCY
399 REAL PROPERTY (other than Tenancy, Contract, Condemnation, Complex Commercial or Construction)
502 BOOK ACCOUNT (debt collection matters only)
505 OTHER INSURANCE CLAIM (INCLUDING DECLARATORY JUDGMENT ACTIONS)
506 PIP COVERAGE
510 UM or UIM CLAIM
511 ACTION ON NEGOTIABLE INSTRUMENT
512 LEMON LAW
801 SUMMARY ACTION
802 OPEN PUBLIC RECORDS ACT (SUMMARY ACTION)
999 OTHER (Briefly describe nature of action)





Track II — 300 days' discovery
305 CONSTRUCTION
509 EMPLOYMENT (other than CEPA or LAD)
599 CONTRACT/COMMERCIAL TRANSACTION
603 AUTO NEGLIGENCE – PERSONAL INJURY
605 PERSONAL INJURY
610 AUTO NEGLIGENCE – PROPERTY DAMAGE
699 TORT – OTHER

Track III — 450 days' discovery
005 CIVIL RIGHTS
301 CONDEMNATION
602 ASSAULT AND BATTERY
604 MEDICAL MALPRACTICE
606 PRODUCT LIABILITY
607 PROFESSIONAL MALPRACTICE
608 TOXIC TORT
609 DEFAMATION
616 WHISTLEBLOWER / CONSCIENTIOUS EMPLOYEE PROTECTION ACT (CEPA) CASES
617 INVERSE CONDEMNATION
618 LAW AGAINST DISCRIMINATION (LAD) CASES
620 FALSE CLAIMS ACT

Track IV — Active Case Management by Individual Judge / 450 days' discovery
156 ENVIRONMENTAL/ENVIRONMENTAL COVERAGE LITIGATION
280 ZELNORM
303 MT. LAUREL
508 COMPLEX COMMERCIAL
513 COMPLEX CONSTRUCTION
514 INSURANCE FRAUD
701 ACTIONS IN LIEU OF PREROGATIVE WRITS

Mass Tort (Track IV)
248 CIBA GEIGY 278 ZOMETA/AREDIA
266 HORMONE REPLACEMENT THERAPY (HRT) 279 GADOLINIUM
271 ACCUTANE 281 BRISTOL-MYERS SQUIBB ENVIRONMENTAL
272 BEXTRA/CELEBREX 282 FOSAMAX
274 RISPERDAL/SEROQUEL/ZYPREXA 283 DIGITEK
275 ORTHO EVRA 284 NUVARING
276 DEPO-PROVERA 601 ASBESTOS
277 MAHWAH TOXIC DUMP SITE 619 VIOXX

If you believe this case requires a track other than that provided above, please indicate the reason on Side 1,
in the space under "Case Characteristics."

Please check off each applicable category:
Verbal Threshold Putative Class Action Title 59
SIDE 2
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Revised 03/2009, CN 10517-English