AMENDMENTS TO “TENANCY SUMMONS & RETURN OF SERVICE”
(RULES APPENDIX XI-B) AND “EXECUTION AGAINST GOODS
AND CHATTELS” (RULES APPENDIX XI-H)
On July 23, 2010 the Supreme Court approved changes to two Appendices to
the Rules of Court that are used in Special Civil Part cases, with those changes to be
effective September 1, 2010. The changes are as follows:
1. Appendix XI-B (Tenancy Summons & Return of Service). The
Return of Service portion of this form has been modified so as to
add a line for the Special Civil Part Officer (“Officer”) to indicate
what unsuccessful efforts were made to effectuate personal service
of the summons and complaint before those documents were
posted on the door of the rental unit or other conspicuous place of
the premises. Also, the words “if posted” have been added to the
line for the Officer to describe the premises so as to make clear that
such description is to be provided only in those situations where the
summons and complaint were posted because the Officer was
unable to make personal service. The Rules of Court require the
plaintiff-landlord to submit a completed summons to the Clerk of the
Special Civil Part in the form set forth in Appendix XI-B at the time
the complaint is filed.
2. Appendix XI-H (Execution Against Goods and Chattels). The form
of the writ of execution against goods and chattels has been
modified so as to exclude from levy those funds that are exempt
from execution under federal or state law, such as Social Security
benefits. The revised writ informs banks and other financial
1
2
institutions how to identify those exempt funds. Since the writ is
generated by the office of the Special Civil Part Clerk upon request,
these amendments do not require any modification of template
forms by attorneys who represent judgment-creditors in Special
Civil Part cases.
Questions regarding these changes to Rules Appendices XI-B and XI-H may be
directed to office of the Special Civil Part Clerk in the county of venue or to the Civil
Practice Division of the Administrative Office of the Courts, P.O. Box 981, Trenton, NJ
08102. Copies of the both amended Appendices are included with this Notice.
/s/ Glenn A. Grant
Hon. Glenn A. Grant, J.A.D.
Acting Administrative Director of the Courts
Dated: August 17, 2010
APPENDIX XI-B. TENANCY SUMMONS
AND RETURN OF SERVICE (R. 6:2-1)
Plaintiff or Plaintiff’s Attorney Information: Superior Court of New Jersey
Name: _____________________________ Law Division, Special Civil Part
Address: ___________________________ __________________ County
___________________________________ ___________________________
Phone: (___)_________________________ ___________________________
(____)______________________
______________________________, Plaintiff(s) Docket Number: LT - _____________
(to be provided by the court)
versus
Civil Action
______________________________, Defendant(s) SUMMONS
LANDLORD/TENANT
Defendant Information:
Name: __________________________ ___Nonpayment
Address: _________________________ ___Other
_________________________________
Phone:(___)_______________________
NOTICE TO TENANT: The purpose of the attached complaint is to permanently remove you and your
belongings from the premises. If you want the court to hear your side of the case you must appear in
court on this date and time: _____________ at ________ a.m./p.m., or the court may rule against you.
REPORT TO: ___________________________________
If you cannot afford to pay for a lawyer, free legal advice may be available by contacting Legal Services at
________________. If you can afford to pay a lawyer but do not know one, you may call the Lawyer Referral
Services of your local county Bar Association at _______________.
You may be eligible for housing assistance. To determine your eligibility, you must immediately contact the
welfare agency in your county at __________________, telephone number ____________________.
If you need an interpreter or an accommodation for a disability, you must notify the court immediately.
Si Ud. no tiene dinero para pagar a un abogado, es posible que pueda recibir consejos legales gratuitos si se
comunica con Servicios Legales (Legal Services) al ____________. Si tiene dinero para pagar a un abogado
pero no conoce ninguno puede llamar a Servicios de Recomendación de Abogados (Lawyer Referral Services)
del Colegio de Abogados (Bar Association) de su condado local al_________________.
Es posible que pueda recibir asistencia con la vivienda si se comunica con la agencia de asistencia publica
(welfare agency) de su condado al _____________________________________, telefono ___________.
Si necesita un interprete o alguna acomodación para un impedimento fisico, tiene que notificárselo
nmediatamente al tribunal. i
Date: ___________________ _________________________________________
Clerk of the Special Civil Part
COURT OFFICER’S RETURN OF SERVICE (FOR COURT USE ONLY)
Docket Number: ________________________Date: __________________Time: ______________
WM ___ WF ___ BM ___ BF OTHER _____ HT ____ WT _____ AGE ___ MUSTACHE ___ BEARD ___ GLASSES___ NAME:
____________________________RELATIONSHIP: __________
Efforts Made to Personally Serve __________________________________________________________________________
_____________________________________________________________________________________________________
Description of Premises if Posted __________________________________________________________________________
_____________________________________________________________________________________________________
I hereby certify the above to be true and accurate: _________________________________________________________
Special Civil Part Officer
Note: Former Appendix XI-B, consisting of model tenancy complaint and summons forms, deleted, and new tenancy
summons and return of service form adopted July 12, 2002 to be effective September 3, 2002; amended July 27, 2006 to be
effective September 1, 2006: amended July 23, 2010 to be effective September 1, 2010.
APPENDIX XI-H – EXECUTION AGAINST GOODS AND CHATTELS
DOCKET NO.: ___ DC-______-__ SUPERIOR COURT OF NEW JERSEY
JUDGMENT NO.: ___ VJ-_______-__ SPECIAL CIVIL PART
WRIT NUMBER: ____ _______________ COUNTY
STATE OF NEW JERSEY
EXECUTION AGAINST GOODS AND CHATTELS
PLAINTIFF(S)
VS.
DEBTORS: __________________________
DEFENDANT(S) __________________________
ADDRESS OF FIRST DEBTOR:
STREET ADDRESS
CITY NJ ZIP
TO: ___________________________________________
COURT OFFICER OF THE SPECIAL CIVIL PART
YOU ARE ORDERED to levy on the property of any of the debtors designated herein; your actions may include,
but are not limited to, taking into possession any motor vehicle(s) owned by any of the debtors, taking possession of
any inventory and/or machinery, cash, bank accounts, jewelry, electronic devices, fur coats, musical instruments,
stock certificates, securities, notes, rents, accounts receivable, or any item(s) which may be sold pursuant to statute
to satisfy this execution in full or in part. Any levy pursuant to this writ shall exclude (1) all funds in an account of
the debtor with a bank or other financial institution, if all deposits into the account during the 90 days immediately
prior to service of the writ were electronic deposits, made on a recurring basis, of funds identifiable by the bank or
other financial institution as exempt from execution, levy or attachment under New Jersey or federal law, and (2) all
funds deposited electronically in an account of the debtor with a bank or other financial institution during the 45
days immediately prior to service of the writ that are identifiable by the bank or other financial institution as exempt
from execution, levy or attachment under New Jersey or federal law. All proceeds are to be paid to the court officer
who shall pay them to the creditor or the attorney for the creditor, or, if this is not possible, to the court. This order
for execution shall be valid for two years from this date.
Local police departments are authorized and requested to provide assistance, if needed, to the officer executing
this writ. This does not authorize entry to a residence by force unless specifically directed by court order.
Judgment Date _________ Date: ________________
Judgment Amount.................................................$________
Costs and Atty. Fees.............................................$________ _________________________________
Subsequent Costs..................................................$________ Judge
Total......................................................................$________
Credits, if any.......................................................$________
Subtotal A.............................................................$________ _________________________________
Interest..................................................................$________ Clerk of the Special Civil Part
Execution costs and mileage.................................$________
Subtotal B.............................................................$________ I RETURN this execution to the Court
Court officer fee....................................................$________
Total due this date.................................................$________ ( ) Unsatisfied ___________________
Date: ________________.................................... ( ) Satisfied ( ) Partly Satisfied
Property to be Levied Amount Collected. . ____________
Upon and Location of Same:
Fee Deducted. . . . . . ____________
Amount Paid to Atty.____________
CITY ST ZIP
CREDITOR’S ATTORNEY AND ADDRESS: Date: ______________
______________________________________
______________________________________
______________________________________ ______________________________
CITY NJ ZIP Court Officer
Telephone: ___-__________
Note: Adopted effective January 2, 1989; amended July 13, 1994, effective September 1, 1994; amended
July 10, 1998 to be effective September 1, 1998; amended July 12, 2002 to be effective September 3,
2002; amended July 28, 2004 to be effective September 1, 2004; amended July 23, 2010 to be effective
September 1, 2010.
