Fill and Sign the New Jersey Claims Tort Form

APPENDIX XI-C. SMALL CLAIMS COMPLAINT (CONTRACT, SECURITY DEPOSIT, RENT OR TORT) Name and Address of Attorney for Plaintiff Name and Address of Court Phone No. Phone No. From Plaintiff: SUPERIOR COURT OF NEWJERSEY Name _________________________________ LAW DIVISION, SPECIAL CIVIL PART Address _______________________________ ___________________________COUNTY City ______________ State _____ Zip ______ Phone No. _____________________________ SMALL CLAIMS SECTION CIVIL ACTION v. COMPLAINT To Defendant: ( ) Contract ( ) Security Deposit Name _________________________________ ( ) Rent Address _______________________________ ( ) Tort other than motor vehicle City ______________ State _____ Zip ______ Phone No. _____________________________ COMPLAINT Demand: $_______, plus costs Plaintiff says: IMPORTANT: Plaintiffs and defendants must bring all witnesses, photos, documents, and other evidence to the hearing. Subpoena forms are available at the Clerk's office to require the attendance of witnesses. Plaintiff will need an interpreter fluent in the _______ language. I certify that the matter in controversy is not the subject of any other court action or arbitration proceeding, now pending or contemplated, and that no other parties should be joined in this action. Dated: ____________________________ Plaintiff's Signature Plaintiff's Name--Typed, Stamped, or Printed [Adopted effective January 2, 1989; amended June 29, 1990, effective September 4, 1990; amended July 14, 1992, effective September 1, 1992; amended July 5, 2000, effective September 5, 2000 .]