Save NOTICE: This is a public document, which means the document as submitted will be available to the public upon request. Therefore, do not enter personal identifiers on it, such as Social Security number, driver's license number, vehicle plate number, insurance policy number, active financial account number, or active credit card number. Filing Attorney Information or Pro Se Litigant: Name NJ Attorney ID Number Address Telephone Number , Plaintiff, Superior Court of New Jersey Law Division, Special Civil Part County Docket Number: LT Landlord-Tenant Division v. , Defendant. Certification by Landlord's Attorney 1. I am the attorney for the landlord in this matter and make this certification pursuant to Rule 6:6-3(b) or Rule 6:6-4. 2. The landlord has asserted that the tenant has failed to pay rent now due and owing in this matter. 3. I have reviewed the applicable federal, state, and local law and the written lease between the parties, and in my opinion the changed and fees sought, other than the base rent, are permitted to be included in the rent for purposes of this action. 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 Print Name Effective 11/01/2001, CN 10513 (Appendix XI-U) American LegalNet, Inc. www.FormsWorkFlow.com