Revised 09/01/2018, CN 11636 (Appendix XI-E) page 1 of 2 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, driver222s 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 Address Telephone Number Plaintiff222s Name Superior Court of New Jersey Street Address Check if new address/phone number Law Division: Special Civil Part County Town, State, Zip Code Docket Number: DC - Civil Action Answer (Auto Accident) Telephone Number vs. Defendant222s Name Street Address Town, State, Zip Code Telephone Number Defendant(s), by way of answer to the complaint, say(s) (select all that apply) : I / We admit deny that the accident took place on the date stated in the complaint. I / We admit deny that I was the owner of the vehicle on the date of the accident. I / We admit deny that I was the operator of the vehicle on the date of the accident. I / We admit deny that the accident took place at the location stated in the complaint. The accident alleged in the complaint was not my/our fault because : Trial by jury requested; an extra $100 cash, check or money order is submitted. Trial by jury requested; and I have submitted an application for a waiver of the $100.00 fee. At the trial, Defendant requests: An interpreter Yes No Indicate Language An accommodation for a disability Yes No Requested accommodation American LegalNet, Inc. www.FormsWorkFlow.com Revised 09/01/2018, CN 11636 (Appendix XI-E) page 2 of 2 Certification I certify, to the best of my knowledge: Must check one that the above matter is not the subject of any other court action or arbitration proceeding now pending or contemplated, or that the following actions or arbitration proceedings are pending or contemplated AND Must check one that no other parties should be joined in this action; or that the following persons or entities should be joined in this action 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). I further certify that this answer was served b y me upon all existing parties Dated Defendant222s Signature Defendant's Name - Typed or Printed Demand for Production of Documents Pursuant to R . 4:18 - 2. By checking this box, demand is made for production of all documents or papers referred to in the pleading for which this answer is provi ded, within 5 days of this demand. American LegalNet, Inc. www.FormsWorkFlow.com