TRIAL DE NOVO REQUEST FORM SUPERIOR COURT OF NEW JERSEY LAW DIVISION, CIVIL PART COUNTY NJ NOTICE OF DEMAND FOR TRIAL DE NOVO If trial de novo is sought this form must be filed with the Arbitration Administrator within 30 days of the filing of the arbitration award and served on all parties within that time. Plaintiff Docket No. VS. Arbitration Date: Defendant The arbitration hearing in the above-captioned matter was held on ___________________________. Payment in the amount of $200.00 being tendered herewith, and this notice having been served on all parties, trial de novo is hereby requested in the above captioned matter, pursuant to RULES 4:21A-6(b) (1) and 4:21A-6(c). Date: By: , Signature (Pro Se Party or Attorney for Filer) THIS NOTICE, WHEN TIMELY FILED AND SERVED ON ALL ADVERSE PARTIES, SHALL BE SUFFICIENT TO RESTORE THE CASE TO THE TRIAL CALENDAR. Makes checks or money orders payable to: TREASURER, STATE OF NEW JERSEY Pro se litigants must use certified check or money order. Revised 08/24/2007, CN 10768-English page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com