INSTRUCTIONS FOR COMPLETING FORM A (Special Civil Part Complaint) A. The plaintiff is you, the person who is suing, and the defendant is the person being sued. B. In the blank spaces in the center of the complaint, you must explain the reasons you are suing the Defendant in detail. Some reasons you might sue a person or company are: • • • • • • • • • a person or company did not comply with a written or oral contract; you paid money as a down payment and you think you have a right to have it returned; your property was damaged in a motor vehicle accident; defendant damaged or lost your property; merchandise you bought is defective; work you paid for was faulty or not completed; you want to be paid for work you did; someone wrote you a bad check; or you gave a landlord a security deposit that was not returned. C. Complete the information regarding interpreters or accommodations for a disability. D. If the complaint (Form A) or any of the copies of papers that you attach to the complaint contain a Social Security number, driver’s license number, vehicle plate number, insurance policy number, active financial account number or active credit card number, you must redact (black out) this information so that it cannot be seen, unless any such personal identifier is required to be included by statute, rule, administrative directive or court order. If an active financial account is the subject of your case and cannot otherwise be identified, you may use the last four digits of the account to identify it. NOTE: Do not redact (black out) this information in the original papers that you are keeping since you may have to show them to the court at some point. E. Date and sign the form. NOTE: You may attach more sheets to the complaint if you need to. Revised 09/1/2009, CN 10541 American LegalNet, Inc. www.FormsWorkFlow.com Special Civil Part Complaint Superior Court Of New Jersey Law Division, Special Civil Part County Plaintiff’s Name Docket No. Street Address Town, State, Zip Code Telephone Number vs. CIVIL ACTION Defendant’s Name (Person you are suing) Complaint Street Address Town, State, Zip Code Telephone Number Type or print the reasons you, the Plaintiff(s), are suing the Defendant(s): (See instruction B) (You may attach more sheets if you need to) The amount you, the Plaintiff(s) are demanding from the Defendant(s) $ _________________ plus interest and $ ___________ for the costs of suing. At the trial Plaintiff will need: An interpreter: Yes No Indicate Language: ______________ An accommodation for a disability: Yes No Indicate Accommodation: ______________ I certify that the above 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. 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). Dated: __________________ __________________________ Your Signature __________________________ Name Typed or Printed Revised 09/1/2009, CN 10541 American LegalNet, Inc. www.FormsWorkFlow.com