TENANCY SUMMONS AND RETURN OF SERVICE (R. 6:2-1) 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, insu rance policy number, active financial account number, or active credit card number.Plaintiff or Filing Attorney Information: Name Superior Court of New Jersey NJ Attorney ID Number Law Division, Special Civil Part Address County Telepho ne Number Docket Number: LT - Plaintiff(s) (to be provided by the court) versus Defendant (s) Defendant Information: Name: Nonpayment Address: Other Phone: NOTICE TO TENANT: The purpose of the attached complaint is to permanently remove you and your belongings from the premises. If you want the court to hear your side of the case you must appear in court on this date and time: at a.m. p.m., or the court may rule against you. REPORT TO: . If you cannot afford to pay for a Services of your local county Bar Association at . You may be eligible for housing assistance. To determine your eligibility, you must immediately contact the welfare agency in your county at , telephone number . If you need an interpreter or an accommodation for a disability, you must notify the court immediately. Si ud. no tiene dinero para pagar a un abogado, es posible que pueda recibir consejos legales gratuitoEs posible que pueda recibir asistencia con la vivienda si se comunica con la agencia de asistencia publica (welfare agency) de su condado al , telefono . Si necesita un interprete o alguna acomodaci363n para un impedimento fisico, tiene que notific341rselo inmediatamente al tribunal. Date: Clerk of the St American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 COURT OFFICER222S RETURN OF SERVICE (FOR COURT USE ONLY) Docket Number: Date: Time: WM WF BM BF OTHER HT WT AGE MUSTACHE BEARD GLASSES NAME: RELATIONSHIP: Efforts Made to Personally Serve Description of Premises if Posted I hereby certify the above to be true and accurate: Special Civil Part Officer American LegalNet, Inc. www.FormsWorkFlow.com