Forms

The legal forms listed here are from Legal Services of New Jersey or the New Jersey Courts website. For more forms, visit the Self-Help Center on the New Jersey Courts website. Please do not use these forms if you have a legal problem in another state.

Courts

Federal Courts

U.S. Court of Appeals for the Third Circuit Forms

U.S. District Court New Jersey Forms

Forms for Lawsuits and Representing Yourself

Non-Prisoner Forms (from the U.S. District Court)

Instead of Lawsuits

Statewide Mediation Program (from the N.J. Judiciary)

New Jersey State Courts > Municipal Courts

How to File an Appeal from a Municipal Court Decision (Forms for Self-Represented Litigants) (from the N.J. Judiciary)

New Jersey State Courts > New Jersey Supreme Court

A Guide to Filing for Litigants without Lawyers (from NJ Courts)

New Jersey State Courts > Superior Court of New Jersey

How to Answer a Complaint in the Special Civil Part (from NJ Courts)

How to Answer a Complaint in the Special Civil Part with a Counterclaim, Cross-claim and/or Third Party Complaint (from NJ Courts)

How to File a Motion Before a Judge to Classify a Record as Confidential or Delete Documents from the eCourts Case Jackets (from NJ Courts)

How to File a Motion to Dismiss the Complaint or to Strike the Answer for Failure to Answer Interrogatories in the Special Civil Part (from NJ Courts)

How To Request a Default Judgment in the Superior Court Of New Jersey - Special Civil Part (Small Claims and Regular Special Civil Part Cases) (from NJ Courts)

How to Sue for an Amount of Money Up To $20,000 (from NJ Courts)

How to Sue for Up To $5,000 in Small Claims Court Motor Vehicle Case (from NJ Courts)

How to Sue for Up To $5,000 in Small Claims Court Non-Motor Vehicle Case (from NJ Courts)

Special Civil Answer and Counterclaim, Cross-claim, Third Party Complaint - Appendix XI-Z (from NJ Courts)

Criminal Charges and Convictions

Reentry > Expungement

Expungement Form 1 - Petition for Expungement

Expungement Form 2 - Order for Hearing

Expungement Form 3 - Expungement Order

Expungement Form 4 - Cover Letter

Expungement Form 5 - Cover Letter

Expungement Form 6 - Proof of Notice

Expungement Form 7 - Cover Letter

Expungement Form 8 - Certification in Further Support - Modified Payment of Fine

Expungement Form 9 - Certification in Further Support of Expungement Application - Public Interest

Disability

Social Security Disability/SSI

Social Security Disability and SSI Claims Forms (from Social Security.gov)

Family and Relationships

Child Support

How to Ask the Court to Change or Enforce a Child Support Order in Your Case (from the New Jersey Judiciary)

Custody/Visitation

How to Ask The Court To Change or Enforce an Order in Your Case (from the New Jersey Judiciary)

Divorce

How to Ask the Court to Change the Name of Your Minor Child (from the New Jersey Judiciary)

Divorce > General Information

How To Change Your Name in New Jersey

Guardianship

How to Become the Legal Guardian of a Person Receiving Services From the Division of Developmental Disabilities (from NJ Courts online)

Name Change

How to Ask the Court to Change a Name in Chancery Division, Family Part (from the NJ Judiciary)

How to Ask the Court To Change Your Name (from the NJ Judiciary)

Paternity

Affidavit in Support of Paternity (from the NJ Judiciary)

Government Aid and Services

Social Security Disability/SSI

Social Security Disability and SSI Claims Forms (from Social Security.gov)

Voting in New Jersey

Voter Registration Forms (from the New Jersey Division of Elections)

Health Care

Advance Directives

Instruction Directive (Living Will) (from the NJ Department of Health)

POLST form (New Jersey Practitioner Orders for Life-Sustaining Treatment) (from the NJ Department of Health)

Proxy Directive (Durable Power of Attorney for Health Care) Designation of Health Care Representative (from the NJ Department of Health)

Medicare

I have Part A and want to apply for Part B (Application for Enrollment in Part B/CMS-40B) (from Medicare.gov)

I want to appoint a representative to help me file an appeal (Appointment of Representative form/CMS-1696)

I want to file a claim for services and/or supplies that I got (Patient Request for Medical Payment form/CMS-1490S) (from Medicare.gov)

I want to make sure Medicare can give my personal health information to someone other than me (Authorization to Disclose Personal Health Information form/CMS-10106) (from Medicare.gov)

I want to request a hearing by an Administrative Law Judge (ALJ) because I’m not satisfied with the decision made during the 2nd level of my appeal (Request for Hearing by an Administrative Law Judge form/CMS-20034A/B) (from Medicare.gov)

I want to request a reconsideration because I’m not satisfied with the decision made during the 1st level of my appeal (Medicare Reconsideration Request form/CMS-20033) (from Medicare.gov)

I want to request an appeal (redetermination) because I disagree with a coverage or payment decision from Medicare (1st level of the appeals process) (Redetermination Request form/CMS-20027) (from Medicare.gov)

I want to sign up for Part B while I’m employed or during the 8 months after employment or my employer/union coverage has ended, and I need to provide employment information (Request for Employment Information/CMS-L564) (from Medicare.gov)

I want to start, stop, or change bank accounts for automatic monthly deductions of my Medicare premium (Authorization Agreement for Pre-authorized Payments form/SF-5510) (from Medicare.gov)

I want to transfer my appeal rights to my provider or supplier (Transfer of Appeal Rights form/CMS-20031) (from Medicare.gov)

Jobs and Employment

Temporary Disability

Application for Temporary Disability Benefits (from New Jersey Department of Labor and Workforce Development)

Unemployment Insurance > Overpayment

Request For Waiver Of Overpayment Of Unemployment Benefits (from the NJDOL)

LGBTQIA+

Name Change

How to Ask the Court to Change a Name in Chancery Division, Family Part (from the NJ Judiciary)

How to Ask the Court To Change Your Name (from the NJ Judiciary)

Military and Veterans

Disability Compensation

Benefit Forms (from the US Department of Veterans Affairs)

Disability Pension

Benefit Forms (from the US Department of Veterans Affairs)

School and Learning

Discipline

Sample Bureau of Controversies and Disputes (BOCD) Appeal

Early Intervention

New Jersey Dispute Resolution Form (from the New Jersey Department of Health and Senior Services)

School Registration/School Residency

New Jersey Department of Education Sample Forms, Notices and Informational Documents (from NJ Deptarment of Education)

Special Education

Request for Due Process Hearing (from the New Jersey Department of Education)

Request for Mediation (from the New Jersey Department of Education)

Sample Bureau of Controversies and Disputes (BOCD) Appeal

Sample Letter: Request for Independent Evaluation

Sample Letter: Request for School Records

Sample Letter: Request for Special Education Evaluation

Sample Letter: Request for Special Education Evaluation (preschool)

Sample Letter: Request for Special Education Reevaluation

Special Education Complaint Form (from the New Jersey Department of Education)

Student Records

Sample Request for School Records

Seniors

Advance Directives

Instruction Directive (Living Will) (from the NJ Department of Health)

POLST form (New Jersey Practitioner Orders for Life-Sustaining Treatment) (from the NJ Department of Health)

Proxy Directive (Durable Power of Attorney for Health Care) Designation of Health Care Representative (from the NJ Department of Health)

Taxes

State Tax Practice and Procedure

Claim Form: Annual NJ Property Tax Deduction for Senior Citizens, Disabled Persons (from the NJ Division of Taxation)

Claim Form: Annual NJ Property Tax Deduction for Veterans (from the NJ Division of Taxation)

Claim Form: NJ Property Tax Exemption for Disabled Veterans (from the NJ Division of Taxation)

Property Tax Reimbursement (Senior Freeze) Information & Forms (from the NJ Division of Taxation)

Legal Services of New Jersey
P.O. Box 1357
Edison, NJ 08818-1357
Contact Us

Regional Programs

Northeast New Jersey Legal Services

Legal Services of Northwest Jersey

Essex-Newark Legal Services

Central Jersey Legal Services

South Jersey Legal Services

Statewide Legal Assistance Hotline
Call or apply online for free legal assistance:
1-888-LSNJ-LAW (1-888-576-5529)
www.lsnjlawhotline.org

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