12778 – Tenant Case Information Statement (TCIS) – New Jersey

The 12778 – Tenant Civil Case Information Statement (TCIS) is a formal document reissued by Directive #15-23 on August 23, 2023, under the Civil Practice Division of the New Jersey Judiciary. This public document, intended for use in tenant-related civil cases, is available to the public upon request. It is crucial to avoid entering personal identifiers such as Social Security numbers, driver’s license numbers, vehicle plate numbers, insurance policy numbers, active financial account numbers, active credit card numbers, or military status.

The TCIS form serves to collect essential information about the tenant(s) involved in a civil case, including their contact details, the rental property address, and the monthly base rent amount. It also captures information about any legal representation the tenant might have. Additionally, the form asks specific questions to determine if the tenant has applied for emergency rental assistance related to COVID-19 or requested the landlord to apply the security deposit toward rent.

Tenants are required to indicate if they dispute the rent amount demanded by the landlord, if they have issues with the landlord concerning the property’s condition, or if there are any other disagreements. Further, tenants may provide additional information about their case or disagreements with the landlord.

The form includes a certification section where tenants or their attorneys affirm the accuracy of the provided information and confirm that personal identifiers have been redacted. The certification also acknowledges that willfully false statements are subject to punishment.

Tenants are encouraged to review online resources on the New Jersey Judiciary website for information on defending their case, accessing legal representation, and finding available rental resources.

Filling out this form is essential for providing the court with accurate information about your case. Follow these step-by-step instructions to complete the form correctly:

Caption County and Docket Number

1. • Caption County: Enter the county where the case is filed.
   • Docket Number: Enter the docket number assigned to your case.

Name of Defendant(s)/Tenant(s)

1. • Provide the full name(s) of the tenant(s) involved in the case.

Daytime Phone Number(s) of Tenant(s)

1. • Enter the phone number(s) where the tenant(s) can be reached during the day.

Email Address(es)

1. • Provide the email address(es) of the tenant(s).

Attorney Information (if applicable)

1. • Attorney Name and Firm: Enter the name and firm of the attorney representing the tenant(s), if applicable.
   • Attorney Email Address: Provide the attorney’s email address.
   • Attorney Mailing Address: Enter the mailing address of the attorney.
   • Attorney Daytime Telephone Number: Provide the attorney’s daytime phone number.

Rental Property Address

1. • Enter the full address of the rental property involved in the case.

Amount of Monthly Base Rent

1. • Provide the amount of monthly rent for the rental property.

Emergency Rental Assistance

1. • Indicate if you or the landlord have applied for any emergency rental assistance related to COVID-19 by selecting “Yes” or “No.”

Security Deposit Application

1. • Indicate if you have asked the landlord to apply any or all of your security deposit toward rent by selecting “Yes” or “No.”

Rent Discrepancy

1. • Indicate if the amount of rent demanded by the landlord in the complaint is incorrect by selecting “Yes” or “No.”

Government Assistance

1. • Indicate if the government helps pay your rent but the amount the landlord says you owe is the government’s portion by selecting “Yes” or “No.”

Disagreement with Landlord

1. • Indicate if you have a disagreement with the landlord about the condition of the property or another issue by selecting “Yes” or “No.” Refer to the Judiciary’s website for common defenses.

Additional Information

1. • Provide any additional information about your case or disagreement with the landlord. Attach additional pages if necessary.

Certification and Signature

1. • Confidential Personal Identifiers: Certify that confidential personal identifiers have been redacted from documents submitted to the court.
   • Truthfulness of Statements: Certify that the statements made are true to the best of your knowledge. Acknowledge that willfully false statements are subject to punishment.
   • Signature: Sign the form.
   • Print Name: Print the name of the person signing the form.
   • Date: Enter the date when the form is signed.

Important Notes

• This form is a public document. Do not include personal identifiers such as Social Security numbers, driver’s license numbers, vehicle plate numbers, insurance policy numbers, active financial account numbers, active credit card numbers, or military status.
• Review online resources on the New Jersey Judiciary website for information on defending your case, accessing legal representation, and available rental resources.

By carefully following these instructions, you can ensure that your Tenant Civil Case Information Statement is complete and accurate. If you have any questions or need assistance, consider seeking legal counsel.