10512 – Certification by Landlord – Appendix XI-T – New Jersey
The 10512 – Certification by Landlord – Appendix XI-T form is used by landlords to certify the details surrounding an eviction case filed in the Superior Court of New Jersey, Law Division, Special Civil Part, Landlord-Tenant Division.
This guide will help you complete the Certification by Landlord form accurately and thoroughly.
Filing Attorney Information or Landlord
- Name: Enter your full name (landlord or attorney).
- NJ Attorney ID Number: If you are an attorney, enter your NJ Attorney ID number.
- Address: Provide your complete mailing address.
- Telephone Number: Enter a valid phone number where you can be reached.
Superior Court of New Jersey, Law Division, Special Civil Part, County
- County: Specify the county where the court is located.
- Docket Number: Enter the docket number assigned to your case (LT-XXXXX).
Plaintiff and Defendant Information
- Plaintiff: Enter the landlord’s name.
- Defendant: Enter the tenant’s name.
Part A: When the Eviction is Based on Unpaid Rent
1. Rent Due: Enter the total amount of rent due, broken down into:
- Basic Rent: The amount of unpaid basic rent.
- Late Charges: Any late fees charged.
- Legal Fees: Legal fees related to the eviction action.
- Filing Fees and Costs: Costs associated with filing the eviction action.
- Other: Any additional charges permitted by the lease agreement and applicable laws (specify what these are).
2. Inclusion in Lease Agreement: Confirm that all items listed are included in the lease agreement as rent.
3. Compliance with Laws: Confirm that all items are permitted by federal, state, and local laws to be charged as rent for eviction purposes.
Part B: When the Eviction is Based on Other Grounds
Provide a detailed description of the grounds for eviction if it is based on reasons other than unpaid rent.
Part C: In All Cases
1. Attach Notices: Attach copies of all notices served to the tenant.
2. Method of Service: Select the method(s) used to serve the notices (ordinary mail, certified mail, personal service) and provide the date of service.
3. Truthfulness of Facts: Confirm that all facts stated in the notices are true.
4. Property Ownership: If proceeding without an attorney, certify that you own the property in your name or in the name of a general partnership of which you are a partner.
5. Registration Compliance: Confirm compliance with the registration requirements of N.J.S.A. 46:8-27 et seq.
6. Ownership Transfer: Confirm that the tenant did not transfer ownership to you and that you have not given the tenant an option to buy the property.
7. Military Service: Confirm that the tenant is not in military service and that the premises are not used for dwelling purposes by a spouse, child, or dependent of a person in military service.
Certification Statement
- Date: Enter the date you are signing the form.
- Landlord Signature: Sign the form.
- Print Name: Print your name clearly.
Final Steps
- Review: Double-check all information for accuracy and completeness.
- Submit: Submit the form to the Superior Court of New Jersey, Law Division, Special Civil Part, Landlord-Tenant Division, in the appropriate county.
Notice: Do not enter personal identifiers such as Social Security numbers, driver’s license numbers, vehicle plate numbers, insurance policy numbers, active financial account numbers, or active credit card numbers, as this is a public document.