Civil Case Information Statement (CIS) - New Jersey - Preparation Worksheet
NEW JERSEY CIVIL CASE INFORMATION STATEMENT COMPLETION WORKSHEET
IMPORTANT USE LIMIT
This is a private worksheet for preparing the official Civil Case Information Statement, CN 10517, Appendix XII-B1. Do not file this worksheet in place of the official form. Transfer the completed information to the current form published by the New Jersey Judiciary.
The current form was promulgated by a January 7, 2026 Notice to the Bar and is effective January 7, 2026. It is used for initial Law Division, Civil Part pleadings, not motions, under Rule 4:5-1. The official form warns that a pleading will be rejected under Rule 1:5-6(c) if the information above the black bar is incomplete or the required signature is missing.
1. FILER AND CASE INFORMATION
| Official form field | Worksheet entry |
|---|---|
| Attorney or self-represented litigant name | [________________________________] |
| Telephone number and extension | [________________________________] |
| County of venue | [________________________________] |
| Firm name, if applicable | [________________________________] |
| Docket number, when available | [________________________________] |
| Office address — street | [________________________________] |
| City, state, and ZIP code | [________________________________] |
| Document type | [________________________________] |
| Jury demand | ☐ Yes ☐ No |
| Name of filing party and role | [________________________________] |
| Full case caption | [________________________________] |
☐ The document is an initial Law Division, Civil Part pleading.
☐ The document is not a motion.
2. REQUIRED CASE QUESTIONS
Case type number selected from Section 3: [________]
Are sexual-abuse claims alleged? ☐ Yes ☐ No
Does the case involve claims related to COVID-19? ☐ Yes ☐ No
Is this a professional-malpractice case? ☐ Yes ☐ No
If yes, the official form directs the filer to N.J.S.A. 2A:53A-27 and applicable case law regarding an affidavit of merit. This worksheet does not determine whether an affidavit is required or calculate any deadline.
Are related cases pending? ☐ Yes ☐ No
If yes, list docket numbers: [________________________________]
Do you anticipate adding parties arising from the same transaction or occurrence? ☐ Yes ☐ No
Defendant's primary insurance company, if known: [________________________________]
☐ None
☐ Unknown
3. CURRENT CASE TYPE NUMBERS
Choose one number from the official January 7, 2026 form.
Track I — 150 Days of Discovery
| Code | Official case type | Select |
|---|---|---|
| 151 | Name Change | ☐ |
| 175 | Forfeiture | ☐ |
| 302 | Tenancy | ☐ |
| 399 | Real Property other than Tenancy, Contract, Condemnation, Complex Commercial, or Construction | ☐ |
| 502 | Book Account — debt collection matters only | ☐ |
| 505 | Other Insurance Claim, including declaratory-judgment actions | ☐ |
| 506 | PIP Coverage | ☐ |
| 510 | UM or UIM Claim — coverage issues only | ☐ |
| 511 | Action on Negotiable Instrument | ☐ |
| 512 | Lemon Law | ☐ |
| 801 | Summary Action | ☐ |
| 802 | Open Public Records Act — summary action | ☐ |
| 804 | Election Law | ☐ |
| 805 | Civil Commitment Expungement | ☐ |
| 999 | Other — briefly describe nature of action | ☐ |
Description for code 999: [________________________________]
Track II — 300 Days of Discovery
| Code | Official case type | Select |
|---|---|---|
| 305 | Construction | ☐ |
| 509 | Employment other than CEPA or LAD | ☐ |
| 599 | Contract / Commercial Transaction | ☐ |
| 603N | Auto Negligence — Personal Injury, non-verbal threshold | ☐ |
| 603Y | Auto Negligence — Personal Injury, verbal threshold | ☐ |
| 605 | Personal Injury | ☐ |
| 610 | Auto Negligence — Property Damage | ☐ |
| 621 | UM or UIM Claim — includes bodily injury | ☐ |
| 699 | Tort — Other | ☐ |
Track III — 450 Days of Discovery
| Code | Official case type | Select |
|---|---|---|
| 005 | Civil Rights | ☐ |
| 301 | Condemnation | ☐ |
| 602 | Assault and Battery | ☐ |
| 604 | Medical Malpractice | ☐ |
| 606 | Product Liability | ☐ |
| 607 | Professional Malpractice | ☐ |
| 608 | Toxic Tort | ☐ |
| 609 | Defamation | ☐ |
| 616 | Whistleblower / CEPA | ☐ |
| 617 | Inverse Condemnation | ☐ |
| 618 | Law Against Discrimination | ☐ |
Track IV — Active Case Management / 450 Days of Discovery
| Code | Official case type | Select |
|---|---|---|
| 156 | Environmental / Environmental Coverage Litigation | ☐ |
| 303 | Mt. Laurel | ☐ |
| 508 | Complex Commercial | ☐ |
| 513 | Complex Construction | ☐ |
| 514 | Insurance Fraud | ☐ |
| 620 | False Claims Act | ☐ |
| 701 | Actions in Lieu of Prerogative Writs | ☐ |
| 816 | Affordable Housing | ☐ |
Multicounty Litigation — Track IV
| Code | Official case type | Select |
|---|---|---|
| 282 | Fosamax | ☐ |
| 291 | Pelvic Mesh / Gynecare | ☐ |
| 292 | Pelvic Mesh / Bard | ☐ |
| 293 | DePuy ASR Hip Implant Litigation | ☐ |
| 296 | Stryker Rejuvenate / ABG II Modular Hip Stem Components | ☐ |
| 300 | Talc-Based Body Powders | ☐ |
| 601 | Asbestos | ☐ |
| 624 | Stryker LFIT CoCr V40 Femoral Heads | ☐ |
| 626 | Abilify | ☐ |
| 627 | Physiomesh Flexible Composite Mesh | ☐ |
| 628 | Taxotere / Docetaxel | ☐ |
| 629 | Zostavax | ☐ |
| 630 | Proceed Mesh / Patch | ☐ |
| 631 | Proton-Pump Inhibitors | ☐ |
| 633 | Prolene Hernia System Mesh | ☐ |
| 634 | Allergan Biocell Textured Breast Implants | ☐ |
| 635 | Tasigna | ☐ |
| 636 | Strattice Hernia Mesh | ☐ |
| 637 | Singulair | ☐ |
| 638 | Elmiron | ☐ |
| 639 | Pinnacle Metal-on-Metal Hip Implants | ☐ |
| 640 | Bard Implanted Port Catheter Products | ☐ |
| 641 | Sexual Abuse in Juvenile Detention Facilities Operated by the State of New Jersey | ☐ |
| 642 | Roundup Products | ☐ |
| 643 | GLP-1 Medications — Gastrointestinal Injuries | ☐ |
| 644 | GLP-1 Medications — NAION Vision Loss | ☐ |
The January 7, 2026 Notice to the Bar added MCL codes 641 through 644. Use the latest official form in case later revisions change this list.
Additional categories on the official form:
☐ Putative Class Action
☐ Title 59
☐ Consumer Fraud
☐ Medical Debt Claim
4. MEDIATION AND CASE-MANAGEMENT CHARACTERISTICS
The official form states that information supplied in this section cannot be introduced into evidence.
Do the parties have a current, past, or recurrent relationship? ☐ Yes ☐ No
If yes, select all that apply:
☐ Employer / Employee
☐ Friend / Neighbor
☐ Familial
☐ Business
☐ Other: [________________________________]
Does the statute governing the case provide for payment of fees by the losing party? ☐ Yes ☐ No
Special case characteristics that may warrant individual management or accelerated disposition:
[____________________________________________________________]
[____________________________________________________________]
5. ACCESSIBILITY AND LANGUAGE
Does the filer or client need a disability accommodation? ☐ Yes ☐ No
Requested accommodation: [________________________________]
Will an interpreter be needed? ☐ Yes ☐ No
Language: [________________________________]
6. REDACTION CERTIFICATION AND SIGNATURE
Before signing the official form, confirm:
☐ Confidential personal identifiers have been redacted from the documents now submitted to the court.
☐ Confidential personal identifiers will be redacted from future submissions in accordance with Rule 1:38-7(b), subject to any controlling statute, rule, or court order.
The official form's instructions note a name-change exception involving information required by N.J.S.A. 2A:52-1. Obtain legal review before deciding that an identifier must be included.
Signature name: [________________________________]
Signature date: [__/__/____]
☐ The same attorney or self-represented litigant named at the top of the official form will sign it.
7. TRANSFER TO THE OFFICIAL FORM
☐ Downloaded the latest CN 10517 from the New Jersey Judiciary
☐ Used the official form, not this worksheet, for filing
☐ Completed every field above the black bar
☐ Selected exactly one case type number
☐ Reviewed the special MCL and category checkboxes
☐ Completed the mediation, accommodation, and interpreter questions
☐ Completed the redaction certification
☐ Signed the official form
SOURCES AND REFERENCES
- Civil Case Information Statement packet, CN 10517
- January 7, 2026 Notice to the Bar — Civil CIS revisions
END OF COMPLETION WORKSHEET
About this template
- Last updated
- August 10, 2026
- Citations checked
- August 10, 2026
- Jurisdiction
- New Jersey
- Category
- Litigation & Court Documents
Legal authority
- N.J. Ct. R. 4:5-1 (official CN 10517 identifies this rule for initial Law Division Civil Part pleadings)
- N.J. Ct. R. 1:5-6(c) (official CN 10517 rejection warning)
- N.J. Ct. R. 1:38-7(b) (official CN 10517 redaction certification)
- Appendix XII-B1, Civil Case Information Statement, CN 10517 (effective January 7, 2026)
These are the filings that drive a lawsuit through the system: complaints, answers, motions, briefs, discovery requests and responses, and post-judgment papers. Each has its own format requirements under federal and state procedural rules, and each has a deadline that cannot be missed without consequences. Clean, procedurally correct filings move a case forward; sloppy ones invite motions to strike, amended responses, and avoidable delays.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on August 10, 2026.
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