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Form Nj Cn 10482 – Fill Out and Use This PDF

The NJ CN 10482 form, also known as the Family Part Case Information Statement, is a critical document filed in family law cases within the Superior Court of New Jersey, Chancery Division, Family Part. It requires comprehensive financial details from the parties involved, including incomes, expenses, and assets, to inform decisions on alimony, child support, and other financial matters. Ensuring the accuracy and completeness of this form is paramount, as it directly impacts the outcomes of family law proceedings. For those navigating family law matters, filling out the NJ CN 10482 form accurately is the first step toward a fair resolution.

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Form Nj Cn 10482 PDF Details

The NJ CN 10482 form, known as the Family Part Case Information Statement, plays a pivotal role in New Jersey's family law proceedings, notably in divorce and other family-related cases. This detailed and confidential document, updated last in September 2017, requires thorough completion and submission by both parties involved in a case, under specific guidelines as per Rules 1:38-3(d)(1) and 5:5-2(f). It calls for comprehensive financial disclosure, including income, assets, and expenses, reflecting the standard of living to be addressed in alimony, child support, and equitable distribution matters. The form also delves into employment details, insurance coverage, and any agreements between the parties regarding the issues at hand. The document is structured to facilitate a transparent portrayal of each party's current economic situation and demands accuracy since any misrepresentation can significantly impact the case's outcome. Its submission, mandated to occur within 20 days following the filing of an answer or appearance, carries the weight of potential consequences for non-compliance, including the dismissal of pleadings. Moreover, it emphasizes the importance of updating the information provided as circumstances change, underlining the form's dynamic role in the evolving landscape of a family law case. Through its comprehensive scope—ranging from income and expenses to insurance and dependents' details—the form underlines the imperative for meticulous attention to detail and truthfulness in presenting one's financial standing.

Question	Answer
Form Name	Form Nj Cn 10482
Form Length	10 pages
Fillable?	Yes
Fillable fields	745
Avg. time to fill out	37 min 53 sec
Other names	case information statement nj, nj form case statement, case information statement civil nj, case information statement nj divorce

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Appendix V

Family Part Case Information Statement

Clear

This form and attachments are confidential pursuant to Rules 1:38-3(d)(1) and 5:5-2(f)

Attorney(s):

Office Address:

Tel. No./Fax No.

Attorney(s) for:

Plaintiff,

vs.

Defendant.

SUPERIOR COURT OF NEW JERSEY

CHANCERY DIVISION, FAMILY PART

COUNTY

DOCKET NO.

CASE INFORMATION STATEMENT

NOTICE: This statement must be fully completed, filed and served, with all required attachments, in accordance with Court Rule 5:5-2 based upon the information available. In those cases where the Case Information Statement is required, it shall be filed within 20 days after the filing of the Answer or Appearance. Failure to file a Case Information Statement may result in the dismissal of a party’s pleadings.

INSTRUCTIONS:

The Case Information Statement is a document which is filed with the court setting forth the financial details of your case. The required information includes your income, your spouse's/partner's income, a budget of your joint life style expenses, a budget of your current life style expenses including the expenses of your children, if applicable, an itemization of the amounts which you may be paying in support for your spouse/partner or children if you are contributing to their support, a summary of the value of all assets referenced on page 8 – It is extremely important that the Case Information

Statement be as accurate as possible because you are required to certify that the contents of the form are true. It helps establish your lifestyle which is an important component of alimony/spousal support and child support.

The monthly expenses must be reviewed and should be based on actual expenditures such as those shown from checkbook registers, bank statements or credit card statements from the past 24 months. The asset values should be taken, if possible, from actual appraisals or account statements. If the values are estimates, it should be clearly noted that they are estimates.

According to the Court Rules, you must update the Case Information Statement as your circumstances change. For example, if you move out of your residence and acquire your own apartment, you should file an Amended Case Information Statement showing your new rental and other living expenses.

It is also very important that you attach copies of relevant documents as required by the Case Information Statement, including your most recent tax returns with W-2 forms, 1099s and your three (3) most recent paystubs.

If a request has been made for college or post-secondary school contribution, you must also attach all relevant information pertaining to that request, including but not limited to documentation of all costs and reimbursements or assistance for which contribution is sought, such as invoices or receipts for tuition, board and books; proof of enrollment; and proof of all financial aid, scholarships, grants and student loans obtained.

Revised to be effective September 1, 2017. CN: 10482 (Court Rules Appendix V)

Page 1 of 10

Part A - Case Information:

Issues in Dispute:

Date of Statement

Cause of Action

Date of Divorce, Dissolution of Civil

Custody

Union or Termination of Domestic

Parenting Time

Partnership (post-Judgment matters)

Alimony

Date(s) of Prior Statement(s)

Child Support

Equitable Distribution

Your Birthdate

Counsel Fees

Birthdate of Other Party

Anticipated College/Post-

Date of Marriage, or entry into Civil Union

Secondary Education

or Domestic Partnership

Expenses

Other issues (be specific)

Date of Separation
Date of Complaint
Does an agreement exist between parties relative to any issue?	Yes	No.
If Yes, ATTACH a copy (if written) or a summary (if oral).

1.Name and Addresses of Parties: Your Name


Street Address	City	State/Zip
Email:
Other Party’s Name
Street Address	City	State/Zip
Email:

2.Name, Address, Birthdate and Person with whom children reside: a. Child(ren) From This Relationship

b. Child(ren) From Other Relationships
Child’s Full Name	Address	Birthdate	Person’s Name

Part B - Miscellaneous Information:

1. Information about Employment (Provide Name & Address of Business, if Self-employed)

Name of Employer/Business

Address

Name of Employer/Business

Address

2. Do you have Insurance obtained through Employment/Business?

Yes

No.

Type of Insurance:

Medical

Yes

No; Dental

Yes

No; Prescription Drug

Yes

No; Life

Yes

No; Disability

Yes

Other (explain)

Is Insurance available through Employment/Business?

Yes

Explain:

Revised to be effective September 1, 2017. CN: 10482 (Court Rules Appendix V)

Page 2 of 10

State Tax Return

Federal Tax Return

3.ATTACH Affidavit of Insurance Coverage as required by Court Rule 5:4-2 (f) (See Part G)

4.Additional Identification:

Confidential Litigant Information Sheet: Filed

Yes

5.ATTACH a list of all prior/pending family actions involving support, custody or Domestic Violence, with the Docket Number, County, State and the disposition reached. Attach copies of all existing Orders in effect.

Part C. - Income Information:

Complete this section for self and (if known) for other party. If W-2 wage earner, gross earned income refers to Medicare wages.

1. Last Year’s Income

			Yours		Joint	Other Party
1.	Gross earned income last calendar (year)	$		$		$
2.	Unearned income (same year)	$		$		$
3.	Total Income Taxes paid on income (Fed., State,	$		$		$
	F.I.C.A., and S.U.I.). If Joint Return, use middle
	column.
4.	Net income (1 + 2 - 3)	$		$		$

ATTACH to this form a corporate benefits statement as well as a statement of all fringe benefits of employment. (See Part G)

ATTACH a full and complete copy of last year’s Federal and State Income Tax Returns. to show total income plus a copy of the most recently filed Tax Returns. (See Part G) Check if attached:

ATTACH W-2 statements, 1099’s, Schedule C’s, etc.,

W-2

Other

2. Present Earned Income and Expenses

					Yours		Other Party
							(if known)
1.	Average gross weekly income (based on last 3 pay periods –			$		$
	ATTACH pay stubs)
	Commissions and bonuses, etc., are:
	included	not included*	not paid to you.
*ATTACH details of basis thereof, including, but not limited to, percentage overrides, timing of payments, etc.
ATTACH copies of last three statements of such bonuses, commissions, etc.
2.	Deductions per week (check all types of withholdings):			$		$

Federal

State

F.I.C.A.

3. Net average weekly income (1 - 2)

S.U.I.

Other

3. Your Current Year-to-Date Earned Income

		Provide Dates: From			To
1. GROSS EARNED INCOME: $			Number of Weeks
2. TAX DEDUCTIONS: (Number of Dependents:		)
a.	Federal Income Taxes		a.	$
b.	N.J. Income Taxes		b.	$
c.	Other State Income Taxes		c.	$
d.	F.I.C.A.		d.	$
e.	Medicare		e.	$
f.	S.U.I. / S.D.I.		f.	$
g.	Estimated tax payments in excess of withholding		g.	$
h.			h.	$
i.			i.	$
i.			i.	$

		TOTAL		$

Revised to be effective September 1, 2017. CN: 10482 (Court Rules Appendix V)

Page 3 of 10

3. GROSS INCOME NET OF TAXES $				$
4. OTHER DEDUCTIONS					If mandatory, check box
a.	Hospitalization/Medical Insurance		a.	$
b.	Life Insurance		b.	$
c.	Union Dues		c.	$
d.	401(k) Plans		d.	$
e.	Pension/Retirement Plans		e.	$
f.	Other Plans - specify		f.	$

g.	Charity		g.	$
h.	Wage Execution		h.	$
i.	Medical Reimbursement (flex fund)		i.	$
j.	Other:		j.	$

		TOTAL		$
5. NET YEAR-TO-DATE EARNED INCOME:				$
NET AVERAGE EARNED INCOME PER MONTH:				$
NET AVERAGE EARNED INCOME PER WEEK				$

4. Your Year-to-Date Gross Unearned Income From All Sources

(including, but not limited to, income from unemployment, disability and/or social security payments, interest, dividends,

rental income and any other miscellaneous unearned income)

Source	How often paid	Year to date amount
		$
		$
		$
		$
		$
		$
		$
		$
		$
TOTAL GROSS UNEARNED INCOME YEAR TO DATE		$

5. Additional Information:

1.	How often are you paid?
2.	What is your annual salary?	$
3.	Have you received any raises in the current year?		Yes	No
	If yes, provide the date and the gross/net amount.
4.	Do you receive bonuses, commissions, or other compensation, including distributions, taxable or non-		Yes	No
	taxable, in addition to your regular salary?
	If yes, explain:
5.	Does your employer pay for or provide you with an automobile (lease or purchase), automobile expenses,		Yes	No
	gas, repairs, lodging and other.
	If yes, explain.:

Revised to be effective September 1, 2017. CN: 10482 (Court Rules Appendix V)

Page 4 of 10

6.	Did you receive bonuses, commissions, or other compensation, including distributions, taxable or non-	Yes	No
	taxable, in addition to your regular salary during the current or immediate past 2 calendar years?
	If yes, explain and state the date(s) of receipt and set forth the gross and net amounts received:

7.	Do you receive cash or distributions not otherwise listed?	Yes	No
	If yes, explain.
8.	Have you received income from overtime work during either the current or immediate past calendar year?	Yes	No
	If yes, explain.
9.	Have you been awarded or granted stock options, restricted stock or any other non-cash compensation or	Yes	No
	entitlement during the current or immediate past calendar year?
	If yes, explain.
10.	Have you received any other supplemental compensation during either the current or immediate past calendar	Yes	No
	year?
	If yes, state the date(s) of receipt and set forth the gross and net amounts received. Also describe the nature
	of any supplemental compensation received.


11.	Have you received income from unemployment, disability and/or social security during either the current or	Yes	No
	immediate past calendar year?
	If yes, state the date(s) of receipt and set forth the gross and net amounts received.

12.List the names of the dependents you claim:

13.	Are you paying or receiving any alimony?	Yes	No
	If yes, how much and from or to whom?

14.	Are you paying or receiving any child support?	Yes	No
	If yes, list names of the children, the amount paid or received for each child and to whom paid or from whom
	received.


15.	Is there a wage execution in connection with support?	Yes	No
	If yes explain.
16.	Does a Safe Deposit Box exist and if so, at which bank?	Yes	No
17.	Has a dependent child of yours received income from social security, SSI or other government program	Yes	No
	during either the current or immediate past calendar year?
	If yes, explain the basis and state the date(s) of receipt and set forth the gross and net amounts received

18.Explanation of Income or Other Information:

Revised to be effective September 1, 2017. CN: 10482 (Court Rules Appendix V)

Page 5 of 10

Part D - Monthly Expenses (computed at 4.3 wks/mo.)

Joint Marital or Civil Union Life Style should reflect standard of living established during marriage or civil union. Current expenses should reflect the current life style. Do not repeat those income deductions listed in Part C – 3.

			Joint Life Style		Current Life Style
		Family, including				Yours and
				children			children
SCHEDULE A: SHELTER
If Tenant:
Rent		$			$
Heat (if not furnished)		$			$
Electric & Gas (if not furnished)		$			$
Renter’s Insurance		$			$
Parking (at Apartment)		$			$
Other charges (Itemize)		$			$
If Homeowner:
Mortgage		$			$
...........................Real Estate Taxes (if not included w/mortgage payment)		$			$
...........................Homeowners Ins. (if not included w/mortgage payment)		$			$
Other Mortgages or Home Equity Loans	......................................................	$			$
Heat (unless Electric or Gas)		$			$
Electric & Gas		$			$
Water & Sewer		$			$
Garbage Removal		$			$
Snow Removal	..............................................	$			$
Lawn Care		$			$
Maintenance/Repairs		$			$
..........................................................Condo, Co-op or Association Fees		$			$
Other Charges (Itemize)		$			$
Tenant or Homeowner:
Telephone		$			$
Mobile/Cellular Telephone		$			$
Service Contracts on Equipment		$			$
Cable TV		$			$
Plumber/Electrician		$			$
Equipment & Furnishings		$			$
Internet Charges		$			$
Home Security System	..............................................	$			$
Other (itemize)		$			$
	TOTAL	$			$
SCHEDULE B: TRANSPORTATION
Auto Payment		$			$
Auto Insurance (number of vehicles:	)	$			$
Registration, License		$			$
Maintenance		$			$
Fuel and Oil		$			$
Commuting Expenses		$			$
Other Charges (Itemize)		$			$
	TOTAL	$			$

Revised to be effective September 1, 2017. CN: 10482 (Court Rules Appendix V)

Page 6 of 10

SCHEDULE C: PERSONAL	Joint Life Style		Current Life Style
	Family, including			Yours and
		children			children
Food at Home & household supplies	$		$
Prescription Drugs	$		$
Non-prescription drugs, cosmetics, toiletries & sundries	$		$
School Lunch	$		$
Restaurants	$		$
Clothing	$		$
Dry Cleaning, Commercial Laundry	$		$
Hair Care	$		$
Domestic Help	$		$
Medical (exclusive of psychiatric)*	$		$
Eye Care*	$		$
Psychiatric/psychological/counseling*	$		$
Dental (exclusive of Orthodontic*	$		$
Orthodontic*	$		$
Medical Insurance (hospital, etc.)*	$		$
Club Dues and Memberships	$		$
Sports and Hobbies	$		$
Camps	$		$
Vacations	$		$
Children’s Private School Costs	$		$
Parent’s Educational Costs	$		$
Children’s Lessons (dancing, music, sports, etc.)	$		$
Babysitting	$		$
Day-Care Expenses	$		$
Entertainment	$		$
Alcohol and Tobacco	$		$
Newspapers and Periodicals	$		$
Gifts	$		$
Contributions	$		$
Payments to Non-Child Dependents	$		$
Prior Existing Support Obligations this family/other families
(specify)	$		$
Tax Reserve (not listed elsewhere)	$		$
Life Insurance	$		$
Savings/Investment	$		$
Debt Service (from page 7) (not listed elsewhere)	$		$
Parenting Time Expenses	$		$
Professional Expenses (other than this proceeding)	$		$
Pet Care and Expenses	$		$
Other (specify)	$		$
*unreimbursed only
TOTAL	$		$

Please Note: If you are paying expenses for a spouse or civil union partner and/or children not reflected in this budget, attach a schedule of such payments.

Schedule A: Shelter	$	$
Schedule B: Transportation	$	$
Schedule C: Personal	$	$
Grand Totals	$	$

Revised to be effective September 1, 2017. CN: 10482 (Court Rules Appendix V)

Page 7 of 10

Part E - Balance Sheet of All Family Assets and Liabilities

Statement of Assets

	Title to	Date of purchase/acquisition.		Date of
		If claim that asset is exempt,	Value $
Description	Property			Evaluation
		state reason and value of	Put * after exempt
	(P, D, J)1			Mo./Day/ Yr.
		what is claimed to be exempt

1.Real Property

2.Bank Accounts, CD’s (identify institution and type of account(s))

3.Vehicles

4.Tangible Personal Property

5.Stocks, Bonds and Securities (identify institution and type of account(s))

6.Pension, Profit Sharing, Retirement Plan(s), 40l(k)s, etc. (identify each institution or employer)

7.IRAs

8.Businesses, Partnerships, Professional Practices

9.Life Insurance (cash surrender value)

10.Loans Receivable

11.Other (specify)

TOTAL GROSS ASSETS: $

TOTAL SUBJECT TO EQUITABLE DISTRIBUTION: $

TOTAL NOT SUBJECT TO EQUITABLE DISTRIBUTION: $

1 P = Plaintiff; D = Defendant; J = Joint

Revised to be effective September 1, 2017. CN: 10482 (Court Rules Appendix V)

Page 8 of 10

Statement of Liabilities

	Name of
Description	Responsible	If you contend liability should	Monthly	Total	Date
Description	Party	not be shared, state reason	Payment	Owed	Date
	Party	not be shared, state reason	Payment	Owed
	(P, D, J)

1.Real Estate Mortgages

2.Other Long Term Debts

3.Revolving Charges

4.Other Short Term Debts

5.Contingent Liabilities

TOTAL GROSS LIABILITIES:	$
(excluding contingent liabilities)
NET WORTH:	$
(subject to equitable distribution)
TOTAL SUBJECT TO EQUITABLE DISTRIBUTION: $
TOTAL NOT SUBJECT TO EQUITABLE DISTRIBUTION:	$

Revised to be effective September 1, 2017. CN: 10482 (Court Rules Appendix V)

Page 9 of 10

Part F - - Statement of Special Problems

Provide a Brief Narrative Statement of Any Special Problems Involving This Case: As example, state if the matter involves complex valuation problems (such as for a closely held business) or special medical problems of any family member, etc.

Part G - Required Attachments

Check If You Have Attached the Following Required Documents

1. A full and complete copy of your last federal and state income tax returns with all schedules and attachments. (Part C-1)

2. Your last calendar year’s W-2 statements, 1099’s, K-1 statements.

3. Your three most recent pay stubs.

4. Bonus information including, but not limited to, percentage overrides, timing of payments, etc.; the last three statements of such bonuses, commissions, etc. (Part C)

5. Your most recent corporate benefit statement or a summary thereof showing the nature, amount and status of retirement plans, savings plans, income deferral plans, insurance benefits, etc. (Part C)

6. Affidavit of Insurance Coverage as required by Court Rule 5:4-2(f) (Part B-3)

7. List of all prior/pending family actions involving support, custody or Domestic Violence, with the Docket Number, County, State and the disposition reached. Attach copies of all existing Orders in effect. (Part B-5)

8. Attach details of each wage execution (Part C-5)

9. Schedule of payments made for a spouse or civil union partner and/or children not reflected in Part D.

10. Any agreements between the parties.

11. An Appendix IX Child Support Guideline Worksheet, as applicable, based upon available information.

12. If a request has been made for college or post-secondary school contribution, all relevant information pertaining to that request, including but not limited to documentation of all costs and reimbursements or assistance for which contribution is sought, such as invoices or receipts for tuition, board and books; proof of enrollment; and proof of all financial aid, scholarships, grants and student loans obtained. A list of the information as promulgated by the Administrative Director of the Courts can be found on the Judiciary website.

I certify that, other than in this form and its attachments, confidential personal identifiers have been redacted from documents now submitted to the court, and will be redacted from all documents submitted in the future in accordance with Rule 1:38-7(b).

I certify that the foregoing information contained herein is true. I am aware that if any of the foregoing information contained therein is willfully false, I am subject to punishment.

DATED:

SIGNED:

Revised to be effective September 1, 2017. CN: 10482 (Court Rules Appendix V)

Page 10 of 10

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Child’s Full Name

Person’s Name