Form Nj Cn 10482 PDF Details

Form Nj Cn 10482 is a form that taxpayers in the state of New Jersey use to file their state income tax return. The form can be filled out and submitted electronically or through the mail. The due date for Form Nj Cn 10482 is April 15th. There are a number of deductions and credits that can be taken on this form, so it's important to understand all of the instructions before filing. In order to file your state income tax return, you will need to have certain information handy, including your Social Security number, your total taxable income, and your New Jersey adjusted gross income.

Listed here, you can see a number of specifics about form nj cn 10482 PDF. There, you will locate the information regarding the document you intend to fill out, such as the likely time to complete it and also other data.

QuestionAnswer
Form NameForm Nj Cn 10482
Form Length10 pages
Fillable?No
Fillable fields0
Avg. time to fill out2 min 30 sec
Other namesnj case information statement, case information statement nj family, form nj family pdf, family part case information statement

Form Preview Example

Appendix V

Family Part Case Information Statement

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

OF

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

 

 

 

 

 

 

 

 

 

 

 

 

Custody

 

 

 

 

Date of Divorce, Dissolution of Civil

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Anticipated College/Post-

Birthdate of Other Party

Date of Marriage, or entry into

Civil Union

Secondary Education

or Domestic Partnership

 

 

Expenses

 

 

 

 

Date of Separation

Other issues (be specific)

 

 

 

 

 

 

 

 

 

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

 

Other Party’s Name

 

 

 

 

 

Street Address

 

City

 

State/Zip

 

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

Child’s Full Name

 

Address

 

Birthdate

 

Person’s Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

No

Other (explain)

 

 

 

 

 

 

 

 

 

 

 

 

Is Insurance available through Employment/Business?

Yes

 

No

 

 

 

 

 

Explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

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

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

Page 2 of 10

4. Additional Identification:

 

 

Confidential Litigant Information Sheet: Filed

Yes

No

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:

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)

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

$

 

$

 

$

 

$

 

$

 

$

 

$

 

$

 

$

 

$

 

$

 

$

 

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. ATTACH W-2 statements, 1099’s, Schedule C’s, etc., to show total income plus a copy of the most recently filed Tax Returns. (See Part G)

Check if attached:

Federal Tax Return

State Tax Return

W-2

Other

2. Present Earned Income and Expenses

 

 

Yours

 

Other Party

1. Average gross weekly income (based on last 3 pay periods –

$

 

$

(if known)

 

 

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.

S.U.I.

Other

 

 

 

 

 

 

 

 

 

 

 

3.

Net average weekly income (1 - 2)

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

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.

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

SCHEDULE A: SHELTER

 

 

 

 

children

 

 

 

children

 

 

 

 

 

 

 

 

 

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)

 

 

$

 

 

$

 

 

SCHEDULE B: TRANSPORTATION

 

TOTAL

$

 

 

$

 

 

 

 

$

 

 

$

 

 

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

Food at Home & household supplies

 

 

 

children

 

 

 

children

 

$

 

 

 

$

 

 

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

Description

If claim that asset is exempt,

Value $

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

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)

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