How to Fill Out New Jersey Form CN-10075 (w/Examples) + FAQs

New Jersey Form CN-10075 is the Certification in Support of Application to Proceed as an Indigent (the fee-waiver certification) that pro se litigants and attorneys file with the New Jersey Judiciary to ask the court to waive filing fees, deposit requirements, and certain service-of-process costs in family, civil, and special civil part matters. The form works hand-in-hand with Rule 1:13-2, and a judge — not the clerk — decides whether the waiver is granted.

If you cannot afford the $300 divorce filing fee, the $250 civil complaint fee, or other court costs, this single sheet of paper is the difference between filing your case today and waiting weeks to save up. According to the New Jersey Judiciary’s annual report, more than 30,000 fee waiver applications are filed across the state each year, and a noticeable share are denied or delayed for missing income details on this exact form.

• 📝 How to complete every box on the current revision of CN-10075 line by line
• 💰 What income, expense, and public-benefit information you must disclose under oath
• ⚖️ How Rule 1:13-2 and N.J.S.A. 22A:2-5 shape what the judge looks for
• 🧾 Three full filled-out scenarios — divorce, domestic violence, and civil complaint
• 🚫 The most common mistakes that get a waiver request denied and how to avoid each one

What Form CN-10075 Is and Who Must File It

Form CN-10075 is a sworn certification — meaning you sign it under penalty of perjury under N.J.S.A. 2C:28-2 — telling the Superior Court of New Jersey that you cannot afford the fees normally required to file or defend a case. It is published by the Administrative Office of the Courts and is accepted in the Family Part, Civil Part, Special Civil Part, and Chancery Division. The form does not waive all costs — it waives statutory filing fees and certain deposits, but appellate fees, transcript costs, and private-process-server fees are handled separately.

You file CN-10075 if you are a pro se litigant (representing yourself) or an attorney filing on behalf of a client whose income falls within the indigency thresholds the court uses. Common filers include people opening divorce or custody cases, domestic violence survivors seeking civil relief beyond the TRO, tenants filing landlord-tenant counterclaims, plaintiffs in small-claims matters above the fee waiver auto-grant, and parents filing non-dissolution (FD) petitions. Attorneys handling Legal Services of New Jersey referrals attach this form to almost every complaint.

The form is required every time a new filing fee is triggered. That means a new certification when you file a motion that carries a $50 motion fee, and again if you appeal. One waiver granted at the trial level does not carry forward to the Appellate Division — that requires its own application under Rule 2:7-1.

Before You Start: Documents and Information You Need

Gathering the right paperwork before opening CN-10075 protects you from rejection. The judge reviews this certification looking for proof that the numbers you swear to are realistic, so the more concrete the documentation behind your answers, the faster the waiver is granted. New Jersey clerks routinely return forms that show a $0 income with no TANF or SNAP attached, because that combination raises a red flag for the reviewing judge.

• Government-issued photo ID. Driver’s license, non-driver ID, or passport. The clerk uses it to confirm the name on the certification matches the name on the underlying complaint.
• Most recent pay stubs (last 3 pay periods). These document the gross and net income figures you list. Missing stubs are the number one reason for a follow-up order to show cause.
• Most recent federal tax return (Form 1040). Required if you had income last year. The judge cross-checks the Adjusted Gross Income line against your stated household income.
• Public-benefit award letters. SNAP, TANF, SSI, WFNJ, Medicaid, or General Assistance letters. Filers receiving these benefits get a near-automatic waiver under Rule 1:13-2(a).
• Bank statements (last 60 days). All checking, savings, and money-market accounts. The court checks for undisclosed deposits that contradict your stated income.
• Monthly bill summaries. Rent or mortgage, utilities, food, transportation, insurance, child care, and medical. These feed the expense block on the form.
• Underlying complaint or motion. CN-10075 must be filed with the document the fees apply to — never alone.
• Social Security number. The form requires the last four digits in the caption block on most county versions.

If any of these are missing the day you walk into the courthouse, the clerk will still date-stamp your filing, but the judge can hold the waiver decision until you supplement the record. That hold pauses your underlying case as well.

Where to Get the Form and How to Access It

The official PDF lives on the New Jersey Judiciary’s forms library at the link for Form 10075. The form is fillable on screen using Adobe Acrobat or any modern browser PDF viewer, and the most recent revision is printed in the lower-left corner of page 1 — confirm you have the current version before signing. Older versions still circulate online and at some self-help centers, and using an outdated revision is grounds for the clerk to ask you to redo it.

You can also pick up paper copies at any county courthouse Ombudsman’s Office or family division intake window. Self-help kits — the divorce kit, the non-dissolution kit, and the domestic violence kit — already include CN-10075 inside them, so you do not need to download it separately if you are using a kit. Legal Services of New Jersey hotline volunteers will also email it on request.

For e-filing, CN-10075 uploads through the Judiciary Electronic Document Submission (JEDS) portal as a PDF attachment to your complaint. JEDS does not charge a filing fee at the upload step — the fee is assessed after the clerk reviews the submission, which gives the judge time to grant or deny the waiver before any charge hits your account.

Step-by-Step: How to Fill Out CN-10075 Line by Line

The form is two pages on the current revision. The top is the case caption, the middle holds the income, expenses, assets, and dependents blocks, and the bottom carries your sworn signature. Work top to bottom and never skip a line — write N/A where a question does not apply rather than leaving it blank, because blanks read as evasion to the reviewing judge.

Caption Box — County, Docket Number, and Case Title

The caption asks for the county of filing, the docket number, and the case title (your name v. the other party). In plain English, this is the same heading that appears on your complaint or motion. Type the county in all caps (ESSEX COUNTY), leave the docket number blank if you have not filed yet (the clerk fills it in), and use the format Smith v. Smith for the title.

For example, Maria Lopez filing for divorce in Hudson County writes HUDSON COUNTY as the county, leaves the docket line blank, and types Lopez v. Lopez as the title. If she had a previous FD docket from a child support case, that docket number does not go here unless this filing is a continuation of that case. The most common mistake on this field is reusing an old docket number from a separate matter, which causes the clerk to file the new complaint into the closed case folder. A misconception people carry is that the caption must be notarized — it does not, only the signature block does.

Part 1 — Applicant Identification

Part 1 asks for your full legal name, current address, date of birth, and last four digits of your Social Security number. In plain English, this is the who you are section, and the answers must match the ID you bring to the clerk. Write the name exactly as it appears on your driver’s license, use a deliverable mailing address (not a friend’s house unless you actually receive mail there), use MM/DD/YYYY for the birth date, and write only the last four SSN digits — never the full nine.

A specific example: Carlos Rivera, born March 14, 1985, living at 412 Grand Street, Apt. 3B, Jersey City, NJ 07302, writes 03/14/1985 and XXX-XX-1234. If you are unhoused, write General Delivery with the post office address that will hold mail for you, and add a phone number where the court can reach you. The most common mistake is writing the full Social Security number, which then sits in a public court file and creates an identity-theft risk. A misconception is that married filers must use their married name — you may use whichever name you legally use, even if it is your maiden name and the marriage certificate shows another.

Part 2 — Employment and Income

Part 2 asks for your employer name, job title, gross weekly or monthly pay, and all other sources of income including unemployment, Social Security, child support received, pensions, and rental income. In plain English, this is every dollar coming in from anywhere. List your current employer (or write Unemployed since [date]), state pre-tax pay, and itemize each other income stream on its own line.

For example, Aisha Johnson, a part-time home health aide earning $480 per week before taxes, also receives $194 monthly in SNAP and $300 monthly in child support. She writes Visiting Angels — Home Health Aide — $480/week gross on the employment line, then lists SNAP $194/month and Child support received $300/month as additional income. The biggest edge case is gig income — if you drive for DoorDash, report the average of your last 4 weeks of net deposits and attach a screenshot. The most common mistake is forgetting to list child support received as income, which appears on the bank statement the judge reviews and creates an inconsistency that gets the waiver denied. A common misconception is that cash tips don’t count — they do, and concealing them is perjury under N.J.S.A. 2C:28-2.

Part 3 — Monthly Expenses

Part 3 lists rent or mortgage, utilities, food, transportation, insurance, child care, medical, and other necessary expenses. In plain English, the court wants to see where the money goes each month. Round to the nearest dollar, use monthly figures (not weekly), and only include necessities — gym memberships and streaming services do not belong here.

A specific example: Janet Thompson, filing for divorce after a 22-year marriage, writes Rent: $1,650, Electric/Gas: $185, Food: $600, Car insurance: $145, Gas for car: $200, Medical co-pays: $80. The edge case to watch is shared expenses — if you split rent with a roommate, list only your share. The most common mistake is inflating expenses to make the budget look tighter, which the judge spots when totals exceed the bank statements. A misconception is that credit card minimums count as necessary expenses — they generally do not unless tied to medical debt.

Part 4 — Assets

Part 4 asks for cash on hand, bank account balances, vehicles owned, real property, and other assets over $1,000. In plain English, what do you own that you could sell or borrow against. List each account, its institution, and current balance, and describe vehicles by year/make/model with estimated value.

For example, Marcus Bell writes Checking — Bank of America — $312, Savings — none, 2011 Honda Civic — approximate value $4,500 — owe $0. Edge case: a jointly titled house with a non-filing spouse goes here with the note jointly owned with spouse, equity approximately $X. The most common mistake is omitting the car because it is old or financed — you must list it either way and let the judge weigh equity. A misconception is that retirement accounts must be liquidated to qualify — they do not, but you must disclose the balance.

Part 5 — Dependents

Part 5 lists every person who depends on your income, by first name, age, and relationship. In plain English, this is everyone you support. Include minor children, disabled adult children, an elderly parent in your household, and any other person whose food or shelter you provide.

For example, Aisha Johnson lists Jamal, 7, son and Layla, 4, daughter. The edge case is shared custody — list the child even if they are with you only half the time, and note the custody split. The common mistake is leaving off children who do not live with you full time, which understates your household size and makes your finances look better than they are. A misconception is that adult children in college never count — they do if you provide more than half their support.

Part 6 — Public Benefits

Part 6 asks whether you receive SNAP, TANF/WFNJ, SSI, General Assistance, Medicaid, or Section 8. Check every box that applies and attach the most recent award letter for each. In plain English, if the State already decided you are low-income, the court will usually accept that determination.

For example, Robert Kim, who receives SSI of $943 per month, checks the SSI box and attaches his SSA award letter. Edge case: if you applied but have not yet been approved, write Application pending — filed [date]. The common mistake is checking a box but forgetting to attach the letter, which forces the judge to issue a deficiency notice. A misconception is that receiving any benefit guarantees the waiver — it strongly favors approval but the judge still has discretion under Rule 1:13-2.

Part 7 — Certification and Signature

Part 7 is the sworn block: I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment. In plain English, you are swearing under oath. Sign in blue or black ink, print your name below, and date the signature using MM/DD/YYYY.

For example, Maria Lopez signs Maria Lopez, prints MARIA LOPEZ below, and dates it 05/23/2026. CN-10075 does not require a notary — the certification language replaces notarization under Rule 1:4-4(b). The common mistake is signing in pencil or having someone else sign for you, both of which void the certification. A misconception is that a typed signature is enough on a paper filing — wet ink is required for paper, while JEDS allows a typed /s/ Maria Lopez electronic signature.

Three Filled-Out Examples Using Real Scenarios

Scenario 1 — Maria Lopez, Divorce Filer in Hudson County

Maria has been separated for 14 months, works part-time at a daycare, and cannot afford the $300 divorce filing fee plus the $25 parenting workshop fee.

Form Section	What Maria Enters
County	HUDSON COUNTY
Case Title	Lopez v. Lopez
Full Legal Name	Maria Elena Lopez
Address	412 Grand Street, Apt. 3B, Jersey City, NJ 07302
Date of Birth	03/14/1985
Employer & Income	Bright Stars Daycare — Teacher Aide — $520/week gross
Monthly Expenses	Rent $1,400; Utilities $160; Food $500; Transit $120
Assets	Checking $230; 2008 Toyota Corolla, value $2,800
Dependents	Sofia, 6, daughter
Public Benefits	SNAP $235/month — letter attached
Signature	Maria Lopez — 05/23/2026

Scenario 2 — Jamal Carter, Domestic Violence Survivor in Essex County

Jamal received a TRO and is filing for the FRO hearing plus a related custody motion. He has fled with his two children and is staying at a shelter.

Form Section	What Jamal Enters
County	ESSEX COUNTY
Case Title	Carter v. Williams
Full Legal Name	Jamal D. Carter
Address	c/o Safe House Shelter, P.O. Box 992, Newark, NJ 07101
Date of Birth	11/02/1990
Employer & Income	Unemployed since 04/15/2026 — applied for WFNJ
Monthly Expenses	Shelter fee $0; Food $0 (shelter); Diapers/clothes $180
Assets	Cash on hand $40; no bank account; no vehicle
Dependents	Devon, 3, son; Aria, 1, daughter
Public Benefits	Medicaid — letter attached; WFNJ application pending
Signature	/s/ Jamal D. Carter — 05/23/2026 (filed via JEDS)

Scenario 3 — Robert Kim, Civil Plaintiff on SSI in Bergen County

Robert is suing a former contractor in Special Civil Part for $4,200 in unfinished work and cannot afford the filing fee.

Form Section	What Robert Enters
County	BERGEN COUNTY
Case Title	Kim v. Premier Renovations LLC
Full Legal Name	Robert J. Kim
Address	18 Maple Avenue, Hackensack, NJ 07601
Date of Birth	07/22/1958
Employer & Income	Retired — SSI $943/month — no other income
Monthly Expenses	Rent $900; Utilities $140; Food $300; Medical $120
Assets	Checking $415; no vehicle; no real property
Dependents	None
Public Benefits	SSI — SSA award letter attached; Medicare
Signature	Robert J. Kim — 05/23/2026

How to File the Completed Form

CN-10075 must be filed at the same time as the underlying complaint, motion, or appeal. You attach it as the very first page after the complaint or as a stapled cover document, and the clerk routes it to the assigned judge for a same-day or next-day decision in most counties. Never mail CN-10075 alone — it has no docket of its own.

• In person. Walk into the county courthouse family or civil intake window during business hours (typically 8:30 a.m. to 3:30 p.m.). No fee. Processing is usually same-day. Keep the date-stamped copy as your proof of filing.
• By mail. Send to the Superior Court Clerk of the filing county at the address listed on the Directory of Courts. No fee. Allow 7–10 business days. Use certified mail with return receipt as proof of filing.
• By JEDS (online). Upload at the JEDS portal as a PDF attachment to your complaint. No fee at upload. Processing is 1–3 business days. Save the JEDS confirmation email as proof of filing.
• By fax. Only accepted in limited emergent matters (e.g., domestic violence). Confirm the fax number with the county family division before sending. Keep the fax confirmation page as proof.

What Happens After You File

Once the clerk uploads CN-10075 to the case, the matter moves to the assigned judge for a Rule 1:13-2 review. The judge can grant the waiver outright, deny it, or order a brief hearing — called an ability-to-pay hearing — if the financial picture is unclear. Most waivers are decided on the papers within 1–5 business days.

If granted, the judge signs an Order Waiving Filing Fees and your underlying case proceeds without any payment. If denied, you receive a written order stating why, and you have 20 days to either pay the fee or file a motion for reconsideration with new financial information. If your finances change mid-case — you get a job, lose a job, or start receiving benefits — you must file an updated CN-10075 within a reasonable time, because the original waiver is conditional on the facts you swore to.

Mistakes to Avoid When Filling Out the Form

• Listing $0 income with no public benefits attached — the judge cannot verify how you live.
• Forgetting to list child support received as income — it shows up on bank statements and triggers a perjury concern.
• Writing your full Social Security number — it then sits in a public file.
• Inflating monthly expenses above what bank statements show — credibility collapses.
• Omitting a financed vehicle because you “don’t really own it” — you must disclose and let the judge weigh equity.
• Leaving boxes blank instead of writing N/A — blanks read as evasion.
• Reusing an old docket number from an unrelated case — the clerk files into the wrong folder.
• Signing in pencil or letting someone else sign — voids the certification.
• Submitting without the underlying complaint — CN-10075 has no standalone docket.
• Using an outdated revision of the form — the clerk asks you to redo it, delaying your case.
• Forgetting to attach benefit award letters after checking the box — triggers a deficiency notice.
• Failing to file an updated certification when income increases — risks sanctions and back-fees.

Do’s and Don’ts

• Do download the current revision directly from the Judiciary forms page — older versions float around online.
• Do attach every public-benefit award letter you reference — it speeds approval.
• Do round numbers to the nearest dollar — clean math reads as careful disclosure.
• Do keep a date-stamped copy — you will need it if the clerk loses the original.
• Do file an updated CN-10075 when your finances change — required under Rule 1:13-2.
• Do use the Ombudsman’s office if you are confused — they are free and trained on this form.
• Don’t sign before reviewing every line — the certification is sworn under N.J.S.A. 2C:28-2.
• Don’t hide assets, even small ones — undisclosed assets discovered later void the waiver.
• Don’t mail the form alone — it has no docket without the underlying complaint.
• Don’t assume one waiver covers your whole case — each new filing fee triggers a new certification.
• Don’t notarize the form — the certification language replaces notarization.
• Don’t wait until the deadline of your underlying case — give the judge time to review.

Pros and Cons of Filing on Your Own vs. With Help

• Pro — Free. Filing CN-10075 yourself costs nothing beyond your time.
• Pro — Fast. A pro se filer at the courthouse window can file the same day.
• Pro — Control. You set the financial picture in your own words.
• Pro — Privacy. Fewer hands touch your financial details.
• Pro — Educational. You learn the court system in a low-stakes filing.
• Con — Errors are common. Pro se filers omit income sources at much higher rates than represented filers.
• Con — No legal review. A small inconsistency you would not catch can sink the application.
• Con — Emotional load. Filling out a financial certification while in crisis is hard.
• Con — Limited recourse on denial. Without counsel, drafting a reconsideration motion is daunting.
• Con — Time off work. In-person filing means daytime hours at the courthouse.

A free alternative is calling the Legal Services of New Jersey hotline, which screens for income and walks eligible callers through the form at no cost.

Filing Channel Comparison at a Glance

Channel	What to Expect
In-person at courthouse	Same-day filing, paper original, immediate date-stamp
Mail (certified)	7–10 business day processing, return receipt as proof
JEDS e-filing	1–3 business days, electronic confirmation, no scanner needed for many filings
Fax (emergent only)	Limited to DV and emergent matters, county-specific number

FAQs

Do I need a notary to sign CN-10075?

No. The form contains a self-executing certification under Rule 1:4-4(b) and N.J.S.A. 2C:28-2, so a notary is not required. Wet ink on paper or a typed /s/ on JEDS suffices.

Does receiving SNAP automatically grant the waiver?

No. It strongly favors approval and is treated as presumptive proof of indigency, but the judge still reviews the full certification and retains discretion under Rule 1:13-2.

Can I file CN-10075 without a complaint already drafted?

No. The certification has no independent docket and must be filed together with the underlying complaint, motion, or appeal it supports.

Do I write my full Social Security number on the form?

No. Only the last four digits are required, and writing the full nine creates an identity-theft risk because the file becomes part of the public record.

Should I leave a question blank if it doesn’t apply to me?

No. Write N/A on every inapplicable line so the judge sees you read and considered the question rather than skipped it.

Does one waiver cover my whole case from start to finish?

No. Each new filing fee — motions, appeals, post-judgment applications — requires a fresh CN-10075 that reflects your current finances.

Do I list child support I receive in the income section?

Yes. Child support received is income for fee-waiver purposes and must be listed; omitting it creates a contradiction with your bank statements.

Can my attorney sign the form for me?

No. Only the applicant — the person whose finances are being certified — can sign Part 7, because the oath is personal under N.J.S.A. 2C:28-2.

Do I need to attach my tax return?

Yes. If you had income last year, attach the most recent Form 1040 so the judge can compare Adjusted Gross Income to the figures you wrote.

Is the JEDS upload free?

Yes. Uploading CN-10075 and the underlying complaint through JEDS costs nothing at the upload stage; any fee is assessed only after the waiver decision.

Will the other party see my financial information?

Yes. CN-10075 becomes part of the case file, so the opposing party and their attorney can view it once served, though SSN digits are limited.

Does a denial of my waiver dismiss my case?

No. A denial gives you 20 days to pay the fee or move for reconsideration, and your complaint stays on file with the date-stamped filing date.

What if I get a job after the waiver is granted?

Yes — you must update. File a new CN-10075 promptly because the original waiver was conditioned on the facts you swore to under Rule 1:13-2.

Can I list a P.O. Box as my address?

Yes. A P.O. Box, General Delivery address, or a shelter c/o address is acceptable as long as you receive mail there reliably.