Form 12770 "Landlord Case Information Statement (Lcis)" - New Jersey

What Is Form 12770?

This is a legal form that was released by the New Jersey Judiciary Court System - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 30, 2021;
  • The latest edition provided by the New Jersey Judiciary Court System;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 12770 by clicking the link below or browse more documents and templates provided by the New Jersey Judiciary Court System.

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Download Form 12770 "Landlord Case Information Statement (Lcis)" - New Jersey

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Side 1
New Jersey Judiciary
Civil Practice Division
Landlord Case Information Statement
(LCIS)
Caption
County of Venue
Docket Number
Name of Plaintiff/Landlord
Email Address
Home/Office Phone
Cell Phone
ext.
Attorney Name (if applicable)
Firm Name (if applicable)
Email Address
Office Phone
Cell Phone
ext.
Attorney/Plaintiff Mailing Address
Name of Defendant(s)/Tenant(s)
Email Address (if known)
Daytime Phone
Cell Phone
ext.
Rental Property Address
Municipal Code (*)
Rental Property Is Owner Occupied
Yes
No
The information provided on this form cannot be introduced into evidence
Type of Tenancy (select only one)
Cause of Action (select all that apply)
Holdover Cause of Action
(select from list on side 2)
Residential
Commercial
Non-Payment
Other (Holdover/For Cause)
Select all that apply to the rental property:
Subsidized Housing.
Type: ☐ Public Housing
☐ Section 8 Voucher
☐ Section 8 HAP Contract
☐ Other Subsidy Program
Notice(s) that are required for Holdover, Public Housing and/or Subsidized Housing are attached to the complaint.
Rental property is not a covered property under the Federal CARES Act, 15 U.S.C. § 9057(f) or 9058(a).
The tenancy is subject to a municipal rent control ordinance.
The total number of months of unpaid rent is:
The first month of unpaid rent was (please provide month and year):
The amount due and owing by the tenant in this case is:
$
I certify that 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 statements made by me are true to the best of my knowledge. I am aware that if any of the
foregoing statements made by me are willfully false, I am subject to punishment.
Attorney/Plaintiff Signature
Print Attorney/Plaintiff Name
Date
/
S
Municipality Codes can be found at
https://www.njcourts.gov/forms/11343_municodes.pdf
Promulgated by 07/30/2021 Notice to the Bar, CN 12770
page 1 of 2
Print
Clear
Side 1
New Jersey Judiciary
Civil Practice Division
Landlord Case Information Statement
(LCIS)
Caption
County of Venue
Docket Number
Name of Plaintiff/Landlord
Email Address
Home/Office Phone
Cell Phone
ext.
Attorney Name (if applicable)
Firm Name (if applicable)
Email Address
Office Phone
Cell Phone
ext.
Attorney/Plaintiff Mailing Address
Name of Defendant(s)/Tenant(s)
Email Address (if known)
Daytime Phone
Cell Phone
ext.
Rental Property Address
Municipal Code (*)
Rental Property Is Owner Occupied
Yes
No
The information provided on this form cannot be introduced into evidence
Type of Tenancy (select only one)
Cause of Action (select all that apply)
Holdover Cause of Action
(select from list on side 2)
Residential
Commercial
Non-Payment
Other (Holdover/For Cause)
Select all that apply to the rental property:
Subsidized Housing.
Type: ☐ Public Housing
☐ Section 8 Voucher
☐ Section 8 HAP Contract
☐ Other Subsidy Program
Notice(s) that are required for Holdover, Public Housing and/or Subsidized Housing are attached to the complaint.
Rental property is not a covered property under the Federal CARES Act, 15 U.S.C. § 9057(f) or 9058(a).
The tenancy is subject to a municipal rent control ordinance.
The total number of months of unpaid rent is:
The first month of unpaid rent was (please provide month and year):
The amount due and owing by the tenant in this case is:
$
I certify that 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 statements made by me are true to the best of my knowledge. I am aware that if any of the
foregoing statements made by me are willfully false, I am subject to punishment.
Attorney/Plaintiff Signature
Print Attorney/Plaintiff Name
Date
/
S
Municipality Codes can be found at
https://www.njcourts.gov/forms/11343_municodes.pdf
Promulgated by 07/30/2021 Notice to the Bar, CN 12770
page 1 of 2
Side 2
Landlord Case Information Statement
(LCIS)
Holdover Causes of Action
(Enter number(s) in appropriate space on side 1.)
Residential Tenancy
1 Disorderly Tenant
N.J.S.A. 2A:18-61.1(b)
2 Willful or Gross Negligent Damage to Premises
N.J.S.A. 2A:18-61.1(c)
3 Violation of Rules and Regulations
N.J.S.A. 2A:18-61.1(d)
4 Violation of the Lease Covenants
N.J.S.A. 2A:18-61.1(e)
5 Violation of the Lease Covenants Under the Control of a Public Housing Authority or Redevelopment
N.J.S.A. 2A:18-61.1(e)
Agency
6 Failure to Pay Rent After Increase
N.J.S.A. 2A:18-61.1(f)
7 Demolish/Board Up Premises
N.J.S.A. 2A:18-61.1(g)
8 Permanently Retiring Residential Building/Mobile Home Park from Residential Use
N.J.S.A. 2A:18-61.1(h)
9 Reasonable Changes to Lease at End of Lease Term that Tenant Refuses to Accept
N.J.S.A. 2A:18-61.1(i)
10 Habitual Late Payment of Rent
N.J.S.A. 2A:18-61.1(j)
11 Converting Property to Condominium or Cooperative Ownership
N.J.S.A. 2A:18-61.1(k)
12 Personal Occupancy by Owner or Purchaser of Unit (property converted to condo/cooperative or fee
N.J.S.A. 2A:18-61.1(l)(1)
simple ownership)
13 Personal Occupancy by Owner or Purchaser of Unit (owner of a building with 3 or fewer
N.J.S.A. 2A:18-61.1(l)(2)
condo/cooperative units.
14 Personal Occupancy by Owner or Purchaser of Unit (building with 3 or fewer residential units)
N.J.S.A. 2A:18-61.1(l)(3)
15 Rental is Conditioned on Tenant’s Employment by Landlord
N.J.S.A. 2A:18-61.1(m)
16 Convicted or Pleaded Guilty to Offenses under the 1987 Comprehensive Drug Reform Act, or Harbors
N.J.S.A. 2A:18-61.1(n)
such Person
17 Convicted or Pleaded Guilty to Assault/Threats against Landlord, Landlord’s Family or Employee, or
N.J.S.A. 2A:18-61.1(o)
Harbors such Person
18 Tenant or Tenant Harbors such Person previously found Liable in a Civil Action for Certain Criminal
N.J.S.A. 2A:18-61.1(p)
Acts on the Rental Premises
19 Tenant or Tenant Harbors Such Person who pleaded or was convicted of theft of property from the
N.J.S.A. 2A:18-61.1(q)
Landlord, the Rental Premises, or Other Tenants
20 Tenant or Tenant Harbors such Person previously found Liable in a Civil Action for Human Trafficking
N.J.S.A. 2A:18-61.1(r)
on the Rental Premises
21 Residents at Residential Health Care Facilities (non-payment or holdover)
N.J.S.A. 30:11A-1 et.
seq.
Commercial Tenancy; Owner-Occupied Premises with Two or Less Residential Units; Rental Unit Held in Trust
on behalf of Immediate Family Member Who Permanently Occupies the Unit not Developmentally Disabled
22 Tenant Stays after Expiration of Lease Term
N.J.S.A. 2A:18-53
23 Tenant Disorderly as to Destroy Peace and Quiet
N.J.S.A. 2A:18-53
24 Tenant Willfully Destroys, Damages or Injures the Premises
N.J.S.A. 2A:18-53
25 Tenant Constantly Violates Landlord’s Written Rules and Regulations
N.J.S.A. 2A:18-53
26 Tenant Breaches/Violates any Agreement in Lease that Provides for Right of Reentry
N.J.S.A. 2A:18-53
27 Violation of Alcoholic Beverages Laws by Commercial Tenant
N.J.S.A. 33:1-54
Promulgated by 07/30/2021 Notice to the Bar, CN 12770
page 2 of 2
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