New Jersey Judiciary form CN 10500. This walkthrough fills the
36 text fields; 12 checkbox(es) on the form are
left for you to mark after download.
This page covers the New Jersey Judiciary form titled “Civil Case Information Statement,” identified on the document as CN 10500 (Rules Appendix VII), revised 08/18/2025 to be effective 09/01/2025. Its heading reads “New Jersey Judiciary, Superior Court - Appellate Division.” The form itself runs four pages and is followed by two pages of instructions. Those instructions open: “Use the Civil Case Information Statement for Civil, Family, Tax Court or State Agency appeals. DO NOT use this form for Criminal appeals.”
The form is organized into twenty-one numbered boxes. Box 1 is the title in full, box 2 the trial court or agency docket number. Boxes 3 and 4 collect the appellant’s attorney and the respondent’s attorney, each with email address, name, client, street address, city, state, zip, and telephone with extension; box 3 also has checkboxes for “Plaintiff,” “Defendant,” and “Other (specify).”
Box 5 asks for the “date and summary of judgment, order, or decision being appealed.” Box 6 is a finality inquiry asking whether all issues have been disposed of as to all parties, including counterclaims, cross-claims, third-party claims and applications for counsel fees, and whether an order has been “properly certified as final pursuant to R. 4:42-2,” citing R. 2:2-4 and 2:5-6, and whether claims were dismissed without prejudice. Box 7 asks whether the validity of a statute, regulation, executive order, franchise or state constitutional provision is being questioned, citing R. 2:5-1(b)(4). Box 8 requests a brief statement of facts and procedural history; box 9 the proposed issues on appeal “as they will be described in appropriate point headings pursuant to R. 2:6-2(a)(6).”
Box 10 concerns oral or written findings by a trial judge sitting without a jury and any statement or opinion under R. 2:5-1(d). Boxes 11 through 14 ask about related or prior appeals and their Appellate Division docket numbers. Box 15 addresses the Civil Appeals Settlement Program (CASP), described on the form as screening for “potential for settlement or, in the alternative, a simplification of the issues.” Box 16 notes that the Judiciary posts all Appellate Division opinions on the Internet. Box 17 is a certification that confidential personal identifiers have been redacted “in accordance with Rule 1:38-7(b),” and boxes 18 through 21 are name, date and signature lines for the appellant or respondent and counsel of record.
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How this works & your privacy
⬇ Blank form in English (PDF) — The English form as published, blank, for printing and filling by hand.
⬇ Este formulario en español (PDF) — la versión oficial en español publicada por el Poder Judicial de Nueva Jersey.
This form in Spanish, as published by the New Jersey Judiciary.