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Tenants Affidavit in Support of Application for Protected Tenancy Status

A tenant applying for a protected tenancy status must subject herself/himself to a third party authentication of the information and documents that s/he submitted to the administrative agent. To declare her/his consent to the verification process, tenant must execute this affidavit.Download

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Notice to All Municipal Clerks  
& 
 Administrative Agents 	
 
Due to the recent surge in condominium conversions in New Jersey, the Landlord-Tenant 
Information Service would like to take this opportunity to remind all municipal clerks and 
administrative agents about their responsibilities under the Condominium Conversion, and 
Senior and Disabled Protected Tenancy Laws of New Jersey.   This correspondence is meant to 
provide a general overview of what administrative agents need to know to properly administer 
the Protected Tenancy Laws.  It is not a complete narration of the laws.  Please refer to the laws 
and regulations concerning condominium conversions and protected tenancy for the entire text of 
the laws.  
 
Condominium Conversions 
Prior to filing the application for registration of conversion with the Planned Real Estate 
Development Office (PRED), the owner must notify the administrative agent of his intent to file 
for the application.   (N.J.S.A. 2A:18-61.27)  After the landlord has registered with the PRED 
office to convert a building to condominium units, the administrative agent should expect to 
receive from the landlord a “notice of intent” and a “full plan of conversion.”  (N.J.A.C. 5:24-
1.3) The owner/sponsor must also serve the tenants with the notice of intent and full plan of 
conversion.  The landlord is required to supply a copy of the New Jersey Administrative Code, 
title 5, chapter 24, subchapter 1, to all tenants of the building being converted as a part of the 
notice of intent to convert and full plan of conversion. (N.J.A.C. 5:24-1.11) 
 
If the landlord intends to evict the tenants due to the conversion, he must serve them with a three 
year notice to quit, 60 days after the notice of intent and full plan of conversion have been served 
on the tenants.  (N.J.A.C. 5:24-1.3)  If it is a non-eviction, meaning the landlord does not intend 
to evict the tenants based on the conversion, the landlord will not serve the tenants with a notice 
to quit, nor will the tenants be eligible to apply for protected tenancy status.  
 
Pre-Conversion tenants that have received a three year notice to quit have the right to request 
comparable housing from their landlord.  This form should be included in the packet sent to the 
administrative agent from the landlord.   The administrative agent must forward this to the 
residence along with the other forms in the packet.   However, the administrative agent is not 
responsible for ensuring that comparable housing is offered.  This matter would be addressed in 
any ensuing eviction action.  In addition, pre-conversion tenants that have received their three 
year notice to quit shall receive a moving expense in the form of a waiver of one month’s rental 
payment from the landlord.  (N.J.A.C. 5:24-1.8)  (Again this provision is enforced by the Court 
not the administrative agent) 
 
Administrative Agent or Agency 
The governing body of the municipality may authorize a municipal board, agency or officer to 
act as its administrative agency to administer the Protected Tenancy Acts or may enter into a 
contractual agreement with a county office on aging or similar agency to act as its administrative 
agency.  If there has been no authorization or agreement the Protected Tenancy Acts shall be 
administered by the municipal Rent Leveling Board or Rent Control Board.  If the municipality 
does not have such a board, the municipal clerk must administer the acts.  (N.J.S.A. 2A:18-
61.26)

Senior and Disabled Protected Tenancy 
Prior to filing the application for registration of conversion with the Planned Real Estate 
Development Office, the owner must notify the administrative agent of his intent to file for an 
application for registration of a condominium conversion.   (N.J.S.A. 2A:18-61.27)  In addition 
the owner must supply the administrative agent with a list of every tenant residing in the 
premises along with stamped envelopes addressed to each tenant, and sufficient copies of the 
notice (Forms T-2 and/or T-3) tenants and application forms for protected tenancy status.  
 
Within 10 days thereafter the administrative agent shall notify each residential tenant in writing 
of the owner’s intention to convert and evict, and the applicability of the Senior and Disabled 
Protected Tenancy Act.   Within two business days of mailing these notices the administrative 
agent must provide the owner and the Landlord-Tenant Information Service with an affidavit or 
certification of mailing.  (N.J.A.C. 5:24-2.10(b)) 
 
A tenant seeking protected tenancy status must file a completed application form with the 
administrative agency within 60 days of receipt of the notice and application form from the 
administrative agency.  However, a completed application form may be submitted at any time 
prior to the conversion recording if the administrative agent is satisfied that there was a 
reasonable cause for the delay in filing the application. (N.J.A.C. 5:24-2.3)  
 
Pursuant to N.J.S.A. 2A:18-61.28, within 30 days after receipt of an application for protected 
tenancy status by a tenant, the administrative agent shall make a determination of eligibility and 
send written notice of the determination of eligibility or ineligibility to the tenant.  Within two 
business days of having mailed all notices of determination of eligibility to all applicants who 
filed during the 60 day period, the administrative agent must notify the Landlord Tenant 
Information Service and the owner of the determinations for protected tenancy status and include 
an affidavit or certification by the person who mailed the notices.  (N.J.A.C. 5:24-2.10 (c))    Any 
determinations subsequent to that should be sent as necessary. The address for the Landlord-
Tenant Information Service is P.O. Box 805, Trenton, New Jersey 08625-0805. 
 
Please note that the administrative agency making the determinations for protected 
tenancy status is responsible for maintaining the protected tenancy determinations on 
record for 40 years or the length of the protected tenancy status which ever is longer.   
 
Administrative Hearings (N.J.A.C. 5:24-2.7) 
Administrative agents must advise all applicants for protected tenancy status of their right to a 
hearing to aggrieve any agency determinations and the requirements for filing for such a hearing. 
Any person aggrieved by any determination of an administrative agency shall be entitled to an 
administrative hearing before the agency or agent.   Application for an administrative hearing 
shall be made within 10 days of receipt of the determination.  Administrative hearings shall be 
held within 10 days of application, except in extenuating circumstances.  Any notice of 
administrative hearings shall be given to all interested parties.     
 
Condominium Packet  
Attached is a list of relevant laws and a condominium packet containing instructions and forms 
to be used by the owner/sponsor, tenants and administrative agent in application of the 
condominium conversion, protected tenancy and eviction laws as they pertain to protected 
tenancy for tenants in condominium conversions.  You may request a copy of the Condominium 
Packet by e-mailing the Landlord-Tenant Information Service at LTInfo@dca.state.nj.us or by 
writing us at  P.O. Box 805, Trenton, New Jersey 08625-0805.

Relevant Laws 	
 
 	
1.  Condominium, Fee Simple and Cooperative Conversion and Mobile Home Park Retirement   
Regulations, N.J.A.C. 5:24-1 through 5:24-1.12. 
 
2.  Senior Citizens and Disabled Protected Tenancy Regulations, N.J.A.C. 5:24-2.1 through 5:24-	
2.11. 
 
3.  Protected Tenancy in Qualified Counties Regulations, N.J.A.C. 5:24-3.1 through 5:24-3.4. 	
 
4.  Condominium and Cooperative Conversion Law, N.J.S.A. 2A:18-61.7 through 61.21. 
 
5.  Senior Citizens and Disabled Protected Tenancy Law, N.J.S.A. 2A:18-61.22 through  
      61.39. 
 
6.  Tenant Protection Law of 1992, N.J.S.A. 2A:18-61.40 through 2A:18-61.65.

Instruction Sheet and Checklist for Administrative Agents 	
 	
Owners Must Submit the following forms to the Administrative Agent/Agency 
The owner must provide the Administrative Agent for the municipality with a Notice of Intent to Convert, A 
Full Plan of Conversion, and the names and addresses of all tenants residing in the building being converted.  
The owner must also provide enough copies for every tenant of each of the following forms provided by the 
Department of Community Affairs along with unsealed, stamped envelopes addressed to each tenant: 
□ 	Instruction Sheet and Checklist for applying for Sr. and Disabled Protected Tenancy and Protected Tenancy; 	
□ 	Rights of Tenants in Condominium Conversion, Pre Conversion Tenants (T-1); 	
□ 	“Notice” (Form T-2 (Sr. and Disabled Tenants) & Form T-3 (Protected Tenancy for Hudson County 
residents only)); 	
□ 	Application (Form T-4); 	
□ 	Tenant Affidavit (Form T-5); 	
□ 	Tenant Notification Requirement; (Form T-6); 	
□ 	Income eligibility List (Form T-7 (Sr. and  Disabled Tenants) & Form T-8 (Protected Tenancy for Hudson 
County residents only)); 	
□ 	Comparable Housing Request	 (Form T-9); 	
□ 	Condominium and Cooperative Conversion Regulations; 	
□ 	Senior Citizens and Disabled Protected Tenancy Regulations; 	
□ 	Protected Tenancy in Qualifying Counties Regulations (Hudson County residents only). 
 
Administrative Agents Instructions for filling out Tenants’ Forms 	
 
Notice (Form T-2  and T-3 ) 
□ 	Insert name of municipality where indicated 	
□ 	Insert current income figures for the relevant county where indicated use form T-7 or T-8  	
□ 	Insert date as indicated (allowing 60 days to apply for protected tenancy status) 	
□ 	Insert the name and address of the administrative agent/agency as indicated	 
□ 	
Insert the administrative agent’s/agency’s phone number as indicated 
 
Application (Form T-4)  	
□ 	Insert the name and address of the administrative agent/agency as indicated in Part C 	
□ 	Insert the administrative agent’s/agency’s phone number as indicated in Part C 
 
Optional Administrative Agency Forms provided by the Department of Community Affairs.   	
You may use the forms listed below when administering your duties under the Senior and Disabled Protected 
Tenancy Act and Protected Tenancy Act of 1992. 
□ 	Letter to Tenant from Administrative Agent (A-1)

□ 	Letter to Tenant Requesting Additional Information (A-2) 	
□ 	Eligibility Letter Granting Protected Tenancy Status or Conditional Eligibility (A-3) 	
□ 	Denial Letter Denying Protected Tenancy Status (A-4) 	
□ 	Right To a Hearing Notice (A-5) 	
□ 	Application for an Administrative Hearing to Aggrieve Protected Tenancy Determination (A-6) 
 
Letter to Tenant from Administrative Agent (Form A-1) 	
□ 	Use as a cover letter when sending out Protected Tenancy Packets to Tenants 
 
Letter to Request Additional Information (Form A-2) 	
□ 	Fill in appropriate information and send to tenant 
 
Eligibility Letter (Form A-3) and Denial Letter ( Form A- 4)  	
□ 	check off the appropriate determination, fill out the remainder of the letter and sign 	
□ 	send a copy of the Comparable Housing Request Form with all denial letters 
 
Right to a Hearing (Form A-5)  	
□ 	Insert name, address & telephone number of the hearing officer or administrative agent/agency as indicated 	
□ 	Be sure to send this form with all denial letters 
  
Application for an Administrative Hearing to Aggrieve Protected Tenancy Determination (Form A-6) 	
□ 	Insert name, address & telephone number of the hearing officer or administrative agent/agency as indicated 	
□ 	Be sure to send this form with all denial letters 
 
 
Administrative Agents may obtain complete Condominium Conversion packets from the: 
Department of Community Affairs 
Landlord-Tenant Information Service 
Post Office Box 805 
Trenton, New Jersey 08625

A-1          
   
    
 
       Date: 
 
 
 
 
 
 
 Re: 
 
 
Dear Tenant, 
 
The owner of your residential building has notified me of his intent to convert the above 
referenced property to a condominium.  I have enclosed a protected tenancy packet for your 
information and use which includes: 
 
a.  Instruction Sheet and Checklist for Applying for Senior and Disabled Protected Tenancy 
and (Protected Tenancy for Hudson County Residents Only); 
b.  Rights of Tenants in Condominium Conversions;  
c.  “Notice” of Intent to Convert; 
d.  Application for Senior Citizen and Disabled Protected Tenancy and (Protected Tenancy 
for Hudson County Residents Only); 
e. Tenant’s Affidavit; 
f.  Tenant Notification Form;  
g.  Income Figures for Senior and Disabled Protected Tenancy;  
h.  Income Figures for Protected Tenancy (Hudson County Residents Only); 
 i.  Comparable Housing Request Form; 
 j.  Regulations for Condo Conversions – N.J.A.C. 5:24-1.1 et seq.; 	
k.  Regulations for Senior and Disabled Protected Tenancy – N.J.A.C. 5:24-2.1 et seq.; 
 l.   Regulations for Protected Tenancy (Hudson County Residents only) - N.J.A.C. 5:24-3.1 	
et seq. 
 
You may be eligible for senior citizen or disabled protected tenancy status if you fall within 
the income eligibility requirements and the building has been your principal residence for a least 
one year and: 
 
1)   you are at least 62 years of age or soon will be 62; or 
2)   you are disabled. 
 
You may be eligible for protected tenancy status for qualifying counties (Hudson County 
only) if: 
 
1) the building has been your principal residence for at least one year; 
2) and you fall within the income eligibility requirements.

A-1          
   
    
You automatically qualify for protected tenancy under the Tenancy Protection Act of 
1992 if you are a Hudson County resident who is disabled or 75 years of age or older.    
However, you must submit the enclosed application to be granted protected tenancy status. 
 
A tenant may be considered to be disabled if the tenant is totally and permanently unable 
to engage in any substantial gainful activity by reason of any medically determined physical or 
mental impairment, including blindness, or a person who has be honorably discharged from 
military service who is rated as having a 60% disability or higher as a result of that service.  
 
If you would like to apply for protected tenancy, follow the instructions and return the 
application and other required documents as indicated on the enclosures.  
 
NOTE:  IF YOU DO NOT QUALIFY FOR SENIOR AND DISABLED PROTECTED 	
TENANCY OR PROTECTED TENANCY FOR HUDSON COUNTY, YOU ARE 
ENTITLED TO COMPARABLE HOUSING. USE THE COMPARABLE 
HOUSING REQUEST FORM (T-9) TO REQUEST COMPARABLE HOUSING.  
        
 
Sincerely,  
 
             
       ____________________________________ 
       Administrative Agent 
 
 
Enclosures

A-2 
        Date: 
 
Tenant’s Address 
 
 
 
 
 
 Re: 
 
 
Dear Tenant: 
 
We have received your application(s) for protected tenancy status.  However, it can not be 
processed until we receive the following checked items: 
 	
□	  Birth Certificate 	
 □	  Proof of Social Security Benefits (i.e. Certificate of Entitlement) 	
□	  Proof of Disability (i.e. Certification of Physician) 	
 □ 	Proof of Income (W-2) 	
□	  Copy of New Jersey Income Tax Return 	
 □ 	Other ____________________________________________________________________ 
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________ 
 
Please send the above requested items within 10 days of receipt of this letter to: 
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________ 	
  	(Insert address and telephone number for the administrative agency) 	
 
If you have any questions, please contact:  
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

A-3 
       Date: 
 
Tenant’s Name & Address 
 
 
 
 
 
Re: 
 
 
Dear Tenant: 
 
Based on the information you submitted with your application for protected tenancy and in 
accordance with the Senior Citizen and Disabled Protected Tenancy Law, N.J.S.A. 2A:18-
61.22 et seq.  and/or the Tenant Protection Act (for Hudson County residents only), 
N.J.S.A. 2A:18-61.40 et seq., I hereby render the following determination: 
 	
□	  Protected Tenancy Status is granted under the Senior Citizen and Disabled 
Protected Tenancy Act. 	
□	  Protected Tenancy Status is granted under the Tenant Protection Act. 	
□	  You are conditionally eligible for protected tenancy status under the Senior 
Citizen and Disabled Protected Tenancy Act or the Tenant Protection Act (Hudson 
county residents only) for the following reason(s): 
_________________________________________________________________________________ 	
 ______________________________________________________ 
 
You will automatically become eligible for protected tenancy status when you turn 
62 years old or 75 years old (Hudson residents) on ____________________  provided 
the conversion recording occurs after this date.     	
(date)	 	
 
  You will automatically become eligible for protected tenancy status when you meet 
the one year principal residency requirement on _______________________  provided 
the conversion recording occurs after this date.             	
(date)	         	     	 
  	
 	
If you have any questions, please contact me at ______________________________. 
          	
(insert your phone number here) 	
 
Sincerely,  
 
        ____________________________________ 
Administrative Agent 
 
c. Owner/sponsor 
 
“YOU HAVE THE RIGHT TO REVIEW, AT THIS OFFICE, ANY DOCUMENTATION UPON 
WHICH THIS DETERMINATION WAS BASED WITHIN FIVE DAYS OF YOUR RECEIPT 
OF THIS NOTICE.”

A-4 
       Date: 
 
Tenant’s Name & Address 
 
 
 
 
Re: 
 
 
Dear Tenant: 
 
Based on the information you submitted with your application for protected tenancy and in 
accordance with the Senior Citizen and Disabled Protected Tenancy Law, N.J.S.A. 2A:18-
61.22 et seq., and the Tenant Protection Act (for Hudson County residents only), N.J.S.A. 
2A:18-61.40 et seq., I hereby render the following determination: 	
□	  Protected Tenancy Status is denied under the Senior Citizen and Disabled 
Protected Tenancy Act for the following reason(s): 
 
□	  Income is over the County Limit  	
□	  Not the applicant’s principal place of residence 	
□	  Applicant failed to provide the requested documentation 	
□	  Other _______________________________________________________________________ 	
*This office will automatically review your application to determine if you qualify for 
protected tenancy under the Tenant Protection Act.  (Hudson County Residents Only) 
 	
□	  Protected Tenancy Status is denied under the Tenant Protection Act for the 
following reason(s) 
□	  Income is over the County Limit  
 	
□	  Not the applicant’s principal place of residence 	
□	  Applicant failed to provide the requested documentation 	
□	  Other  ______________________________________________________________________ 
 
If you have any questions you may contact me at  ________________________________________. 
   	
           (insert your phone number here) 
 	
Sincerely,  
 
        ________________________________________________ 
Administrative Agent 
 
c. Owner/Sponsor 
“YOU HAVE THE RIGHT TO REVIEW, AT THIS OFFICE, ANY DOCUMENTATION UPON 
WHICH THIS DETERMINATION WAS BASED WITHIN FIVE DAYS OF YOUR RECEIPT 
OF THIS NOTICE.”

A-5 	
 
Right To A Hearing 
 	
“The owner/sponsor and the tenant have a right to review at this office, any 
documentation upon which this determination is based within five days of 
receipt of this notice.” 
 
The owner/sponsor and the tenant have a right to appeal the determination of 
the agent/agency granting or denying Senior Citizen or Disabled Protected 
Tenancy Status and/or  Protected tenancy status for Hudson County residents. 
 
The landlord/sponsor and the tenant have the right to file for a hearing to 
aggrieve this determination.  The application for a hearing must be filed, 
together with any required filing fees and other documents, within 10 days of 
receipt of the determination notice.  
 
The application for a hearing must include a statement setting forth the legal 
or factual basis for the appeal.  
 
The application for a hearing to appeal the determination must be filed with the 
following person at the following address: 
 
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________ 	
(insert the name and address of the hearing officer or administrative agent/agency) 	
 
If you are 75 years of age or older and a resident of Hudson County you 
automatically qualify for Protected Tenancy under the Tenant Protection 
Act.   
 
If you do not qualify for protected tenancy status, see the Pre-Conversion 
Tenant’s Rights Handout included in this packet for your rights.  
 
You have the right to request comparable housing.  You may do so by 
filling out and returning the Comparable Housing Request Form to your 
landlord.

A-6 	
 
Application for an Administrative Hearing To Aggrieve  	
Protected Tenancy Determination 	
 
Name of Person Filing Grievance: ______________________________________________ 
 
Street Address:   ______________________________________________________________ 
 
Apartment number:  __________________________________________________________ 
 
City:  _____________________________________  State:  ___________________________ 
 
Zip Code:  __________________  County:  _______________________________________ 
 
Home phone:  ____________________    Work phone:  ____________________________ 
 
Name of Building or Project (if any): ___________________________________________ 
 
Are you the tenant applicant?  _________   
Are you the Owner/Sponsor?  _________ 
Other ? _______________, please explain _______________________________________ 
 
I am grieving the determination of (circle one) eligibility/ineligibility made by the 
Administrative Agent on ___________________ for (circle all that apply) Senior 
Citizen and Disabled Protected Tenancy Status/Protected Tenancy Status (for 
Hudson County residents only) for the following tenant: 
 
Tenant’s Name:  ______________________________________________________________ 
 
Street Address:   ______________________________________________________________ 
 
Apartment number:  __________________________________________________________ 
 
City:  _____________________________________  State:  ____________________________ 
 
Zip Code:  __________________  County:  ________________________________________ 
 
All applications for an administrative hearing must be made within 10 days 
of receipt of your determination notice.  The application must include a 
statement setting forth a factual or legal basis for this grievance.   Please 
attach your statement to this application and forward it along with any 
relevant documentation and applicable fees to: 	
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________         
(insert address and telephone number of hearing officer of administrative agent/agency)

Instruction Sheet and Checklist for Owners/Sponsors 	
 	
When an owner/sponsor seeks to convert a building from the rental market to a condominium or cooperative he 
or she must comply with the Condominium and Cooperative Conversion, Protected Tenancy, and Eviction 
statutes and regulations for the State of New Jersey. 
 
Notices to Tenants 
Pursuant to the Condominium and Cooperative Conversion law, the owner must provide each tenant with a 
copy of the following documents: 
□ 	60 Day Notice of Intent to Convert;  	
□ 	Full Plan of Conversion. 
 
Required Forms and Documents Concerning Tenants Rights  	
The owner/sponsor must provide the Administrative Agent for the municipality with a Notice of Intent to 
Convert, A Full Plan of Conversion, and the names and addresses of all tenants residing in the building being 
converted.  The owner/sponsor must also provide enough copies for every tenant of each of the following forms 
provided by the Department of Community Affairs along with unsealed, stamped envelopes addressed to each 
tenant: 
□ 	Instruction Sheet and Checklist for applying for Sr. and Disabled Protected Tenancy and Protected Tenancy; 	
□ 	Rights of Tenants in Condominium Conversion, Pre Conversion Tenants (T-1); 	
□ 	“Notice” (Form T-2 (Sr. and Disabled Tenants) & Form T-3 (Protected Tenancy)); 	
□ 	Application (Form T- 4); 	
□ 	Tenant Affidavit (Form T-5 ); 	
□ 	Tenant Notification Requirement; (Form T- 6); 	
□ 	Income Eligibility List (Form T- 7 (Sr. &  Disabled Tenants) &  Form T-8 (Hudson County residents only)); 	
□ 	Comparable Housing Request (Form T-9); 	
□ 	Condominium and Cooperative Conversion Regulations; 	
□ 	Senior Citizens and Disabled Protected Tenancy Regulations; 	
□ 	Protected Tenancy In Qualifying Counties Regulations (Hudson County Only). 
 
Owner/Sponsor Instructions for Filling Out Forms 	
Tenant Notification Requirement (Form T -6) 
□ 	Insert owner’s/sponsor’s address where indicated 
 
Comparable Housing Request (Form T-9) 	
□ 	Insert name and address of owner/sponsor as addressee 	
□ 	Insert project name and reference information on the re: line 
 
A copy of the Administrative Agent’s/agency’s affidavit of mailing must be submitted along with the 
owner’s/sponsor’s request for registration to the Department of Community Affairs, Planned Real Estate 
Development Office, P.O. Box 805, Trenton, New Jersey 08625.

Instruction Sheet and Checklist for Tenants  	
Applying for Senior and Disabled Protected Tenancy and 	
Protected Tenancy for Hudson County 	
 
 
Enclosed are the following documents for your information and use in applying for protected tenancy status. 
Please follow the instructions below when applying for protected tenancy status. 
 
Checklist  
□ 	Instruction Sheet and Checklist for applying for Sr. and Disabled Protected Tenancy and Protected Tenancy 	
□ 	Rights of Tenants in Condominium Conversion, Pre Conversion Tenants (T-1) 	
□ 	“Notice” (Form T-2 (Sr. and Disabled Tenants) & Form T-3 (Protected Tenancy)) 	
□ 	Application (Form T-4) 	
□ 	Tenant Affidavit (Form T-5) 	
□ 	Tenant notification requirement; (Form T-6) 	
□	  Income Eligibility List (Form T- 7 (Sr. and Disabled Tenants) &  Form T-8 (Hudson County residents only)) 	
□ 	Comparable Housing Request Form (T-9) 	
□ 	Condominium and Cooperative Conversion Regulations 	
□ 	Senior Citizens and Disabled Protected Tenancy Regulations 	
□ 	Protected Tenancy in Qualifying Counties Regulations (Hudson County Only) 
 
Instructions  	
 
Application (Form T-4) 
□ 	Check off the type of protection for which you are applying 	
□ 	In	 Part A (Personal Information) fill in all of the information requested 	
□ 	If you are disabled be sure to include proof of your disability when you return the application 
 
Note:  For Hudson County residents only.  If you are applying for Protected Tenancy for Hudson 	
County and you are disabled or 75 years of age or older you do not have to provide proof of 
income. You may skip Part C. 	
□ 	In Part B (Financial Information) fill in all sources and amounts of income for each member of your     
household 	
□ 	Provide proof of income for each household member, such as tax returns and W-2s 	
□ 	Provide additional information regarding your liabilities where indicated 	
□ 	Mail the completed application along with supporting documents and the Tenant’s Affidavit to the 
Administrative Agent/Agency at the address listed in Part C on the bottom of the form, by certified mail, 
return receipt requested

Tenant’s Affidavit (Form T-5) 
□ 	Fill in your name, address and telephone number where indicated on the top of the affidavit 	
□ 	Fill in your name on the first line where indicated 	
□ 	Under paragraph number 1 fill in the date you received the Protected Tenancy Packet from the 
Administrative Agent/Agency 	
□ 	Read and sign the affidavit.  Have your signature witnessed and notarized by a notary public or other officer 
authorized to notarize legal documents 	
□ 	Mail the completed Tenant’s Affidavit along with the Application to the Administrative Agent/ Agency at 
the address listed on the bottom of the form, by certified mail, return receipt requested 
 
Tenant Notification Requirement Form (Form T-6) 	
□ 	Check off the type of protection for which you are applying 	
□ 	Fill in the appropriate information where indicated 	
□ 	Sign and date the form 	
□ 	Mail the completed form to the owner/sponsor at the address listed on the bottom of the form, by certified 
mail, return receipt requested 
 
Comparable Housing Request  (Form T-9) 	
□ 	If you are not applying for protected tenancy status or do not qualify, fill out the comparable housing form 	
□ 	Include	 any additional reasonable requests in the space provided on page two of the form 	
□	 Insert your address where indicated on page two of the form 	
□	 Sign letter and mail certified mail, return receipt requested to your landlord. 
 
Comparable Housing Requests must be made within 18 months of receiving your 3 year notice to quit.  
 
Be sure to keep copies of your completed Application, Affidavit and Tenant Notification Requirement 
Form for your records.

T-1 
 	
 	
 	 	
             New Jersey Department of Community Affairs 
Division of Codes and Standards	
 
 Landlord-Tenant Information Service
 	
 
 
Rights of Tenants in Condominium Conversion 	
Pre-Conversion Tenants	 	
 
 
Pre-Conversion Tenants are those tenants whose initial tenancy began before the master 
deed was recorded.  Tenants in any residential rental property may only be evicted when 
the Court has ordered an eviction.  A landlord may ask a tenant to move; however, the 
tenant is not required to move unless a landlord files a complaint in Superior Court and 
the Court has ordered the eviction.  Self-Help Evictions, that is entry into a dwelling unit 
and removal of the tenants, their property, disconnection of utilities or changing the locks 
without the tenant’s consent or without a judgment from a court, are not permitted in N.J.   
 	
‰ 	The landlord must give tenants a three-year Notice to Quit before he or she can 
file for an eviction.  The landlord must wait 60 days after serving the “Notice of 
intent” to convert and the “the full plan of conversion” before giving the three-
year notice.  N.J.S.A. 2A:18-61.8. 	
 	
‰ 	The landlord must provide the tenants with a Notice of Intent to Convert and the 
Full Plan of Conversion (after the landlord has registered with the Planned Real 
Estate Development Office).  N.J.A.C. 5:24-1.3.   	
 	
‰ 	In the Notice of the Intent to Convert, tenants shall be notified of their exclusive 
right to purchase his or her unit, for the first 90 days after the notice is given.  
N.J.S.A. 2A:18-61.8. 	
 	
‰ 	The landlord must provide the tenants with a copy of N.J.A.C. 5:24 as a part of the 
notice of intent to convert and full plan of conversion.  N.J.A.C. 5:24-1.11.  	
 
‰ 	Notice of the right to apply for comparable housing. The tenant has the right to 
request comparable housing within 18 months of receipt of the notice.  N.J.S.A. 
2A:18-61.11. 
 
 	
‰ 	If comparable housing is not provided the tenant may be entitled to 5-one-year 
stays, allowing the tenant to remain in the rental unit.  After the first one-year stay 
a landlord who is unable to relocate the tenant may buy the tenant out by paying

T-1 	
the tenant for five months rent or by waiving five months rent and allowing the 
tenant to remain in the unit for that 5 month period, N.J.S.A. 2A:18-61.11 and 
61.16  
 	
‰ 	During the 3-year notice period (or up to 8 years in the case of 5 one-year stays of 
evictions) rent increases cannot be unreasonable.  If the property was regulated by 
the municipal rent control or rent leveling board prior to conversion, after 
conversion rent increases should remain in line with the limits set by the rent 
control ordinance.  N.J.A.C. 5:24-1.12. 	
 
‰ 	After the 3-year notice period, the landlord may file for an eviction, however, if 
the tenant remains in possession and the landlord accepts the rent, the landlord 
may not rely upon the conversion as a ground for eviction.  Fairken Assoc. v. 
Hutchen, 223 N.J.Super. 274 (1987) 	
 	
‰ 	Pre-Conversion tenants who are evicted because the unit is being converted to a 
condo are entitled to moving expenses, a waiver of one month’s rent.  N.J.S.A. 
2A:18-61.10. 
 	
‰ 	Qualifying senior citizens and disabled citizens may receive protected tenancy.  
The landlord must provide the Administrative Agent with a list of tenants for the 
property being converted.  The Administrative Agent will then, based on the list 
send out applications for protected tenancy to all of the tenants in the building.  
Tenants who want to apply for protected tenancy must complete the application 
and return it to the Administrative Agent.  The Administrative Agent works for the 
city or town, in which the property is located.  If the tenant is approved for 
protected tenancy status, the landlord could not evict the tenant for up to 40 years, 
as long as the tenant continues to qualify for the protected tenancy.  N.J.S.A. 
2A:18-61.22 – 61.39. 
 
The administrative agent provides the final determination of protected tenancy 
status.  The tenant is responsible for keeping a copy of his or her protected tenancy 
determination in case of future questions.  	
 	
Hudson County residents only  
Pre-conversion residents in Hudson County may also apply for protected tenancy 
under the Tenant Protection Act of 1992, which provides protection for tenants in 
qualifying counties.	
  N.J.S.A. 2A:18-61.40 –61.65.

T-2 
 
 
 
 	
“NOTICE” 
 
SENIOR CITIZEN AND DISABLED PROTECTED TENANCY 	
 
THE OWNER OF YOUR APARTMENT HAS NOTIFIED ______________________ OF HIS  
               	
(insert name of municipality)  	
INTENTION TO CONVERT TO A CONDOMINIUM OR COOPERATIVE.   THE 
LEGISLATURE HAS PROVIDED THAT, IF YOU ARE A SENIOR CITIZEN, 62 YEARS OF 
AGE OR OLDER, OR DISABLED, YOU MAY BE ENTITLED TO A PROTECTED 
TENANCY PERIOD.  PROTECTED TENANCY MEANS THAT YOU CANNOT BE 
EVICTED BECAUSE OF THE CONVERSION.  YOU MAY BE ELIGIBLE: 
(1) IF YOU ARE 62, OR WILL SOON BE 62, OR IF YOU ARE DISABLED; AND  
(2) IF YOU HAVE LIVED IN YOUR APARTMENT FOR AT LEAST ONE YEAR OR 
IF THE LEASE ON YOUR APARTMENT IS FOR A PERIOD OF MORE THAN 
ONE YEAR; AND  
(3) IF YOUR HOUSEHOLD INCOME IS LESS THAN ________________________  .  	
     (insert current income figure ) 
 	
IF YOU WISH THIS PROTECTION, SEND IN THE APPLICATION FORM BY 
______________________________ TO THE _______________________________________ 
 
(insert date 60 days after municipality’s mailing) 
_____________________________________________________________________________ .   	
(insert name and address of administrative agent/agency) 	
FOR FURTHER INFORMATION CALL THE ADMINISTRATIVE AGENT, 
_________________________________. 
(insert administrative agency’s/agent’s phone number ) 
 
 
IF YOU DO NOT APPLY YOU CAN BE EVICTED BY YOUR LANDLORD UPON 
PROPER NOTICE.

T-3 
 
 	
 
“NOTICE” 
 
PROTECTED TENANCY FOR HUDSON COUNTY RESIDENTS 	
 
THE OWNER OF YOUR APARTMENT HAS NOTIFIED ______________________ OF HIS  
               	
(insert name of municipality)  	
INTENTION TO CONVERT TO A CONDOMINIUM OR COOPERATIVE.   THE 
LEGISLATURE HAS PROVIDED THAT, IF YOU ARE A RESIDENT OF A QUALIFYING 
COUNTY, YOU MAY BE ENTITLED TO A PROTECTED TENANCY PERIOD.    
PROTECTED TENANCY MEANS THAT YOU CANNOT BE EVICTED BECAUSE OF THE 
CONVERSION.  YOU MAY BE ELIGIBLE: 
(1) IF YOU HAVE LIVED IN YOUR APARTMENT FOR AT LEAST A YEAR; AND  
(2) IF YOUR HOUSEHOLD INCOME IS LESS THAN ________________________  .  	
     (insert current income figure ) 
 	
IF YOU WISH THIS PROTECTION, SEND IN THE APPLICATION FORM BY 
______________________________ TO THE _______________________________________ 
 
(insert date 60 days after municipality’s mailing) 
_____________________________________________________________________________ .   	
(insert name and address of administrative agent/agency) 	
FOR FURTHER INFORMATION CALL THE ADMINISTRATIVE AGENT, 
_________________________________. 
(insert administrative agency’s/agent’s phone number ) 
 
 
IF YOU DO NOT APPLY YOU CAN BE EVICTED BY YOUR LANDLORD UPON 
PROPER NOTICE.

T-4       
   
Application for Senior and Disabled Protected Tenancy for all 	
Residents and (Protected Tenancy for Hudson County 	
Residents Only) 	
 
Check all that apply 
□	  Check here if you are applying for Senior Citizen and Disabled Protected 
Tenancy Status 	
□ 	 Check here if you are applying for Protected Tenancy Status (Hudson County 
Residents only).  If you are 75 years of age or older or disabled, do not fill 
out Part B of this application.  However, you must provide proof of age or 
disability.  
 
Part  A  (Personal Information) 	
 
Name of Applicant: ____________________________________________________________ 
 
Date of Birth:  ________________________________________________________________ 
 
Name of Spouse, if residing in the household:  _________________________________ 
 
Spouse’s Date of Birth:  _______________________________________________________ 
 
Street Address:   ______________________________________________________________ 
 
Apartment number:  __________________________________________________________ 
 
City:  _____________________________________  State:  ___________________________ 
 
Zip Code:  __________________  County:  _______________________________________ 
 
Home phone:  ____________________    Work phone:  ____________________________ 
 
Name of Building or Project (if any): ___________________________________________ 
 
Is this your principal place of residence:  ______________________________________ 
 
If this is you principal residence on what date did you begin occupying it as your 
principal place of residence: ___________________________________________________ 
 
Are you disabled:  ____________________________________ 
 
If you are disabled, please provide proof of disability.

T-4 
Part B  (Financial Information)  
 
List each household member currently residing in the rental unit and provide 
the following information with respect to each household member including the 
applicant: 
       Relation to  
Name      Age  Applicant    Income   
 
              
 
              
 
              
 
              
Provide proof of income for each household member 
 
Total Household Income for the last full calendar year:  ________________________   
 
Amount of current monthly rent:  ______________________________________________ 
 
Additional charges paid by the tenant, please check all that apply: 
 
__________  Heat 
 
__________  Gas 
 
__________  Electric  
 
__________  Water  
 
__________ Other, Please explain  ______________________________________________ 
 
_______________________________________________________________________________ 
 
_______________________________________________________________________________ 
 
 
Part C 
Please mail the completed application along with the Tenant’s affidavit (T-5) and 
all supporting documents to the address listed below by (date)_________________  
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________ 	
(Insert address for the administrative agency) 	
 	
If you require further information or assistance, contact:  _____________________ 	
        	(Insert phone number for  
                                                            the administrative agency	
)

T-5 
 
Applicant’s Name ________________________ 
Address  _________________________________ 
__________________________________________ 
__________________________________________ 
Telephone number _______________________ 
 
 
 
STATE OF NEW JERSEY  :            Tenant’s Affidavit in   
            Support of Application for  
COUNTY OF    :       Protected Tenancy Status  
 
 
I _________________________________________________, of full age, hereby declare: 	
 (insert tenant applicant’s name) 
 	
1. On _______________ I received the “Protected Tenancy Packet” from the 
administrative agency for my municipality.  The packet included and 
application and instructions for Senior Citizen and Disabled Protected 
Tenancy Status and/or Protected Tenancy Status for Hudson County 
residents, income eligibility figures, a “Notice” of intent to convert, a 
tenant’s rights notice, a copy of N.J.S.A. 5:24-1 through 5:24-2.11 (or 5:24-	
3.4 for Hudson County residents only), comparable housing request and a 
tenant Notification form, that I have completed and returned to the 
owner/sponsor.       
 
2. I consent to independent verification of information and documentation 
submitted to the administrative agency/agent by me in support of my 
application for protected tenancy status.  
 
3. I certify that all information provided by me in support of my application 
for protected tenancy status is true and accurate to the best of my 
knowledge.  I am aware that any statements made by me that are willfully 
false may be grounds for disqualification or termination of my protected 
tenancy status and subject me to penalties under the law. 
 
 
 
_________________________          __________________________________________ 
Date       Applicant’s Signature  
 
Sworn and subscribed to  
before me this         day 
of       200__ 
 
 
_________________________ 
Notary Public

T-6 
   	
Tenant Notification Requirement Form 	
 
I have received the Protected Tenancy Packet from the administrative agent for 
my municipality.  I have or will be filing an application for Protected tenancy 
status under the: 
 
Check all that apply 	
□	  Senior Citizen and Disabled Protected Tenancy Act 	
□ 	Tenant Protection Act (for Hudson County) 
 
Applicant’s Name:  ___________________________________________________________ 
 
Street Address:   _____________________________________________________________ 
 
Apartment number:  _________________________________________________________ 
 
City:  _____________________________________   State:  __________________________ 
 
Zip Code:  __________________  County:  _______________________________________ 
 
Home phone:  ________________________   Work phone:  ________________________ 
 
Name of Building or Project (if any): __________________________________________ 
 
 
 
 
__________________________   ____________________________________ 
Date        Signature  
 
 
 
Be sure to mail this form to: 
 
______________________________________________________________________________ 
 
______________________________________________________________________________ 
 
______________________________________________________________________________ 	
(Owner/Sponsor insert your address here)

T-7 
             
  LANDLORD-TENANT INFORMATION SERVICE 
SENIOR CITIZENS AND DISABLED PROTECTED TENANT INCOME FIGURES	
 	
 
2011 Applications    2012 Applications 
 	
Per Capita  Maximum Income    Per Capita  Maximum Income 
    Income      Income 	
 COUNTY    Column A Column B    Column C Column D  
Atlantic    $ 37,530 $ 112,589   $ 38,844 $ 116,532 
Bergen   $ 61,668 $ 185,005   $ 64,320 $ 192,960 
Burlington    $ 44,493  $ 133,479      $ 46,050  $ 138,150 
Camden   $ 39,703 $ 119,108   $ 41,093 $ 123,279 
Cape May    $ 42,128  $ 126,383      $ 43,602  $ 130,806 
Cumberland  $ 31,401  $   94,203      $ 32,500  $   97,500 
Essex   $ 47,164 $ 141,493   $ 49,192 $ 147,576 
Gloucester    $ 36,905  $ 110,715      $ 38,197  $ 114,591 
Hudson   $ 38,241 $ 114,723   $ 39,885 $ 119,655 
Hunterdon    $ 68,928  $ 206,783      $ 71,892  $ 215,676 
Mercer   $ 51,839 $ 155,516   $ 54,068 $ 162,204 
Middlesex    $ 46,470  $ 139,409      $ 48,468  $ 145,404 
Monmouth     $ 53,253  $ 159,760      $ 55,543  $ 166,629 
Morris   $ 68,270 $ 204,809   $ 71,206 $ 213,618 
Ocean   $ 38,952 $ 116,855   $ 40,627 $ 121,881 
Passaic   $ 38,592 $ 115,775   $ 40,025 $ 120,075 
Salem   $ 36,039 $ 108,118   $ 37,300 $ 111,900 
Somerset    $ 66,198  $ 198,594      $ 69,045  $ 207,135 
Sussex   $ 46,348 $ 139,044   $ 48,341 $ 145,023 
Union   $ 49,995 $ 148,784   $ 51,728 $ 155,184 
Warren   $ 40,643 $ 121,929   $ 42,391 $ 127,173 
The above figures are calculated pursuant to the Senior Citizens and Disabled Protected Tenancy Act (N.J.S.A. 2A:18-61.28).  These figures are to be 
used by all administrative agents in the determination of “tenants annual household income.”  Columns A and B are to be used for all applications 
filed in 2011.  Columns C and D are to be used for all applications filed after January 1, 2012 until new figures are promulgated by this Office. 
“Tenant Annual Household Income” means the total income from all sources during the last full calendar year for all members of the household 
who resided in the dwelling unit at the time the tenant applied for SENIOR CITIZENS AND DISABLED PROTECTED TENANCY status, whether or	
 not 
such income is subject to taxation by any taxing authority.

T-8 
 	
 
 
 
LANDLORD-TENANT INFORMATION SERVICE 
 	
HUDSON COUNTY QUALIFYING INCOME FIGURES 	
 
 
The maximum qualifying income figures for the purpose of determining qualified tenant status 
under the “Tenant Protection Act of 1992” are as follows: 
 	
2012 Applications 	
 
One Person                        $46,967.00 	
Two Persons                       $58,812.00 
Three Persons                  	$68,435.00 	
Four Persons                       $76,838.00 
Five Persons                       $85,284.00 
Six Persons                       $89,973.00 
Seven Persons                      $94,709.00 
Eight or More Persons                  $101,669.00 	
 	
 
Qualified disabled tenants and tenants 75 years  of age or  older are eligible regardless of  
income. 	
  	
 

T-9 
  	
 
       	Comparable Housing Request 	
 
 
       	
Date: 
 
 
Owner/Sponsor Name and Address 	
 
 
 
 
 
 
  Re: 
 
 
Dear  Sir or Madam: 
 
  According to the condominium conversion regulations (N.J.A.C. 5:24-1.1 
et seq.), since I have received a notice to quit due to my building being 
converted to a condominium, the landlord must provide me with comparable 
housing upon my written request.  I understand that I must make my request 
for comparable housing within 18 months of receiving my three year notice to 
quit.  Therefore, I hereby request that you offer me comparable housing and a 
reasonable opportunity to examine and rent said housing. Pursuant to the law, 
I am entitled to housing that is:   
 
1) decent, safe, sanitary, and in compliance with all local and State housing 
codes; 
 
2) open to all persons regardless of race, creed, national origin, ancestry, 
marital status, or sex; and  
 
3) provided with facilities equivalent to those provided by the landlord in 
the dwelling unit in which I current reside with regard to: 
a. apartment size including number of rooms; 
b. rent range; 
c. major kitchen and bathroom facilities; and 
d. special facilities necessary for the handicapped and infirmed. 
 
4) located in an area not less desirable than the area in which I currently 
reside with regard to:     
a. accessibility to my place of employment;  
b. accessibility to community and commercial facilities; and  
c. environmental quality and conditions.

T-9 
   
 
 
According to the law, I may request additional reasonable criteria for 
comparable housing.  Therefore, I also request the following additional criteria: 
 
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________ 
  
I currently reside at: 
 
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________ 
 
Thank you. 
 
 
__________________________________________
 Tenant’s Signature
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