
State of New Jersey
Department of Health
Governor Phil Murphy · Lt. Governor Sheila Oliver
Improving Health Through Leadership and Innovation
a Personal Benefits Statement from the previous year;
a 1099R from the previous year, or
a Certificate of Pension Membership.
a. Joint deed, mortgage agreement or lease;
b. Joint bank account;
c. Designation of one of the persons as primary beneficiary in the other person’s will;
d. Designation of one of the persons as primary beneficiary in the other person’s insurance policy or retirement plan; or:
e. Joint ownership of a motor vehicle.
For information relating to Pensions or Health Benefits please access their website at http://www.state.nj.us/treasury/pensions and click on the link for Domestic Partnership or (609) 292-7524.