Last Name
Driver's License #
Applicant Information
State
Business/Cell #
Email
City
{[PNAME]}
Application
State Issued
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[PPHONE]}
Township of Verona Official Website
Application Type
Residence Address
ZIP
First Name
Residence Phone #
  • Employment Information
  • Certification
Address (No PO Boxes)
Phone #
ZIP
City
Vehicle Information
List all the vehicles that are being used in the section below:
Employer Information
State
Email
# of Vehicles
Employer/Company Name
Type Full Name :
Sign With Hand
or
Applicant Signature
Pay Later
Certification
Application Fee
By signing below I do hereby swear that all of the foregoing statements are true and correct to the best of my knowledge and belief.
If you need to make your payment by mail or in person, our office is located at:

Township of Verona
Bloomfield Ave
Verona, NJ 07044

Attachments
Please attach the following:
  • Certificate of Insurance in name of applicant/company showing:
    • Required insurance limits.
    • Policy#.
    • Policy effective dates.
    • VIN of all covered vehicles.
  • Copy of current vehicle registration.
  • Copy of current vehicle insurance.
  • Click here to fill out and upload a signed Power of Attorney form.
In order to receive your license, you must first pay the Application Fee.

If you'd like to pay now by Credit Card, click the Submit & Pay Now button below.

Fees
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