Certification

Business Information

Required Attachments

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This application must be accompanied by a recent Sanitary Inspection Report issued by the Burlington County Health Department.

Food Handler’s Permits expire annually on December 31st of the year of issuance.

The fee for a Food Handler’s Permit is $45.00. Payments may be made by credit card online, or you can also visit our Township Offices at 12 Manor House Court, Eastampton, NJ 08060 to make a payment with exact cash, check or money order made payable to Eastampton Township.

**Food Handler Permits shall be placed conspicuously in the establishment upon receipt.**

Phone #

Name of Establishment

Type of Business

Lot

Fee

Address

Owner/Manager Information

Application Fee

Address

Signature

Block

Important Notice

ZIP

State

If you are vending at an event, please specify the date

By signing below, I the owner certify that all the information provided in this application is true and accurate.

Address 2

City

Email

Please attach a recent Sanitary Inspection Report issued by the Burlington County Health Department.

Name