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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.**

Owner/Manager Information

Phone #

Vehicle Model

License Plate Number

Name of Establishment

Type of Business

Lot

Fee

Address

Vehicle Information

Application Fee

Do you operate more than one Food Truck?

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

Vehicle Make

Email

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

Name