Type Full Name :
Sign With Hand
Email
Address
Certification
Website (if any)
ZIP
Attachments
Begin typing Premise Address and select from the populated drop-down
Address 2
Phone #
Same as Applicant?
Has there been any change in percentage regarding business ownership?
Name
State
City
The fee for this application is:
Business Details
Applicant Details
Email
Fee Schedule
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
www.twp.maplewood.nj.us/
Class Type
Have you paid State and Local taxes?
Address 2
ZIP
Applicant Signature
State Tax Identification Number
Address 2
Is there any additional changes since the initial application or your last renewal?
Class Type Fee
Class 1 Cultivator $2,500.00
Class 2 Manufacturer $2,500.00
Class 3 Wholesaler $2,500.00
Class 4 Distributor $2,500.00
Class 5 Retailer $2,500.00
Class 6 Delivery $750.00
Microbusiness $1000.00
Name
Premise Address
By signing below, I certify that all of the information provided in this application is true and accurate.
{[PNAME]}
Application
City
Phone #
Licensee Name
Mailing Address Same as Premise Address?
State
Application Type
Mailing Address
ZIP
Email
City
Address 2
If you decide to pay online, there is a transaction fee and if you decide against paying online after clicking the link, your application may be lost. However, when you pay in person by exact cash, check or money order, there isn’t a transaction fee.
Have you paid the State fee?
State
If Yes, please attach any additional changes since the initial application or your last renewal.
Doing Business As
Federal Tax Identification Number
State License #
Business Ownership
Address
ZIP
Phone #
Contact Person Details
City
State