Type Full Name :
Sign With Hand
Phone #
Please submit current Food Handlers & Manager Certificate.
Food Truck License Plate #
Mobile Food Details
Registration Type
Email
Name of Mobile Vendor
Food Truck Type
Name
Phone #
Fee Schedule
If selling soft served ice cream, please include a copy of your submitted state license/application (m-5).
Amount Due
Certification
Are you selling soft served ice cream?
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Required Documents
Address
If applicable, add additional driver(s)
Applicant Signature
Applicant Details
Address
City, State, ZIP

Your signature below attests that you have read and agree to the following conditions:

  1. You will use only properly licensed wholesalers as food suppliers. 
  2. You will not sell any potentially hazardous foods prepared in a home kitchen or otherwise in an unlicensed facility or which is not in accordance with the NJ Chapter 24 Cottage Food Operator Regulations. 
  3. You will not transfer, sell or copy your given license to any other business, establishment or entity. 
  4. You will comply with all applicable Federal, State & Local Regulations. 
  5. This license is VOID upon selling the business and the NEW OWNER MUST apply for a new license. 
  6. You will permit access to a health authority to all parts of the establishment to conduct inspections as often as it deems necessary. 
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