Type Full Name :
Sign With Hand
Phone # *
Building Owner Name
Please only fill this section out if the applicant is a new occupant.
Mailing Address
Email *
Borough of
Business Type
Federal ID #
301 Christiana Street
Brooklawn, NJ 08030
(856) 456-0750
Business Information
Secondary Phone #
New Occupant Details
Complete Name
Home Address *
Mailing City, State, ZIP
Type of New Business
NOTE: Chapter 180-75 of the Town Ordinances requires that before the occupancy or possession of any building of structure may pass from one person to another a Certificate of Re-occupancy is required.
Phone # *
Business Name *
24-Hour Emergency Contacts
Building Owner Information
Will food be served? (An additional $10 shall apply) *
Type of New Occupant
State *
Federal ID # *
Phone # *
Property Location
Send license to:
Fee Schedule
Last Name *
Complete Name
Complete Name *
Phone #
Phone #
The fee for this application is $50. Payment is due by January 31st, after which a late fee of $25.00 shall apply.
Name of New Business
Phone #
Home Address
Applicant Signature *
Applicant / Business Owner Information
Description of Business *
First Name *
City *
Secondary Phone #
Email *
Annual Business Registration