Fillable 1-DEV-APPLICATION-2019 TOWNSHIP OF LONG HILL

Fill Online, Printable, Fillable, Blank 1-DEV-APPLICATION-2019 TOWNSHIP OF LONG HILL Form

Use Fill to complete blank online TOWNSHIP OF LONG HILL (NJ) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

1-DEV-APPLICATION-2019 TOWNSHIP OF LONG HILL

On average this form takes 66 minutes to complete

The 1-DEV-APPLICATION-2019 TOWNSHIP OF LONG HILL form is 21 pages long and contains:

  • 1 signature
  • 28 check-boxes
  • 245 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Township of Long Hill

BROWSE TOWNSHIP OF LONG HILL (NJ) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
TOWNSHIP OF LONG HILL
COUNTY OF MORRIS
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
APPLICATION FOR DEVELOPMENT – SUBMISSION REQUIREMENTS
1. FIVE (5) COLLATED SETS OF THE FOLLOWING:
Completed Application for Development (one with original signature).
Completed Addendum – Statement of Facts in Support of an Application
Completed Application for Development Checklist (A or B)
Completed Checklist Waiver Request Form
Zoning Officer’s denial letter with Zoning Table where applicable
Completed Morris County Land Development Review Application where applicable
Completed Soil Erosion & Sediment Control Certification
Completed Disclosure of Corporate Owners or Partners where applicable
Completed Owner’s Letter of Consent where applicable
Photographs of the subject property and/or areas of proposed changes. Minimum of 5-10 is
suggested.
Original signed & sealed survey / site plan or plot plan (as applicable) must include original
signature and seal of a licensed Engineer/Surveyor showing existing conditions of the property.
Survey / site plan or plot plan showing the proposed buildings and structures drawn to scale with
all dimensions for the proposed changes and all setbacks from all property lines (front, rear and side
yard setbacks).
Architectural Plans (as applicable); all floor plans & elevations must have the seal of a licensed
New Jersey Architect, and be folded to fit in mailing envelope.
2. ADDITIONAL SUBMISSION SETS FOR ALL SITE PLAN & SUBDIVISION APPLICATIONS:
Two (2) collated sets of all documents listed above AND electronic files either by email, USB or eight (8) CD’S
containing copies of all documents listed above in portable electronic format (PDF) must also be submitted to the
Long Hill Environmental Commission (LEC) with submission to the Planning & Zoning Coordinator. The LEC
submission should be addressed to:
Long Hill Environmental Commission
c/o Karen Shear, Secretary
915 Valley Road, Long Hill, NJ 07933
3. Fees as required by Ordinance (fee schedule attached); Please make checks payable to the Township of
Long Hill.
4. One (1) completed Proof of Payment of Taxes, which will provide certification from the Tax Collector that no
taxes or assessments for local improvements are due or delinquent.
5. One (1) completed Request for Certified List of Property Owners, in order to obtain list of all property owners
within 200 feet of the property.
6. One (1) completed W-9 form in order to set up the Applicant’s Escrow account.
Page 1 of 4
TOWNSHIP OF LONG HILL
COUNTY OF MORRIS
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
Once all of the submission items are received and the checklist has been reviewed, the Planning & Zoning
Coordinator will determine if the application is complete and notify the Applicant via email. Once the application is
deemed complete, copies will be distributed to the Board Professionals to begin review. At such time the reports are
received from the Board Professionals, the Planning & Zoning Coordinator will review with the Applicant to
determine if changes/updates to the Application are required or if the application is ready to be scheduled for a
hearing date. If it is determined that a review meeting would be beneficial to the Applicant, upon agreement, the
Planning & Zoning Coordinator will coordinate a meeting date and time with both the Applicant and their
professionals and the Board Professionals. Once a hearing date is determined, the Planning & Zoning Coordinator
will notify the Applicant via email.
ITEMS REQUIRED TEN (10) DAYS PRIOR TO HEARING DATE
1. Fifteen (15) additional copies of the submission items listed in item #1 above. All copies must be collated and
organized to be distributed to the Board members.
2. Notice of Hearing must be placed in the Echoes Sentinel Newspaper ten (10) days prior to hearing date. Return
notarized Affidavit of Publication (issued by the newspaper with copy of Public Notice article) to the Planning &
Zoning Coordinator for the file.
3. Provide all property owners within 200 feet of property with the Notice of Hearing letter via hand delivery
obtaining owner’s signature or via Certified US Mail. Return all original signatures and/or Certified Mail
Receipts along with a completed and notarized Affidavit of Service of Notice to the Planning & Zoning
Coordinator for the file.
Attachments:
Application for Development
Addendum – Statement of Facts
Checklist A or B
Checklist Waiver Request Form
Zoning Table
Morris County Land Development Application
Soil Erosion & Sediment Control Certification
Disclosure of Corporate Owners or Partners
Owner’s Letter of Consent
Proof of Payment of Taxes
Request for Certified List of Property Owners
W-9 Form
Public notices are a jurisdictional requirement. The application cannot be heard until publication and public
notice is properly served and proof of said notice is received.
This application does not relieve the Applicant from complying with other Township ordinances. Obtaining
the necessary approvals and permits under such ordinances will be the responsibility of the Applicant.
MORRIS COUNTY PLANNING BOARD
In the event that this project is bounded on any side by a county road or is within 200’ of another
municipality or includes a subdivision, a county application must be completed and submitted to Morris
County Planning Board directly. Submit to the Planning Department verification that the application was
filed with the County Planning Board.
Page 2 of 4
TOWNSHIP OF LONG HILL
COUNTY OF MORRIS
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
Page 1 of 2
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
APPLICATION FOR DEVELOPMENT
PROPERTY ADDRESS
BLOCK(S) LOT(S) ZONE
APPLICANT TELEPHONE
ADDDRESS (if different from above) EMAIL
PROPERTY OWNER (if different from above) TELEPHONE
ADDRESS EMAIL
ATTORNEY* TELEPHONE
*REQUIRED for Corporations, LLC or Limited Partnerships
ADDRESS EMAIL
ENGINEER or SURVEYOR TELEPHONE
ADDRESS EMAIL
ARCHITECT TELEPHONE
ADDRESS EMAIL
OTHER TELEPHONE
ADDRESS EMAIL
APPLICANT MUST PROVIDE AN ADDENDUM / STATEMENT OF FACTS IN SUPPORT OF THE APPLICATION.
Provide written statement on a separate sheet or on the form provided stating what the Applicant is proposing to do, what variances
are requested and the reasons why variances are needed.
Has there been a previous variance appeal or approval of any development application (i.e. site plan, subdivision or conditional use)
involving the property? YES ___ NO ___ If YES, attach copies of the decisions and/or resolutions.
Is the property in a density modification subdivision? YES ___ NO ___
THIS BOX FOR OFFICE USE ONLY
DATE OF SUBMISSION: APPLICATION NUMBER:
SITE PLAN _____ SUBDIVISION _____ BULK VARIANCES _____ USE VARIANCE _____ OTHER_____
PLANNING BOARD ____ ZONING BOARD ____ MEETING DATE:
TOWNSHIP OF LONG HILL
COUNTY OF MORRIS
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
Page 2 of 2
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
PROPERTY ADDRESS
BLOCK(S) LOT(S)
APPLICANT
I affirm that all statements in this submitted application are true.
Signature of Applicant Print Name Date
SUBMISSION REQUIREMENT
For all applications, FIVE (5) COLLATED sets of all COMPLETED and SIGNED application forms are required for
submission to the Planning & Zoning Coordinator for completeness review. For any/all subsequent changes or updates to a
pending application, five (5) copies are also required for resubmissions. All required documents are listed in the
Application Checklists.
Once an application is deemed complete and scheduled for a hearing, fifteen (15) collated sets of the application forms
must be submitted to the Planning & Zoning Coordinator for distribution to the appropriate Board.
ESCROW DEPOSITS
In accordance with the Ordinances of the Township of Long Hill, escrow accounts are established to cover the cost of
professional services including but not limited to planning, engineering, legal and other expenses associated with the
review of submitted materials. If additional sums are deemed necessary, the Planning & Zoning Coordinator will notify
the Applicant of the required additional amount. Please note: without sufficient funds in an Applicant’s escrow
account, the review and subsequent scheduling of the application for a meeting will cease until such time that the
Applicant has replenished the escrow account as per the Planning & Zoning Coordinator’s request.
Sums not utilized in the application process shall be returned upon written request by the Applicant and after verification
that all Board expenses have been satisfied. A W-9 Form (Request for Taxpayer Identification Number and Certification)
must be completed and submitted with any escrow deposits.
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
TOWNSHIP OF LONG HILL
COUNTY OF MORRIS
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
ADDENDUM
Statement of Facts in Support of an Application
Applicant:
Property Address:
Block: Lot(s): Date:
Statement of Facts to include the following:
Present and/or previous use of the building(s) and premises.
Detailed description of the proposed use.
Detailed description of the proposed improvements to the building(s) and premises.
What conditions are preventing the Applicant from complying with the Zoning Ordinance?
Any other detailed information to further explain what the Applicant proposes for the building(s) and premises.
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
TOWNSHIP OF LONG HILL
COUNTY OF MORRIS
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
CHECKLIST WAIVER REQUEST FORM
Use for Checklists A, B & SPW
Applicant:
Property Address:
Block: Lot(s): Date:
ITEM # EXPLANATION FOR WAIVER REQUEST
If additional waivers are requested, please use another form to continue.
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
TOWNSHIP OF LONG HILL
COUNTY OF MORRIS
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
ZONING TABLE
FILL IN ALL APPLICABLE BOXES
Property Address:
Lot:
Zone:
Total Square Feet:
Is this property in a density modification subdivision? YES ______ NO ______
BULK REQUIREMENTS
REQUIRED /
ALLOWED
EXISTING PROPOSED VARIANCE
Lot Area
Lot Width (Feet)
Floor Area (Square Feet)
Building Width (Feet)
Front Yard Setback (Feet)
Side Yard Setback (Feet)
Rear Yard Setback (Feet)
Building Height (Stories & Feet)
Building Coverage (Percent)
Lot Coverage (Percent)
Floor Area Ratio (FAR – Percent)
Buffer (Feet)
LAND DEVELOPMENT REVIEW APPLICATION
-
Mail To: Office Location:
MORRIS COUNTY PLANNING BOARD 30 Schuyler Place
P.O. Box 900 4
th
Floor
Morristown, NJ 07963-0900 Morristown, New Jersey
A
LL FILINGS TO THE PLANNING BOARD SHOULD BE IN DUPLICATE WITH APPROPRIATE FILING FEE
Section I. Submission Requirements (TWO COPIES OF ALL DOCUMENTS SHOULD BE SUBMITTED)
Submission:
□ New □ Planning Board □ Review fee enclosed
□ Revised □ Board of Adjustment □ No review fee
Section II. Project Information
Project Name: ________________________________________ Block(s) __________________ Lot(s) _____________
Municipality: ________________________________________ Road Frontage Name:____________________________
Applicant's Name: ____________________________________ Telephone: ________________ Fax: _______________
Mailing Address: ___________________________________________________________________________________
Section III. Site Data
What is being proposed? _____________________________________________________________________________
Zone District(s) in which property is located: _____________________________________________________________
Present Use(s) _______________________________________ Proposed Use(s) _______________________________
Proposed Water Source: ________________________________ Sewage Disposal_______________________________
□ Subdivision:
Gross
Area of Subdivision Tract ________ acres ▪ Net Lot Area ________ acres ▪ Number of Lots ___________
□ Site Plan: Lot Area ______ Acres
If Residential: If Non-Residential
# of Dwelling Units _____ New
Floor Area __________________ Total Floor Area __________________
New
Parking Spaces_______________ Total Parking Spaces _______________
New
Impervious Surface____________ Total Impervious Surface ___________
Section IV: Review Fees
(not required for revised submissions)
Applicant hereby applies for:
(check one)
Municipal Classification Rate Fees
□ Subdivision: Sketch no charge
□ Subdivision: Minor $100.00 $____________
□ Subdivision: Preliminary $500.00 + $25.00 per lot $____________
□ Subdivision: Final $100.00 $____________
□ Site Plan: Multi-Family $500.00 + $25.00 per dwelling unit $____________
□ Site Plan: Non-Residential $500.00 + $5.00 per new parking space $____________
Total enclosed (payable to "Treasurer of Morris County"). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$____________
Application completed by: ___________________________________
□ applicant / □ owner / □ attorney / □ engineer
(please print)
Signature: ___________________________________________________________ Dated: _____________________
MORRIS COUNTY PLANNING BOARD
LAND DEVELOPMENT REVIEW
APPLICATION PROCEDURES
SUBMISSION REQUIREMENTS:
Subdivision – All subdivisions must be submitted to the County Planning Board for review.
Major Subdivisions – will be reviewed for County approval
Minor Subdivisions – will be reviewed to determine:
1. If the project fronts along a County road; and/or
2. If the project will affect any County drainage facilities.
For those minor subdivisions which meet either one or both of the above criteria, the project will be reviewed for
approval. If a minor subdivision does not meet either criteria, an exemption letter will be sent.
Site Plans – Site Plans will be reviewed to determine:
1. If the project fronts along a County road; and/or
2. If the project contains an amount of impervious surface equal to or greater than one acre (43,560 sq. ft.)
For those site plans which meet either one or both of the above criteria, the project will be reviewed for approval.
If the site plan does not meet either criteria, an exemption letter is sent.
PROCEDURES:
New applications must be submitted to the County Planning Board by the municipal approving authority or by the applicant and
accompanied by the transmittal letter stating that the application has also been made to the municipal approving authority.
Development applications revised in response to County Planning Board requirements may be submitted directly to the County
Planning Board by the applicant.
Digital copy of final plat and fully signed paper copy of final plat are required prior to filing of final plat at the Morris County Clerk’s Office.
REVISIONS:
Subdivision plats and site plans which are revised to comply with the County Planning Board requirements, or would alter a previous
County Planning Board approval, must be resubmitted to the County Planning Board for review and approval.
REPORTS:
The County Planning Board has a statutory review period of thirty (30) days from the date of a complete submission. Upon
completion of the County Planning Board review, a report will be mailed to the municipal approving authority with copies mailed to
the applicant and his/her engineer. For those site plans and minor subdivisions found to be exempt, a notice of exemption will be
mailed to the municipal approving authority.
SUBMISSION PACKAGE:
A complete application consists of the following:
□ 1. Two (2) completed copies of the County application form (on the reverse side).
□ 2. Two (2) copies of the subdivision or site plan drawings.
□ 3. Two (2) copies of the drainage study (if required by the County Land Development Standards or municipal ordinance).
□ 4. Two (2) copies of the traffic impact study (if required by the County Land Development Standards or municipal ordinance).
□ 5. Payment of the review fee in accordance with the fee schedule on the reverse side of this application. If no fee is included, the
applicant will be billed and the project may not be reviewed until payment is received. No fee is required for resubmissions.
Package should be submitted via mail to: Morris County Planning Board
P.O. Box 900
Morristown, NJ 07963-0900
Or via personal delivery or overnight to: Morris County Planning Board
30 Schuyler Place, 4
th
Floor
Morristown, New Jersey 07960
Questions, please call: (973) 829-8120
(Revised 5/11)
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
TOWNSHIP OF LONG HILL
COUNTY OF MORRIS
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
INFORMATION REGARDING
SOIL EROSION AND SEDIMENT CONTROL CERTIFICATION
The State of New Jersey Soil Erosion an Sediment Control Act, Chapter 261, P.L. 1975 defines a project
which requires a soil erosion and sediment control certificate as "any disturbance of more than 5,000
square feet of the surface area of land:
(1)
for the accommodation of construction for which the State Uniform Construction Code would
require a construction permit, except that the construction of single-family dwelling unit shall
not be deemed a "project" under this act unless such unit is part of a proposed subdivision, site
plan, conditional use, zoning variance, planned development or construction permit application
involving two or more such single-family dwelling units,
(2)
for the demolition of one or more structures,
(3)
for the construction of a parking let,
(4)
for the construction of a public facility,
(5)
for the operation of any mining or quarrying activity, or
(6)
for the clearing or grading of any land for other than agricultural or horticultural purposes.”
Soil Erosion and Sediment Control Certifications must be obtained from:
Morris County Soil Conservation District
Court House
Morristown, New Jersey 07960
Phone: (973) 285-2953 or 538-1552
Fax: (973) 605-8195
Property Address:
This project does not involve work for which a Soil Erosion and Sediment Control Plan
Certification is required from the Morris County Soil Conservation District.
This project requires a Soil Erosion and Sediment Control Plan Certification from the
Morris County Soil Conservation District. I certify that an application has been made to
the Morris County Soil Conservation District for this project.
Signature Date
Print Name
TOWNSHIP OF LONG HILL
COUNTY OF MORRIS
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
DISCLOSURE OF CORPORATE OWNERS OR PARTNERS
Date:___________________
Name of Applicant:
Name of Corporation:
List all names of corporate stockholders or partners owning at least 10% of its stock or any class
or at least 10% of the interest in the partnership, as the case may be.
Name Address Percentage
_____________________________ ___________________________________ __________
_____________________________ ___________________________________ __________
_____________________________ ___________________________________ __________
_____________________________ ___________________________________ __________
_____________________________ ___________________________________ __________
_____________________________ ___________________________________ __________
_____________________________ ___________________________________ __________
PLEASE NOTE: Corporations, LLC or Limited Partnerships must be represented by an
attorney when applying to and appearing before the Planning Board or Zoning Board of
Adjustment.
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
TOWNSHIP OF LONG HILL
COUNTY OF MORRIS
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
OWNER’S LETTER OF CONSENT
Applicant:
Property Address:
Block: Lot(s):
I certify that I am the owner of record or duly authorized representative of the owner and that I concur
with the application and plans presented to the Planning Board or Zoning Board of Adjustment.
Additionally, I give consent to Township of Long Hill Board Members and Consultants to enter and
inspect the subject property.
Permission is hereby granted to as Applicant for the proposed
development.
Owner’s Signature & Title Date
Owner (Print Name)
Address
Phone & Email Address
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
TOWNSHIP OF LONG HILL
COUNTY OF MORRIS
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
PROOF OF PAYMENT OF TAXES
Application to: [ ] Planning Board [ ] Zoning Board of Adjustment
Applicant:
Property Address:
Block: Lot(s):
I certify that I am the owner of record of the property described herein and in compliance with and/or
N.J.S.A. 40:55D-39e; N.J.S.A. 40:55D-65h; and/or Ordinance #32-88. I hereby request the Tax Collector
to determine whether there are delinquent taxes/assessments due.
Owner’s Signature & Title Date
Owner (Print Name)
TAX COLLECTOR’S CERTIFICATION
I DECLARE THAT: [ ] All taxes have been paid.
[ ] All assessments due have been paid.
[ ] The following are delinquent:
Water Source: [ ] City
[ ] Well
Sewage Disposal: [ ] Sewer
[ ] Septic
Tax Collector’s Signature Date
TOWNSHIP OF LONG HILL
MORRIS COUNTY
GILLETTE, HOMESTEAD PARK, MEYERSVILLE, MILLINGTON, STIRLING
TOWNSHIP OFFICES – 915 VALLEY ROAD, GILLETTE, NJ 07933
908-647-8000 / www.longhillnj.gov
REQUEST FOR CERTIFIED LIST OF PROPERTY OWNERS
[ ] Planning Board Public Hearing List #:
[ ] Zoning Board of Adjustment Date Requested:
List of property owners served within 200’ of Block Lot(s)
Owner: Applicant:
Address: Address:
The certified list of required names and addresses shall be obtained from the Tax Assessor
This form shall clearly indicate the type of service (i.e. personal service or certified mail service).
IN ADDITION TO THE NAMES ON THE ATTACHED LIST, THOSE CHECKED OFF BELOW MUST BE
SERVED NOTICE.
[ ] Property owners within 200' of the town of must be notified.
[ ] Property borders the Passaic River – property owners within 200' in must be notified.
[ ] Property is on a county road. Morris County Planning Board is to be notified at the following address:
Morris County Planning Board
Courthouse CN 900
Morristown, N.J. 07960-900
[ ] Chapter 245, Session Laws of 1991 states that the public utilities of a municipality should be notified. The public
utilities in the Township of Long Hill:
1
JCP&L
300 Madison Avenue
PO Box 1911
Morristown, NJ 07962
3
NJ American Water Co.
No. Div. (NJAWC)
1025 Laurel Oak Road
Voorhees, NJ 08043
2
PSE&G
Corporate Properties Manager
80 Park Plaza, T6B
Newark, NJ 07102
4
Comcast Cable Communications
100 Randolph Road
Somerset, NJ 08873
Type of Service: [ ] Certified Mail Service [ ] Personal Service
Certified by:
Brett Trout, Tax Assessor
INSTRUCTIONS TO PRINTERS
FORM W-9, PAGE 1 of 4
MARGINS: TOP 13mm (
1
⁄ 2 "), CENTER SIDES. PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216mm (8
1
⁄ 2 ") 3 279mm (11")
PERFORATE: (NONE)
Give form to the
requester. Do not
send to the IRS.
Form
W-9
Request for Taxpayer
Identification Number and Certification
(Rev. October 2007)
Department of the Treasury
Internal Revenue Service
Name (as shown on your income tax return)
List account number(s) here (optional)
Address (number, street, and apt. or suite no.)
City, state, and ZIP code
Print or type
See Specific Instructions on page 2.
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid
backup withholding. For individuals, this is your social security number (SSN). However, for a resident
alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is
your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.
Social security number
or
Requester’s name and address (optional)
Employer identification number
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose
number to enter.
Certification
1.
The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
2.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. See the instructions on page 4.
Sign
Here
Signature of
U.S. person
©
Date
©
General Instructions
Form W-9 (Rev. 10-2007)
Part I
Part II
Business name, if different from above
Cat. No. 10231X
Check appropriate box:
Under penalties of perjury, I certify that:
13
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT
TLS, have you
transmitted all R
text files for this
cycle update?
Date
Action
Revised proofs
requested
Date
Signature
O.K. to print
Use Form W-9 only if you are a U.S. person (including a
resident alien), to provide your correct TIN to the person
requesting it (the requester) and, when applicable, to:
1. Certify that the TIN you are giving is correct (or you are
waiting for a number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S.
exempt payee. If applicable, you are also certifying that as a
U.S. person, your allocable share of any partnership income from
a U.S. trade or business is not subject to the withholding tax on
foreign partners’ share of effectively connected income.
3.
I am a U.S. citizen or other U.S. person (defined below).
A person who is required to file an information return with the
IRS must obtain your correct taxpayer identification number (TIN)
to report, for example, income paid to you, real estate
transactions, mortgage interest you paid, acquisition or
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA.
Individual/Sole proprietor
Corporation
Partnership
Other (see instructions)
©
Note. If a requester gives you a form other than Form W-9 to
request your TIN, you must use the requester’s form if it is
substantially similar to this Form W-9.
● An individual who is a U.S. citizen or U.S. resident alien,
● A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United
States,
● An estate (other than a foreign estate), or
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are:
Special rules for partnerships. Partnerships that conduct a
trade or business in the United States are generally required to
pay a withholding tax on any foreign partners’ share of income
from such business. Further, in certain cases where a Form W-9
has not been received, a partnership is required to presume that
a partner is a foreign person, and pay the withholding tax.
Therefore, if you are a U.S. person that is a partner in a
partnership conducting a trade or business in the United States,
provide Form W-9 to the partnership to establish your U.S.
status and avoid withholding on your share of partnership
income.
The person who gives Form W-9 to the partnership for
purposes of establishing its U.S. status and avoiding withholding
on its allocable share of net income from the partnership
conducting a trade or business in the United States is in the
following cases:
● The U.S. owner of a disregarded entity and not the entity,
Section references are to the Internal Revenue Code unless
otherwise noted.
● A domestic trust (as defined in Regulations section
301.7701-7).
Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership)
©
Exempt
payee
Purpose of Form
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

1-DEV-APPLICATION-2019 TOWNSHIP OF LONG HILL

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 13 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document