Fillable Application and Information Sheet for Approval to Construct (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

Fill Online, Printable, Fillable, Blank Application and Information Sheet for Approval to Construct (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General) Form

Use Fill to complete blank online STATE OF NEW JERSEY, DEPT. OF LAW & PUB. SAFETY, OFFICE OF THE ATTORNEY GENERAL (NJ) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Application and Information Sheet for Approval to Construct (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

On average this form takes 28 minutes to complete

The Application and Information Sheet for Approval to Construct (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General) form is 4 pages long and contains:

  • 2 signatures
  • 19 check-boxes
  • 95 other fields

Country of origin: US
File type: PDF

U.S.A. forms for State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General

BROWSE STATE OF NEW JERSEY, DEPT. OF LAW & PUB. SAFETY, OFFICE OF THE ATTORNEY GENERAL (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
 
New Jersey Ofce of the Attorney General
Division of Consumer Affairs
New Jersey Cemetery Board
124 Halsey Street, 6th Floor, P.O. Box 45036
Newark, New Jersey 07101
(973) 504-6553
Application and Information Sheet for
Approval to Construct and Operate a Crematory
In accordance with N.J.S.A. 45:27-39 and N.J.A.C. 13:44J-9.1
Name of Applicant: ___________________________________________________________________________________
Address:
___________________________________________________________________________________________________
Street or P.O. Box City State ZIP code County
Mailing Address (If different than above.):
__________________________________________________________________________________________________
Street or P.O. Box City State ZIP code County
________________________ ____________________________ Contact Person: _______________________________
Telephone number (include area code) E-mail address
Organized Under
Special Act N.J.S.A. Title 8 or 8A N.J.S.A. Title 16 (Religious Corporation)
N.J.S.A. Title 14 N.J.S.A. Title 15 or 15A N.J.S.A. Chapter 45
Cemetery Act of 1851 Cemetery Act of 1875 Unincorporated
Date Organized: _______________________________ Date of Incoporation: ____________________________________
Type of Cemetery
Non-Prot Prot
Religious: ______________________________________________________________________________________
Name and Address of Church or Synagogue as Owner of Cemetery
Municipal Governmental Entity
Other (explain): __________________________________________________________________________________
______________________________________________________________________________________________
NOTE: The New Jersey Cemetery Board approval is required to construct all Crematories
in the State of New Jersey.
1. Are there outstanding certicates of indebtedness? Yes No
2. Are there outstanding certicates of interest? Yes No
3. If you answered “Yes” to either 1 or 2 above, please provide the following information:
a. The name of the person/entity that holds these certicates
b. Initial Value:
c. Date Issued:
d. Current Value:
e. Describe method by which being paid/retired:
4. If you le a 990, please submit a copy of last 2 scal years with this application.
5. If you do not le a 990 and are a for prot company, please submit a prot loss statement for the last 2 scal years and
identify any and all owners of stock or other interest.
Please provide the following cemetery information:
1. Total Acreage: __________________ Acres Developed: _______________ Acres Sold: __________________
2. Fiscal Year-End-Date: ______________________________________________________________________
3. Date, Time and Place of Annual Lot Owner’s Meeting: ____________________________________________
4. If not lot owner, Date, Time and Place of Annual Meeting: __________________________________________
5. Copies of the minutes reecting consideration and Trustee approval of the Crematory Construction.
6. Name and Address of Custodial Institution Maintaining Maintenance and Preservation Fund:
____________________________________________________________________________________________
7. Book Value of M&P Fund: ______________________________________________________________________
8. Market Value of M&P Fund: _____________________________________________________________________
9. Names and Addresses of Trustees or Directors:
NOTE: You must list a business address. If you provide your residence address, the New Jersey Cemetery
Board will accept this submission as permission to release your residence address upon request.
____________________________________________________________________________________________
Name Street Address City State ZIP code
____________________________________________________________________________________________
Name Street Address City State ZIP code
____________________________________________________________________________________________
Name Street Address City State ZIP code
____________________________________________________________________________________________
Name Street Address City State ZIP code
____________________________________________________________________________________________
Name Street Address City State ZIP code
____________________________________________________________________________________________
Name Street Address City State ZIP code
____________________________________________________________________________________________
Name Street Address City State ZIP code
____________________________________________________________________________________________
Name Street Address City State ZIP code
_______________________________________________ ____________________________________________
Name Street Address City State ZIP code
10.NameandAddressofOfcers:
NOTE: You must list a business address. If you provide your residence address, the New Jersey Cemetery
Board will accept this submission as permission to release your residence address upon request.
____________________________________________________________________________________________

President-NameStreetAddressCityStateZIPcode
____________________________________________________________________________________________

Vice-President-NameStreetAddressCityStateZIPcode
____________________________________________________________________________________________

Secretary-NameStreetAddressCityStateZIPcode
____________________________________________________________________________________________

Treasurer-NameStreetAddressCityStateZIPcode
Crematory Application Elements
In accordance with N.J.A.C. 13:44J-13.8, please submit the following along with this application:
1. Copyofallmunicipal,zoningandplanningboardapprovals,submittedtotheDepartmentofEnvironmental
Protectionandapprovalsissuedfortheconstructionandoperationofthecrematory.
2. Copyofconstructionplansforthecrematory,includingamapidentifyingtheproposedlocationandconstruction
nancing.
3. Copyofproposedcremationprocedures,pricelistofservicesincludingcremationfees,andacopyoftheproposed
cremationauthorizationandreceiptforms.
4. IfapplicantholdsacerticateofauthorityissuedbytheNewJerseyCemeteryBoard,astatementfromanancial
institutionlistingthecurrentassetsoftheMaintenance&PreservationFund.
ThisapplicationandallsupportingdocumentsshallbesenttotheNewJerseyCemeteryBoardattheaddresslisted
belowbydeliveryserviceprovidingareceiptfordelivery.
NewJerseyCemeteryBoard
P.O.Box45036
Newark,NewJersey07101
NOTE:Ifthereareanyadditionsofchangestotheinformationprovidedinthisapplication,youaretosubmitthe
newinformationtotheNewJerseyCemeteryBoardwithin10days.

AffidAvit
State of_______________________
County of _____________________
I __________________________________________________ of full age, being duly sworn according to law,
upon this oath, depose and say that:
1. I am the _________________________________ of ________________________________________ .
Title Name of Cemetery
and authorized to submit this application on behalf of ________________________________________ .
Name of Cemetery
2. I have reviewed and understand the provisions of N.J.S.A. 45:27 et seq. and N.J.A.C. 13:44J.
3. I am also aware that there are other laws and regulations governing the construction and operation of
crematory and understand that the Cemetery is bound to comply with all applicable federal, state and local
laws.
The applicant named in this application and the statements contained herein are true to the best of my
knowledge and belief.
.
Sworn & Subscribed before me
this _______ day of ______, _________
_________________________________
Signature of Notary Public
_________________________________
Date commission expires
___________________________________
Signature of Cemetery Ofcial
Afx Seal Here
Corporate Seal
Month Year
} ss.
click to sign
signature
click to edit
click to sign
signature
click to edit
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

Application and Information Sheet for Approval to Construct (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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 14 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document