Fillable Application for Cemetery Salespersons Branch License New Jersey (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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Application for Cemetery Salespersons Branch License New Jersey (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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The Application for Cemetery Salespersons Branch License New Jersey (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General) form is 1 page long and contains:

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Country of origin: US
File type: PDF

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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 for Cemetery Salesperson’s Branch License
Print or type all information.
I hereby apply for a Cemetery Salesperson’s Branch License for the cemetery listed below. I am enclosing the fee of $75.00
(check or money order), payable to the State of New Jersey, if I am being licensed during the rst year of the biennial
renewal period, or $37.50 if I am being licensed during the second year of the biennial renewal period.
1. Name:___________________________________________________LicenseNo.:______________________________
2. ResidentAddress:
___________________________________________________________________________________________________
StreetorP.O.Box CityStateZIPcodeCounty
_______________________________________________________

E-mailaddress
3. BranchCemetery:_________________________________________________________________________________
Name
__________________________________________________________________________________________________
StreetorP.O.Box CityStateZIPcodeCounty
_________________________________CemeteryCerticateofAuthorityNumber:_____________________________
Telephonenumber(includeareacode)
_________________________________
E-mailaddress
4. MainCemetery:_____________________________________________________________________________________
Name
__________________________________________________________________________________________________
StreetorP.O.Box CityStateZIPcodeCounty
____________________________________________________________________________________________________________
Telephonenumber(includeareacode)E-mailaddress
Do Not Write In This Space
Date received: _________________________________ License No.: _________________________________________
Fee(s): New:____________________ Transfer:____________________ Renewal:____________________
__________________________________________
AuthorizedSignature
Note: It will be cause for the Cemetery Board to refuse to issue a license if:
The Cemetery Salesperson’s license application is not completed in its entirety;
False information is furnished; and/or
The check or money order in payment of the license fee is returned by the institution on which it is drawn.
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Application for Cemetery Salespersons Branch License New Jersey (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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Completed 14 August 2020

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