Fillable New Jersey Ofce of the Attorney General (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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New Jersey Ofce of the Attorney General (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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New Jersey Ofce of the Attorney General
Division of Consumer Affairs
State Board of Professional Planners
124 Halsey Street, 3rd Floor, P.O. Box 45016
Newark, New Jersey 07101
(973) 504-6465
Application for a License to Practice as a Professional Planner
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   

 

For Ofce Use Only

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 
 
must 

  




 

 
 




 
 
 


 
  



 

   
  
  
   
   
   
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

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
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


“Ability to practice as a professional planner”
                  

 

 

“Medical Condition”





“Chemical substance”

“Currently”


“Illegal use of controlled dangerous substance”           




   
 

   
 
    
 
    
 
  
 
   
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            

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 
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                   
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 any
  

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
  
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This afdavit is to be executed by the applicant before a notary public:

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 
          





                   
                






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
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New Jersey Ofce of the Attorney General (State of New Jersey, Dept. of Law & Pub. Safety, Office of the Attorney General)

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Completed 15 August 2020

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