Form Center

By signing in or creating an account, some fields will auto-populate with your information.

Retail Food Licenses Application

  1. OFFICE OF THE TOWNSHIP CLERK

    95 West Veterans Highway

    Jackson, NJ 08527

    (732) 928-1200 ext. 1200-1201 | Fax (732)928-4377

  2. RETAIL FOOD LICENSE APPLICATION

  3. *RETAIL FOOD LICENSES ARE VALID UNTIL DECEMBER 31 AND MUST BE RENEWED ANNUALLY*

  4. Are foods prepared at another location?
  5. Please provide the following certificate information:

  6. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  7. Do Not Complete Below

    ***************************************************************************************

    HEALTH OFFICER’S INSPECTION REPORT
    Inspection of the above premises was completed on _____________________ and it is recommended that
    The licensed BE______ NOT BE_____ issued. If recommendation is for non-issuance, attach inspection report. 

                                                                                                       ___________________________________
                                                                                                                                     HEALTH OFFICER 

  8. Payment type:
  9. In person or by mail: 95 West Veterans Highway, Jackson, NJ, 08527

  10. Leave This Blank:

  11. This field is not part of the form submission.