DIVISION OF TAX ABATEMENT & SPECIAL TAXES LICENSE UNIT 920 BROAD STREET

DIVISION OF TAX ABATEMENT & SPECIAL TAXES LICENSE UNIT 920 BROAD STREET – ROOM B-17 NEWARK NJ 07102
SELECT REGISTRATION TYPE *

RESIDENTIAL REGISTRATION FEE: $50.00 RESIDENTIAL,REGISTRATION FEE: 1-4 UNITS: NO FEE RESIDENTIAL,ANNUAL FEE, MORE THAN 4 UNITS: $50.00 BUSINESS,REGISTRATION FEE: $85.00 BUSINESS,ANNUAL FEE: $50.00
PLEASE ENCLOSE MONEY ORDERS OR CHECKS FOR FEES SEPERATELY
AND ROBBERY ALARM SYSTEMS ARE SUBJECT TO THE PROVISIONS AND PENALTIES OF TITLE 17, CHAPTER 3A OF THE REVISED ORDINANCE OF THE CITY OF NEWARK, NEW JERSEY AND THE REGULATIONS OF THE CHIEF OF POLICE. A COPY OF THE ORDINANCE MAY BE OBTAINED AT THE OFFICE OF THE CITY CLERK. BYE SIGNING THIS QUESTIONNAIRE; I ACKNOWLEDGE THAT I HAVE READ THE ABOVE CITY ORDINANCE AND THE REGULATIONS OF THE CHIEF OF POLICE.
1.BUSINESS/RESIDENT NAME *
1.TELEPHONE NUMBER *
Please enter a valid phone number.
ALARM LOCATION *
BUSINESS/RESIDENT ADDRESS IF NOT THE SAME AS ABOVE *
2.LEGAL ENTITY RESPONSIBLE FOR ALARM *
2.TELEPHONE NUMBER *
Please enter a valid phone number.
2.ADDRESS OF LEGAL ENTITY:
3. DATE OF INSTALLATION: *

Month Day Year
Date
4.COMPANY/INDIVIDUAL INSTALLING ALARM *
5.COMPANY/INDIVIDUAL SERVICING ALARM *
SERVICING CO. ADDRESS: *
6. IS SERVING COMPANY CONTRACTED FOR IMMEDIATE ALARM RESPONSE?

YES NO
7. TYPE OF ALARM SYSTEM:

BURGLARY ROBBERY OUTSIDE TELEPHONE ALARM CENTRAL STATION
8. PREMISES:

RESIDENCE STORE FACTORY WAREHOUSE HOSPITAL SCHOOL TAVERN RESTAURANT Other
HOW MANY UNIT *
9. IS THERE A WATCHMAN OR GUARD ON THE PROTECTED PREMISES? *

YES NO
IF YES, ARE THEY ARMED?

Yes No
ARE THEY IN UNIFORM?

YES NO
10. ARE THERE ANIMALS ON THE PREMISES WHILE THE ALARM IS ACTIVATE?

YES NO
IF YES, INDICATE HOW MANY AND WHAT TYPE
11. ARE THERE HAZARDOUS MATERIALS USED OR STORE ON THE PROTECTED PREMISES?

YES NO
12. LISTED BELOW ARE THREE PERSONS DESIGNATED TO RESPOND TO AN EMERGENCY ALARM. ONE OF THE BELOW LISTED WILL BE AVAILABLE TO RESPOND TO THE PREMISES, WITHIN ONE HOUR, UPON REQUEST BY THE NEWARK POLICE DEPARTMENT.

THE PERSON RESPONDING WILL HAVE KEYS TO THE PREMISES AND POSSESS SUFFICIENT INFORMATION TO IDENTIFY THE ALARM SYSTEM. THE LOCATION OF THE ALARM SYSTEM AND THE LOCATION OF ANY OTHER DEFENSIVE SYSTEM ON THE PREMISES.

EACH PERSON LISTED HAS BEEN INSTRUCTED TO VERIFY AL POLICE RESPONSE REQUESTS BY TELEPHONING THE NEWARK POLICE DEPARTMENT’S COMMUNICATION CENTER, (733-6000) PRIOR TO RESPONDING TO THE PREMISES.

I UNDERSTAND THAT THE OFFICE OF THE CHIEF OF POLICE, NEWARK POLICE DEPARTMENT, MUST BE NOTIFIED, IN WRITING, IF THERE IS A CHANGE IN DESIGNATED PERSONNEL.
A. NAME *
A.TELEPHONE NUMBER
Please enter a valid phone number.
A. ADDRESS: *
B. NAME *
B. TELEPHONE NUMBER *
Please enter a valid phone number.
B. ADDRESS: *
C. ME *
C. TELEPHONE NUMBER *
Please enter a valid phone number.
C. ADDRESS: *
ALARM REGISTRANT’S SIGNATURE *

Clear
Email
example@example.com
DATE *

Month Day Year
Date
Total Fees

Application Fee

USD Description

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

DIVISION OF TAX ABATEMENT & SPECIAL TAXES LICENSE UNIT 920 BROAD STREET – ROOM B-17 NEWARK NJ 07102

PLEASE ENCLOSE MONEY ORDERS OR CHECKS FOR FEES SEPERATELY