Authorized WIC Vendors

New Jersey WIC Vendor Application Packet Deadline has been extended to 12:00 midnight July 13, 2015

Print and mail your completed New Jersey WIC Vendor Application Packet to the New Jersey Department
of Health, Family Health Services, WIC Services, Vendor Unit. The completed vendor application packet
 must be mailed in a sealed envelope and post marked by
12:00 midnight July 13, 2015 to:

New Jersey Department of Health
Family Health Services, WIC Services - Vendor Unit - 6th Floor
Attention: Johanna Mason, Vendor Manager
P.O. Box 364
50 East State Street
Trenton, New Jersey 08625-0364

Cover letter: Current Authorized Vendors and Pharmacies New Jersey WIC Vendor Application Announcement for October 1, 2015 - September 30, 2018

Print, complete and submit the following documents:

1. WIC-40 Application for WIC Vendor Authorization
   [pdf 31k, doc 106k]
   
   
2. WIC-6 Vendor Selection Criteria
   [pdf 15k, doc 30k]
   
   
3. WIC-21 Authorization Agreement for Direct Deposit (ACH) Credits [pdf 15k, doc 32k]
   
   
4. WIC-8 New Jersey Division of Taxation Authorization for Release of Tax Return information [pdf 21k, doc 742k]
   
   
5. WIC-12 Designation of Infant Formula Manufacturer, Retailer, Wholesaler and Distributor Form
   [pdf 14k, doc 30k]
   
   
6. WIC-26 Commodity Price List Survey-Minimum Stock Requirements [pdf 94k, doc 79k]

Retain the following documents for your records; do not return this information to the State Office:

1. WIC-15A Vendor Agreement (without Signature Page) October 1, 2015 - September 30, 2018 [pdf 88k]
   
   
2. List of Infant Formula Manufacturers Wholesalers and Distributors [pdf 9k]
   
   
3. Becoming a New Jersey WIC Vendor (English) [pdf 124k]
   
   
4. Becoming a New Jersey WIC Vendor (Spanish) [pdf 127k]
   
   
5. New Jersey Healthy Corner Store Network Fact Sheet (English & Spanish) [pdf 162k]
   
   
6. New Jersey WIC Food List - Effective January 2015 [A] (English) [pdf 124k]
   
   
7. New Jersey WIC Food List - Effective January 2015 [B] Insert [English pdf 55k]
   
   
8. New Jersey WIC Food List - Effective January 2015 (Spanish) [pdf 132k]
   
   
9. New Jersey WIC Cash Value Vouchers - Effective July 2015 (English) [pdf 1.53m]
   
   
10. New Jersey WIC Cash Value Vouchers - Effective July 2015 (Spanish) [pdf 1.03m]
    
    
11. Retail Grocers and New Jersey WIC Program (English) [pdf k]
    
    
12. Retail Grocers and New Jersey WIC Program (Spanish) [pdf 508k]