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Public Health and Food Protection Program

Forms and Applications

Application Instructions:

Please select your license from the following license types. The Public Health and Food Protection Program issues several different types of licenses and permits. Carefully read the following list and select the license type that appears at the top of your printed certificate:

 

FREQUENTLY ASKED QUESTIONS

Q: Why do I have to use Adobe Acrobat Reader to fill out the form?

A: Forms which are filled out in any program other than Adobe Acrobat Reader may open incorrectly in this office. This office utilizes Adobe Acrobat to create and view all application forms. If you complete a form in any program other than Adobe Acrobat, the information you saved may appear corrupted, incomplete, or blank when we view it in the office. To ensure the information appears the same on your screen and ours, always use Adobe Acrobat Reader to complete your form.

Q: When I click on the application link the form opens automatically. Can I fill out the form on this screen?

A: Do NOT fill out a form that appears automatically after you click the form link. The form that automatically appears is showing in your browser. Forms that are filled out from your browser will save incorrectly and may deliver corrupted or incomplete information to this office. Always SAVE the file, then open it through Adobe Acrobat Reader.

Q: How do I install Adobe Acrobat Reader on my PC, Mac, or laptop?

  1. Visit the following webpage: https://get.adobe.com/reader/otherversions
  2. Follow the instructions on the screen to download and install the FREE program called Adobe Acrobat Reader DC.


Q: How do I download the application form on my PC, Mac, or laptop?

  1. Click or tap the form link to open it.
  2. At the top, click or tap the option to DOWNLOAD or SAVE the pdf.
  3. Select the location where you want to save the file and complete the save.


Q: How do I open the application form in Adobe Acrobat Reader on my PC, Mac, or laptop?

  1. Open the Adobe Acrobat Reader program.
  2. At the top left corner of Adobe Acrobat Reader, select FILE then select OPEN.
  3. In the popup screen, find and select the application form that you had previously downloaded. If you are unsure, check your DOWNLOADS folder.
  4. Select the OPEN button to open the form.

Q: How do I install Adobe Acrobat Reader on my tablet or phone?

  1. Visit your device's App Store.
  2. In the App Store, search for Adobe Acrobat. One of the first results will be the FREE Adobe Acrobat Reader app.
  3. Download the FREE Adobe Acrobat Reader app.


Q: How do I open the application form in Adobe Acrobat Reader on my tablet or phone?

  1. Tap on the link to the application.
  2. Select Open in Adobe Acrobat Reader.


Q: I have finished filling out the application in Adobe Acrobat Reader. How do I send my form? 

  1. SAVE the form to your device.
  2. EXIT Adobe Acrobat reader.
  3. Open your email inbox and create a new email.
  4. Select the option in your email to ATTACH a file.
  5. Select the file that you saved to your device.


Q: Can I send my application through the "Send File by Email" option in Adobe Acrobat Reader?

A: If you use the "Send File by Email" option, always make sure the "Attach a Link" option is NOT selected. Any applications that are submitted through a cloud network such as Document Cloud are not accepted. Due to security restrictions, this office cannot open files that are stored in the cloud. All applications must be directly attached as a PDF attachment to the email.

 

HOW TO PAY YOUR APPLICATION FEE ELECTRONICALLY

Online payment is strongly recommended. Advantages to submitting your payment and application online include:

✔ Faster processing time
✔ No processing delays due to unintended loss or separation of checks or money orders
✔ Immediate, verifiable electronic documentation that your payment was successfully submitted
✔ Easy, no-hassle corrections in the event you need to resubmit an application
✔ If you pay by e-check, there is NO extra processing fee

Online payment options include checks and most credit cards. (Discover, American Express, MasterCard, Visa)

 

After you click or tap PAY ONLINE in the section for your appropriate license, fill out the following fields:

  • Trade or Individual Name and Physical Address: Must match the business name and address on your renewal form.

  • Responsible Party Information: The last name and first name of the contact person for any questions about the payment submission.

  • Application Type Information: Select License/Permit/Certificate in the dropdown.

  • Pertinent Number: Input your existing permit number and expiration date.

  • Payment Information: Indicate Electronic Check Payment or Credit Card Payment. Enter the fee amount you are paying. A nominal processing service fee will be additionally charged for credit card payments. There is no service fee for electronic check payments.

  • Security Message: The security message is a string of letters and numbers in the gradated box. Click Refresh if you cannot see the security message. Enter the security message in the indicated text field.

  • Click Continue when you are finished. Depending on your payment type selection, you will be directed to a check payment or credit card payment page where you can complete your online payment.

    • If you experience a technical error after you have submitted your check or credit card information, do not try again. A processed payment may take a day or more to appear in your account. Write “ERROR RECEIVED” in the Payment Confirmation Number/Check Number box and submit your application. We will notify you if your payment was not processed.

  • When payment is complete, you will be presented with a payment confirmation number. You will also receive an email receipt that includes your payment confirmation number. Copy your payment confirmation number to the Payment Confirmation Number or Check Number box on the application.

If you do not have access to a credit card or checking account, or if you are not able to utilize the online payment system, paper checks or money orders are accepted. Write the number and date of the check or money order in the box provided on the application form. Make checks and money orders payable to NJ Department of Health. All checks and money orders must be dated and signed. State policy prohibits processing of money orders or checks that do not include signatures and legible dates.

 

HOW TO SUBMIT VIA MAIL OR COURIER

ONLINE submission via email is strongly preferred. If you already submitted your renewal via email, do NOT mail a paper copy. Do not email your renewal in addition to mail unless requested by this office. Duplicated renewals will cause a significant delay in processing.

If you must submit your renewal via mail, send your printed renewal form and a check or money order:

Via US Postal Service

NJ Department of Health
Public Health & Food Protection
P.O. Box 369
Trenton, NJ 08625

Via Courier (UPS/FedEx/DHL)

NJ Department of Health
Public Health & Food Protection
135 East State Street
Trenton, NJ 08608

In-person delivery of applications is NOT accepted. There is no receptacle at the office to accept walk-in applications or personal delivery by applicants. The office is not open to the public. To ensure your application is promptly delivered to the appropriate office, all paper applications must be submitted by mail or courier. If you would like to expedite the process or ensure the application is received as quickly as possible, submit your application via email.

 

BOTTLED OR BULK WATER CERTIFICATION
  1. Download the Bottled or Bulk Water Renewal Form F-19 (right-click and "Save Link As")
  2. PAY ONLINE
  3. Send your completed renewal application form via email to: bottledwater@doh.nj.gov 

For New Bottled or Bulk Water Certification Applications or for more information about the Bottled or Bulk Water Certification, see the Bottled Water webpage.

To Inactivate your certification, send an email to bottledwater@doh.nj.gov and include the name of the business, the license number, the reason for inactivation, and your name and title.

 

COTTAGE FOOD OPERATOR PERMIT
  1. Download the Cottage Food Operator Permit Application (right-click and "Save Link As")
  2. PAY ONLINE
  3. Send your completed renewal application form via email to: cfo@doh.nj.gov 

For more information about the Cottage Food Operator Permit, see the Cottage Food Operator Permit webpage.

To Inactivate your certification, send an email to cfo@doh.nj.gov and include your name, your CFO number, and the reason for inactivation.

 

DRUG AND MEDICAL DEVICE REGISTRATION
  1. Download the Renewal Application Form (F-13) (updated September 2022)
    Download the renewal form and complete all attestations before signature. Electronic and scanned signatures are accepted. All registrations expire January 31. Submit annually by December 31 to renew an active registration. Please allow 3-4 weeks for processing. There is no penalty payment for late submission. Renewals for the following year are accepted beginning October 1.

  2. Pay online with check or credit card
    The online payment portal is for payment processing only. Submission of online payment alone is insufficient to renew your registration. The completed renewal form F-13 is required to be completed and submitted by email. Submit a separate payment for each registration number. Do not combine fees.

  3. Email the completed renewal application and any supporting attachments to wholesaledrugs@doh.nj.gov 
    If any attestation is marked No on the application form, attach supporting documentation.

For further submission process information and instructions for fees, CPA signatures, update notices, changes of ownership, corporate structure, officers, designated representatives, product lists, and locations, see the FAQ.

For New Drug or Medical Device Registrations or for more information about the Drug and Medical Device Registration, see the Wholesale Drugs webpage.

To Inactivate your registration, submit a signed letter on company letterhead indicating the registration number to be discontinued, the reason for discontinuance, and the effective date. If a manufacturing or warehouse facility is closing, include verification that all remaining drug, medical device or API inventory has been accounted for, reclaimed and/or disposed of properly. This may be submitted as a pdf attachment via email to: wholesaledrugs@doh.nj.gov 

 

MILK PLANT OR BULK MILK HAULER PERMIT
  1. Download the Milk Plant Renewal Form M-8 or Download the Initial Application for a Milk Plant Permit Form M-3 (right-click and "Save Link As")
  2. PAY ONLINE
  3. Send your completed renewal application form via email to: dairy@doh.nj.gov

 

For more information about the Milk Plant or Bulk Milk Hauler Permit, see the Dairy webpage.

To Inactivate your permit, send an email to dairy@doh.nj.gov and include the name of the business, the license number, the reason for inactivation, and your name and title.

 

FROZEN DESSERTS MANUFACTURER LICENSE
  1. Download the Frozen Desserts Renewal Form M-6 or Download the Initial Application for a Frozen Desserts License Form M-5 (right-click and "Save Link As")
  2. PAY ONLINE
  3. Send your completed renewal application form via email to: dairy@doh.nj.gov

 

For more information about the Frozen Desserts Manufacturer License, see the Dairy webpage.

To Inactivate your license, send an email to dairy@doh.nj.gov and include the name of the business, the license number, the reason for inactivation, and your name and title.

 

NITROUS OXIDE PERMIT
  1. Download the Nitrous Oxide Form F-17 (right-click and "Save Link As")
  2. PAY ONLINE
  3. Send your completed application form via email to: phfpp@doh.nj.gov

 

For more information about the Nitrous Oxide Permit, see the Nitrous Oxide webpage.

To Inactivate your permit, send an email to phfpp@doh.nj.gov and include the name of the licensee and the permit number.

 

NON-ALCOHOLIC BEVERAGE MANUFACTURING PLANT LICENSE
  1. Download the Non-Alcoholic Beverage Renewal Form F-39 or Download the Initial Application for a Non-Alcoholic Beverage License Form F-9 (right-click and "Save Link As")
  2. PAY ONLINE
  3. Send your completed application form via email to: wholesalefood@doh.nj.gov 

 

For more information about the Non-Alcoholic Beverage Manufacturing Plant License, see the Wholesale Food webpage.

To Inactivate your license, send an email to wholesalefood@doh.nj.gov and include the name of the business, the license number, the reason for inactivation, and your name and title.

 

REFRIGERATED WAREHOUSE AND/OR LOCKER PLANT LICENSE
  1. Download the Refrigerated Warehouse Renewal Form F-19 or Download the Initial Application for a Refrigerated Warehouse License Form F-8 (right-click and "Save Link As")
  2. PAY ONLINE
  3. Send your completed application form via email to: wholesalefood@doh.nj.gov 

 

For more information about the Refrigerated Warehouse and/or Locker Plant License, see the Wholesale Food webpage.

To Inactivate your license, send an email to wholesalefood@doh.nj.gov and include the name of the business, the license number, the reason for inactivation, and your name and title.

 

TANNING FACILITIES REGISTRATION
  1. Download the Tanning Facilities Application Form PHSS-1 (right-click and "Save Link As")
  2. PAY ONLINE
  3. Send your completed application form via email to: tanningfacilities@doh.nj.gov 

 

For more information about the Tanning Facilities Registration, see the Tanning Facilities webpage.

To Inactivate your registration, send an email to tanningfacilities@doh.nj.gov and include the name of the business, the TF registration number, the reason for inactivation, and your name and title.

 

WHOLESALE FOOD-COSMETIC ESTABLISHMENT LICENSE
  1. Download the Wholesale Food-Cosmetic Renewal Form F-41 or Download the Initial Application for a Wholesale Food-Cosmetic License Form F-29 (right-click and "Save Link As")
  2. PAY ONLINE
  3. Send your completed application form via email to: wholesalefood@doh.nj.gov 

 

For more information about the Wholesale Food-Cosmetic Establishment License, see the Wholesale Food webpage.

To Inactivate your license, send an email to wholesalefood@doh.nj.gov and include the name of the business, the license number, the reason for inactivation, and your name and title.

 

YOUTH CAMP LICENSE
  1. Download the Youth Camp application Form CB-11 (right-click and "Save Link As")
  2. PAY ONLINE
  3. Send your completed application form via email to: youth.camps@doh.nj.gov 

 

For more information about the Youth Camp License, see the Youth Camp License webpage.

To Inactivate your license, send an email to youth.camps@doh.nj.gov and include the name of the camp, the camp ID number, the reason for inactivation, and your name and title.

 

Last Reviewed: 12/23/2022