Form T

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PLEASE USE THE UPDATED VERSION OF THIS FORM, WHICH CAN BE FOUND HERE:

https://sussexnj-portal-health.app.transform.civicplus.com/forms/form-t

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By continuing I acknowledge the application payment is a non-refundable review fee. Applications must be submitted two weeks prior to the event, there is no guarantee the application will be reviewed and approved in less than two weeks, a refund will not be given.
Cottage Food Law?
Type of Org
Handwashing Facilities
Ware-washing
Required Equipment
Type of water supply
Sanitizers to be used
Food Storage or Display Equipment
Cooking Equipment
Certified food manager available?
Water Storage Tank?
Your Name HereClick to Sign
Signature HereClick to Sign
Services provided at commissary
Report time am or pm?
EOD report time am or pm?
Your Name HereClick to Sign
Signature HereClick to Sign
10/15/2026Click to Sign
Your Name Here
Signature HereOwner Will Sign Here
10/15/2026
Attachment Checklist
Classified Risk Type
Signature HereInspector Will Sign Here
Inspector
x

Additional Signatures Required