Get NJ Agriculture New Store Milk License App 2011-2024

Nj. gov/agriculture APPLICATION FOR NEW STORE MILK LICENSE PLEASE PRINT OR TYPE Owner Information Business Location Information Owner Name Franchisee s Name If Applicable Federal Tax ID FEIN Trade Name If Applicable Social Security Number Street Address City Suite/Room No. County State Zip Mailing Address Municipality Type of Ownership - Please check only one COOPERATIVE CORPORATION PARTNERSHIP SOLE PROPRIETORSHIP Type of Store Example Bakery/Supermarket/Coffee Shop Contact Information Contact Name Milk Supplier s - Title List your current milk supplier s Phone Number Fax Number E-mail Address Signature of Applicant Information will be provided to the Division of Taxation for Tax Administration Purposes. STATE OF NEW JERSEY - DEPARTMENT OF AGRICULTURE DIVISION OF MARKETING AND DEVELOPMENT PO BOX 332 TRENTON NJ 08625-0332 PHONE 609 292-5646 FAX 609 984-2508 ONLINE LICENSING IS NOW AVAILABLE AT WWW*NJFARMS*NJ*GOV www. The applicant certifies that he will comply with all applicable orders and regulations of the Division of Marketing and Development. MAKE CHECKS/MONEY ORDERS PAYABLE TO NJDA COMPLETE BOTH SIDES Revised 08/11 Store at new location fee 25. 00 for first year of operation Existing store purchased from Name of Previous Owner and Trade Name if known Date of Purchase NJDA ID of previous owner if known owner in accordance with the store fee schedule below Weekly Average Quart Equivalents License Fee FEE SCHEDULE - STORE MILK LICENSE The Milk Control Act provides that store milk license fees are based on the volume of milk sold during the previous two months Stores selling 500 quart equivalents or less per week 25. 00 50. 00 75. 00 100. 00 Quart equivalents should include all MILK defined as follows Milk The natural product of a dairy animal or animals and includes fluid milk and cream fresh sour or storage lowfat milk skim milk flavored milk any milk drink buttermilk yogurt and condensed or concentrated whole or skim milk except when contained in hermetically sealed cans. CONVERSION TABLE 1-Gallon 4 Quarts 1- Half Gallon 1- Quart 2- Pints 4- Half Pints 3- 10 oz. Containers 4- 8 oz. The applicant certifies that he will comply with all applicable orders and regulations of the Division of Marketing and Development. MAKE CHECKS/MONEY ORDERS PAYABLE TO NJDA COMPLETE BOTH SIDES Revised 08/11 Store at new location fee 25. MAKE CHECKS/MONEY ORDERS PAYABLE TO NJDA COMPLETE BOTH SIDES Revised 08/11 Store at new location fee 25. 00 for first year of operation Existing store purchased from Name of Previous Owner and Trade Name if known Date of Purchase NJDA ID of previous owner if known owner in accordance with the store fee schedule below Weekly Average Quart Equivalents License Fee FEE SCHEDULE - STORE MILK LICENSE The Milk Control Act provides that store milk license fees are based on the volume of milk sold during the previous two months Stores selling 500 quart equivalents or less per week 25. 00 for first year of operation Existing store purchased from Name of Previous Owner and Trade Name if known Date of Purchase NJDA ID of previous owner if known owner in accordance with the store fee schedule below Weekly Average Quart Equivalents License Fee FEE SCHEDULE - STORE MILK LICENSE The Milk Control Act provides that store milk license fees are based on the volume of milk sold during the previous two months Stores selling 500 quart equivalents or less per week 25. 00 50. 00 75. 00 100. 00 Quart equivalents should include all MILK defined as follows Milk The natural product of a dairy animal or animals and includes fluid milk and cream fresh sour or storage lowfat milk skim milk flavored milk any milk drink buttermilk yogurt and condensed or concentrated whole or skim milk except when contained in hermetically sealed cans. .