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Get NJ DoT GTB-10 2021-2024

Applications received without payment will not be processed. Questions about the tax clearance process may be directed to 609 292-6400. O. Box 272 Trenton NJ 08695-0272 APPLICATION FOR TAX CLEARANCE BUSINESS ASSISTANCE AND INCENTIVES Application Fee Required Standard processing 75. As a precondition to or as a component of t he application process th e applicant must provide to the State agency a current tax clearance certificate issued by the Director of the Division of Taxation. This application form i s intended to provide the Division of Taxation with the necessary information to conduct its research and determine if the applicant is compliant with New Jersey tax laws such that a tax clearance certificate may be issued. If the Director determines that the applicant has not filed all required tax returns and has not paid all tax penalties interest or fees due the Director shall issue a notice to the applicant of the particulars to be resolved before a tax clearance certificate may be issued. Effective March 1 2009 a fee will be imposed for all Applications for Tax Clearance Business Assistance and Incentives. By signing this tax clearance application I consent to the release of such general status information by the Division of Taxation. Print Name Contact Phone Number Signature of Authorized Representative Gtb-10 R5 10/10 Title Date Page 1 Name of Applicant NJ Tax Registration Effective July 1 2007 P. Name of Issuer State Agency Due Date Name of Assistance Program Application Agency Contact Person I certify that I am autho rized to complete this tax clearance application that it is true and complete and that if any informatio n contained in this tax clearan ce application is willfully false I may be subje ct to penalty. 00 Expedited processing a response within 3 business days 200. 00 Legal Name of Applicant Trade Name of Applicant Business Location Address Mailing Address for Clearance Certificate If different from Business Location Address NJ Tax Registration FID/TIN Type of Business List All Officers or Partners on page 2 of application. Please list on page 2 of this application any parent company subsidiary or other related entity that will directly benefit from this assistance. State of New Jersey Division of Taxation Business Assistance Clearance Section 50 Barrack Street 9th Floor P. I understand that the Division of Taxation may communicate to the issuer Stat e agency the status of th e tax compliance of the applicant. L* 2007 c* 101 established a tax cle arance program for a wards of certai n other monetary or fin ancial benefit i ssued by the State and its i ndependent agencies and authorities to assist in the conduct or o peration of a business occupation trade or profession in the State. The application fee is 75. 00 for standard processing* An expedited service response within three 3 business days is available for 20 0. 00. The fee is non -refundable and will cover updates if nee ded for thi s application for up to one ye ar.

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