Hackensack, MT · Bergen County
Residential Safety Affidavit
Property owners or managers submit this affidavit to certify residential safety conditions in non-owner-occupied or multiple-dwelling properties.
What this form is
The Hackensack Fire Prevention Bureau accepts this certification in lieu of an inspection for residential units in non-owner-occupied or multiple-dwelling properties. The signer initials applicable statements about smoke alarms, carbon monoxide detectors, self-closing doors, and fire hazards; identifies units not checked and explains why; and provides contact information for those units. A certified professional’s report must accompany the wired-smoke-alarm option.
Who needs it
Owners or managers of non-owner-occupied or multiple-dwelling properties can use this affidavit to certify residential safety conditions to the Hackensack Fire Prevention Bureau.
How to submit it
The form identifies the Hackensack Fire Prevention Bureau at 205 State Street, Hackensack, New Jersey 07601. It does not state a submission method; confirm current delivery details with the Bureau.
About notarization
This affidavit is signed and dated without a notary; attach a certified professional’s report when reporting wired smoke alarms.
How to submit this form
- 1
Download The Affidavit
Download the Residential Safety Affidavit PDF.
- 2
Complete The Checklist
Initial applicable safety statements and identify units not checked, with a reason for each.
- 3
Gather Attachments
Attach a certified professional’s report if reporting wired smoke alarms.
- 4
Sign And Date
Provide the requested tenant or owner contact information for units not checked, then sign, print your name, and date the affidavit.
- 5
Submit To The Bureau
The form lists the Hackensack Fire Prevention Bureau at 205 State Street; confirm current delivery details because no submission method is stated.
Frequently asked questions
- What does the Residential Safety Affidavit certify?
- It certifies applicable residential safety conditions, including smoke alarms, carbon monoxide detectors, self-closing doors, and freedom from fire hazards.
- Who uses the Residential Safety Affidavit?
- Owners or managers of non-owner-occupied or multiple-dwelling properties use it to certify conditions to the Hackensack Fire Prevention Bureau.
- Do I need a notary for the Residential Safety Affidavit?
- No. The affidavit is signed and dated without a notary. If you report wired smoke alarms, attach a report from a certified professional.
- How do I submit the Residential Safety Affidavit?
- The form lists the Hackensack Fire Prevention Bureau at 205 State Street, Hackensack, New Jersey 07601, but does not specify a submission method. Confirm current delivery details with the Bureau.
Need something notarized?
This Residential Safety Affidavit doesn’t need a notary — but if you have another Hackensack form that does, a commissioned online notary can help.