Hackensack, MT · Bergen County
Application for a Temporary Health License
Businesses apply to the Hackensack Department of Health for a temporary health license using this application and providing event and operation details.
What this form is
This application is for a business seeking to operate under a temporary health license in Hackensack. It asks for business and owner details, the type of business, and information about the event, location, chairperson, food or beverages, and food preparation and storage. The form states that a health license is valid only when a certificate of occupancy has first been obtained and is currently in effect.
Who needs it
A business seeking a temporary health license in Hackensack should complete this application, including the event and operation details requested on the form.
How to submit it
Submit it to the Hackensack Department of Health, 215 State St, Hackensack, NJ 07601-5582, or fax it to 201-646-3989.
About notarization
This application is signed and dated without a notary; it does not identify any notarized attachment or related step.
How to submit this form
- 1
Download The Application
Download the Temporary Health License Application PDF.
- 2
Complete The Application
Provide the requested business, owner, event, location, and operation details.
- 3
Gather Event Details
Include the event information and details about foods, beverages, their source, and preparation and storage.
- 4
Submit To The Health Department
Submit the application to the Hackensack Department of Health by mail or fax using the contact information on the form.
Frequently asked questions
- Who uses the Temporary Health License Application?
- A business seeking a temporary health license in Hackensack uses this application to provide business, owner, event, and operation details.
- What information does the application request?
- It asks for business and owner information, the type of business, event details and location, chairperson contact information, and food or beverage and preparation details.
- Do I need a notary for the Temporary Health License Application?
- No. The application is signed and dated without a notary, and it does not identify a notarized attachment or related step.
- How do I submit the Temporary Health License Application?
- Submit it to the Hackensack Department of Health at 215 State St, Hackensack, NJ 07601-5582, or fax it to 201-646-3989.
Need something notarized?
This Application for a Temporary Health License doesn’t need a notary — but if you have another Hackensack form that does, a commissioned online notary can help.