West Orange, NJ · Essex County
Application to Amend a License
This application requests an amendment to a bingo or raffle license and is filed by the license applicant with the Municipal Clerk in the municipality where the games will be conducted.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
Use this form to request a change to an existing bingo or raffle license. The applicant describes the requested amendment, attaches any additional proofs, signatures, and verifications, and includes the registration slip from the Legalized Games of Chance Control Commission. Submit four copies to the Municipal Clerk in the municipality where the games will be conducted; the form says one copy will be returned. The applicant and members in charge must sign the sworn statement on the reverse.
Who needs it
A license applicant seeking to amend a bingo or raffle license must file this application with the Municipal Clerk where the games will be conducted.
Why it needs a notary
The reverse has a state jurat, and the applicant’s officer and members in charge sign the sworn statement before the notary public.
How to get this notarized
- 1
Download the Application
Get the Application to Amend a License and review the instructions, including the requirement to submit four copies.
- 2
Fill Out the Form
Enter the applicant and municipality details, describe the requested amendment, and prepare required proofs and the registration slip.
- 3
Book an Online Notary
Arrange a notarial appointment for the sworn statement on the reverse.
- 4
Sign on Video
The applicant’s officer and members in charge sign the statement before the notary, who completes the jurat.
- 5
Submit to the City
Submit four copies to the Municipal Clerk where the games will be conducted, with the required attachments.
Preview the form
The blank PDF straight from West Orange. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I notarize the sworn statement?
- Complete the application, then have the officer and members in charge sign the sworn statement during a notarial appointment. The notary completes the jurat after the oath or affirmation.
- Do I need to submit multiple copies?
- Yes. The form instructs applicants to submit four copies to the Municipal Clerk in the municipality where the games will be conducted, and says one copy will be returned.
- Can I use an online notary for this form?
- New Jersey permanently authorizes remote online notarization and remote ink notarization for its own notaries. A commissioned online notary can perform the notarial act; confirm with the municipality if unsure.
- What else must accompany the application?
- The form says to attach additional proofs, signatures, and verifications required for the amendment. It also says the applicant’s registration slip from the Legalized Games of Chance Control Commission must be presented to the Municipal Clerk.
Other forms in West Orange
Application to Amend a License in other New Jersey cities
Each city publishes its own version of this form. Pick the city where you’re filing.