City of Passaic

Weatherly Frias, City Clerk 330 Passaic Street, Room 103 Passaic, NJ, 07055, US

Hector C. Lora, Mayor

Gary Schaer,
C. President

Council Members:
Jose Garcia
Terrence Love
Thania Melo
Chaim Munk
Daniel Schwartz
Maritza Colón Montañez

P: 973-365-5584
F: 973-365-0115

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Passaic, NJ Online Forms

Office Of The City Clerk

FAX: (973)-365-0115 Email: acurling@cityofpassaicnj.gov

By continuing on to complete and sign this form you are acknowledging that you are forgoing a notary and are in fact the owner of said business.

Upon submission you will be prompted to upload a Photo ID.

Al continuar y completar con su firmar este formulario, usted reconoce que usted está renunciando a un notario y es, de hecho, el propietario de dicho negocio

Al completar la aplicacion se le pedirá cargar una identificación con foto.

Please check that you agree before continuing.

I acknowledge that I am forgoing a notary and certifying I am the owner of said business. Reconozco que estoy renunciando a un notario y certifico que soy el propietario de dicho negocio.

Create Your Signature

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Additional Signatures Required

Upload Attachment(s)

Please upload the following attachments:

There is a 250MB limit on each attachment.

2 Passport Size Photos Click Here to Upload

A photocopy of your N.J. State Driver's License Click Here to Upload

Receipt from 5 pane Drug Test Click Here to Upload

Report of Physical Examination Click Here to Upload

Submit Proof of insurance - Taxi/ Limo Company's Policy Click Here to Upload

Limo Drivers - Limousine Qualification Certificate Click Here to Upload

Sign Now!

Please provide accurate information below to ensure the delivery of the signed copies of the document.

Listed Signers

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Applicant
I'm not a signer listed above

Other Signers (The signers below will be invited to sign once the above signers have signed.)

	Arely Barrera
	Edward Valentin
	Luis Guzman