NJDEP

Community Right To Know Facility Identification Number Request Form

Please provide the following information in order to receive a Facility ID Number from our office.

*Company Name:
Trading as Name:
*FEIN (Federal Employer Identification Number):
*Description of Business Activity:
**Mailing Address: Street Address, City, Zip	City State: Zip
**Physical Address: Street Address, City, Zip	City State: Zip
*Contact Name:
*Phone Number :
*Email Address:	*


* Required Fields **Please include Suite # or Unit # if applicable.