New Jersey (NJ) Electrical Contractor Business Permit Bond Application

Note: Please complete this form in full and submit. Upon submission you will be taken to a new page where you can pay by Master Card, Visa, or by PayPal. A $50.00 (Fifty Dollar) fee must be paid in order to complete the processing of your application. If do not submit payment, your application will be discarded.

Application Form

Your Name:

Business Name: (for reference only)

Street 1:

Street 2:

City:

County:

State:

Zip:

Electrical License #: (if renewal)

Home Phone:

Business Phone:

Cell Phone:

Email:

This statement is required by the NJ Dept. of Insurance for all new policies. General Fraud Statement: Any person who knowingly and with intent to defraud any insurance company or another person files an application for insurance containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects the person to criminal and civil penalties.

I Agree

PRIVACY POLICY: We never sell, trade, or share your personal information with any third party or organization, and only our agency or the bonding company will contact you regarding the bond or electrical contractor insurance. When you provide the above information, you give us express permission to call you even if your phone number is on a state "do not call" list.