Return Form to:

Toms River Twp. Clerk

33 Washington St.

Toms River, NJ 08753

Application for No Knock Registry

I am requesting registration of the following address upon Toms River Township’s

“Do Not Knock” Registry.

I am the (check appropriate): ____ Owner ___ Occupant of the premises.

I understand that my address shall be placed upon a list to be kept by the

Township Clerk which will be updated twice per year. The list will be provided to

any licensee who is issued a license to conduct door to door sales pursuant to

Article III, Section 391-31 of the Code of the Township of Toms River. I understand that

registration upon the “Do Not Knock Registry” does not prohibit door to door

solicitation by non-profit, charitable, religious or political organizations.

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Information to be included on “Do Not Knock” Registry:

Street Address:____________________________________________________

Building – Apt. #:___________________________________________________

City:_____________________________ State: NJ_ Zip:_____________

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For Township Clerk’s Purposes Only:

Resident Name:____________________________________________________

Telephone Number:________________ (Optional)

Owner Name:______________________________________________________

(If different than resident)

Telephone Number:________________ (Optional)

Owner Street:______________________________________________________

(If different than resident)

Owner City:______________________ Owner State:____ Owner Zip:_________

(If different than resident)

__________________________________ ______________________

Signature Date