APPLICATION FOR NO KNOCK REGISTRY

I am requesting registration of the following address in the Borough of Woodcliff Lake for the “No 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 Borough Clerk, which will be updated twice per year January 1^st, April 1^st, July 1^st and October 1^st. Addresses will remain on the registry until notification to the Borough that the owner or occupant wishes to be removed. The list will be provided to any licensee who is issued a license to conduct door to door sales pursuant to Woodcliff Lake Borough Ordinance 06-15. I understand that registration upon the “No Knock Registry” does not prohibit door to door solicitation by non-profit, charitable, religious or political organizations.

Information to be included on “No Knock” Registry:

Street #_________ Street Name_______________________________________

Woodcliff Lake, New Jersey 07677

Residents Name____________________________________________________

Phone Number______________________________(OPTIONAL)

Owners Name________________________________

(If different than resident)

Owners Phone Number_______________________(OPTIONAL)

Owners Street_________________ Owners City_________________

Owners State__________ Owners Zip Code_______________________

____________________________________ __________________________

Signature Date