Additional Health Department Forms

Forms for Smoke-free Air Act Initiative

Forms
Form # Form Name/Title Linked File Instruction/ Comments
OC-51 Notice of Claim of Exemption of Tobacco Retail Establishment
pdf (35k)
doc (85k)
 
OC-53 Application for Registration of Exempt Cigar Bar or Lounge
pdf (42k)
doc (93k)
 
OC-54 Application for Renewal of Registration of Exempt Cigar Bar or Lounge
pdf (49k)
doc (95k)
 
OC-56 NJ Smoke Free Air Act / Complaint
(Updated January 25,2022)
OC-56 (135k)
 
OC-58 NJ Smoke Free Air Act / Anonymous Request for Investigation
(Updated January 25,2022)
OC-58 (89k)
 
OC-59 Notice - Smoke Free Air Act
(Updated January 25,2022)
OC-59 (259k)
 
Go to Smoke-free Air Act Initiative     Additional Health Department Forms