N.J. Admin. Code § 7:26-16.4

Current through Register Vol. 56, No. 21, November 4, 2024

Section 7:26-16.4 - Content of disclosure statement

(a) The disclosure statement shall be filed on forms supplied by the Division of Law, and shall include the following information:

1. The full name, business address, home address, date of birth, social security number and/or Federal Employer Identification Number of the applicant, permittee or licensee, of any officers, directors, partners, or key employees thereof and all persons holding any equity in or debt liability of that business concern, or, if the business concern is a publicly traded corporation, all persons holding more than five percent of the equity in or debt liability of that business concern, except that where the debt liability is held by a chartered lending institution, the applicant, permittee or licensee need only supply the name and business address of the lending institution;

2. The full name, business address, home address, date of birth and social security number of all officers, directors, or partners of any business concern disclosed in the disclosure statement and the names and address of all persons holding any equity in or the debt liability of any business concern so disclosed, or, if the business concern is a publicly traded corporation, all persons holding more than five percent of the equity in or debt liability of that business concern, except that where the debt liability is held by a chartered lending institution, the applicant, permittee or licensee need only supply the name and business address of the lending institution;

3. The full name and business address of any company which collects, transports, treats, stores, transfers or disposes of solid waste or hazardous waste in which the applicant, permittee or licensee holds an equity interest;

4. A description of the experience and credentials in, including any past or present licenses for, the collection, transportation, treatment, storage, transfer or disposal of solid waste or hazardous waste possessed by the applicant, permittee or licensee, or by the key employees, officers, directors, or partners thereof;

5. A listing and explanation of any notices of violation or prosecution, administrative orders or license revocations issued by any state or Federal authority, in the 10 years immediately preceding the filing of the application, which are pending or have resulted in a finding or a settlement of a violation of any law or regulation relating to the collection, transportation, treatment, storage, transfer or disposal of solid waste or hazardous waste by the applicant, permittee or licensee, or by any key employee, officer, director, or partner thereof;

6. A listing and explanation of any judgment of liability or conviction which was rendered, pursuant to any State or Federal statute or local ordinance, against the applicant, permittee or licensee, or against any key employee, officer, director, or partner thereof, except for any violation of Title 39 of the Revised Statutes (N.J.S.A.), other than a violation of the provisions of 39:5B-18 et seq., 39:5B-25 et seq., or 39:5B-30 et seq., or comparable motor vehicle offenses in jurisdictions other than New Jersey;

7. A listing of all labor unions and trade and business associations in which the applicant, permittee or licensee was a member or with which the applicant, permittee or licensee had a collective bargaining agreement during the 10 years preceding the date of filing of the disclosure statement;

8. A listing of any agencies outside of New Jersey which had regulatory responsibility over the applicant, permittee or licensee in connection with its collection, transportation, treatment, storage, transfer or disposal of solid waste or hazardous waste;

9. A listing of all persons employed by the applicant, permittee or licensee in its solid waste or hazardous waste operations in New Jersey and not otherwise required to be listed, and as to each, the full name, home address, date of birth and social security number;

10. As to every person required to be listed in the disclosure statement (other than holder of debt liability or non-supervisory employee required to be listed under 7:26-16.4(a)9 ) , a completed Personal History Disclosure Form or forms supplied by the Department, including information about family, education and employment history. Holders of debt liability or non-supervisory employees may be required to provide Personal History Disclosure Forms if this information is requested by the Department or the Attorney General; and

11. Any other information the Attorney General or the Department may require that relates to the competency, reliability, honesty, integrity or good character of the applicant, permittee or licensee.

(b) The disclosure statement shall be sworn to or affirmed and subscribed and dated by the applicant, permittee, licensee or the author before a person legally competent to take an oath or affirmation, who shall himself subscribe and date the signature of affiant and indicate the basis of his authority to take oaths and affirmation. Personal History Disclosure Forms shall be sworn to or affirmed and subscribed in the same manner, by the individual and the oath-taker. The following statement shall immediately precede the signature of the affiant: "I swear (or affirm) that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment."

(c) Disclosure statements shall be signed by each of the following:

1. If of a corporation, by its president, its chairman of the board, any other chief executive officer thereof, its secretary and its treasurer.

2. If of a partnership, by each of its partners; if of a limited partnership, only by each of its general partners.

3. If of any other business concern, by its chief executive officer, its secretary and its treasurer.

4. If of a natural person, by the person himself or herself.

(d) Personal History Disclosure Forms shall be signed by the individual described thereon.

(e) All signatures shall be signed in ink and dated on original papers, but may be photocopied, typed, stamped or printed on copies. The name and address of the signatory shall be typed, stamped or printed beneath each signature.

N.J. Admin. Code § 7:26-16.4

Amended by R.2002 d.181, effective 6/17/2002.
See: 33 New Jersey Register 4218(a), 34 New Jersey Register 2049(a).
Rewrote the section.