New jersey reciprocity application 2026

1. Click ‘Get Form’ to open the New Jersey Reciprocity Application in the editor.
2. Begin by entering the 'Name of Licensee' in the designated field. This should be the person or firm proposing to conduct activities within New Jersey.
3. Select the type of report you are submitting, such as 'Annual', from the dropdown menu.
4. Fill in the 'Address of Licensee' accurately, ensuring all details are correct for correspondence.
5. Provide your contact information including 'Licensee Contact and Title', 'Telephone Number', and 'Email'.
6. In section 7, specify the activities you will conduct under the general license. Check all applicable boxes such as 'Service Provider' or 'Radiography'.
7. List additional work sites if necessary, and complete sections regarding client information and scheduled dates.
8. Finally, ensure you complete the certification section by signing and dating it to confirm that all information is true and accurate.

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