2025 | Mercantile License Application

General Information

In accordance to Ordinance #22-28 –Chapter 303A –Licensing Article II, every Glassboro business must submit proof of insurance with their Mercantile License Application. Renewal Applications are due no later than February 7, 2025.

Today's Date*

Is this your initial application or renewal?*

InitialRenewal

Invoice Number (if applicable/renewals only)

If you are a NEW Business have you received the CO or the Commercial Transfer of Title/Tenancy:*

YesNoN/A (we are not a new business)

Where would you like us to mail your Mercantile License?*

Business AddressBusiness Owner's Home Address

If a new business, would you like to host a Ribbon Cutting?*

YesNo

Business Name:*

DBA:

Number of Full Time Employees:*

Number of Part Time Employees:*

Contact Email for Business:*

This email address will be to use to communicate Borough news, meeting dates, and exclusive advertising and marketing opportunities.

Business Phone Number:*

Please enter a valid phone number.

Website:*

Social Media Pages:

Block #:*

Lot #:*

Street Address:*

Street Address

Street Address 2

CityState

Zip Code

Business Owner's Full Name:*

First NameLast Name

Business Owner's Email:*

example@example.com

Business Owner's Phone Number:*

Please enter a valid phone number.

Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name of Corporation/Partnership LLC:

If Corporation/Partnership/LLC: Provide names, address and phone numbers of registered agent, all officers, members or partners:

Do you own or lease the property?*

OwnLease

Do you have a property manager?*

YesNo

Property Owner's Full Name:*

First NameLast Name

Property Owner's Email :*

example@example.com

Property Owner's Phone Number:*

Please enter a valid phone number.

Property Owner's Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What is the name of the Property Management Company?*

Property Manager's Full Name:*

First NameLast Name

Property Manger's Email:*

example@example.com

Property Manger's Phone Number:*

Please enter a valid phone number.

Property Manager's Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Insurance Company's Name*

Policy Number*

Policy Effective Date*

Policy Expiration Date*

Is your policy in an amount of not less than $500,000 for combined property damage and bodily injury?*

YesNo

Has any previous Business License in this Borough, held by the applicant, been suspended or revoked?*

YesNo

If yes, please describe:

Have you been convicted of any crimes of the 1st, 2nd, 3rd or 4th degree? *

YesNo

If yes, please provide date and location of conviction:

Proof of Business Insurance:*

PDF or JPEG File Only. The owner of a business shall maintain liability insurance for negligent acts and omissions in an amount of not less than $500,000 for combined property damage and bodily injury to or death of one or more persons in any one accident or occurrence.

501(c)3 Determination Letter (only applies to nonprofits)

My Products

2025 Mercantile License

$10.00

Subtotal

$0.00

Shipping

$0.00

Total

$0.00

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

2025 Mercantile License Application

Business Information

Business Owner Information

Property Information

Property Manager

Certification and Insurance