Salutation
Acting Commissioner Bishop Brother Capt. Chief Commissioner Dr. Elder Fr. Hon. L. Lt. Lt. Governor M. Major Mayor Miss Mr. Mrs. Ms. Msg. Pastor Patrolman Rabbi Rev. Rev. Dr. Sgt. Sister Sr. The Honorable The Reverend
First Name
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Middle Name
Last Name
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Email
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Title (Must be Executive Director, Mayor or Chief Operating Officer)
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Agency Name
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Agency Vendor Number (Obtain a Vendor Number )
Agency Street Address (No PO Box allowed)
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Agency Address continued
Agency Address continued
Agency City
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Agency State
AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY *
Agency Zip Code (Obtain +4 digits extension )
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Agency County (Location)
2300: Out-Of-State (NJ) 0100: Atlantic 0200: Bergen 0300: Burlington 0400: Camden 0500: Cape May 0600: Cumberland 0700: Essex 0800: Gloucester 0900: Hudson 1000: Hunterdon 1100: Mercer 1200: Middlesex 1300: Monmouth 1400: Morris 1500: Ocean 1600: Passaic 1700: Salem 1800: Somerset 1900: Sussex 2000: Union 2100: Warren
Agency Municipality (Location)
Agency Phone
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Agency Phone Extension
Agency Fax
Initial Agency Type
Community Development Financial Institutions (CDFI) Fire Districts Business Improvement Districts Other Local Entities with Taxing Authority, Non-educational Regional Health Commission Primary & Secondary School Districts, School Boards Educational Services Commissions Private Primary & Secondary Schools Institutions of Higher Education Hospitals and Clinics Mental Health and Counseling District Management Corporation District Management Corp. (Main Street Community) Community Action Agencies Hispanic Community-based Organization Women Community-based Organization Multi-purpose Community-based Organization Volunteer Fire-fighting, Rescue, or EMS Organization Other Community-based Organization Non-Profit Veteran Organizations Private For-profit Affordable Housing Developers CHDOs - Community Housing Development Organizations Other Non-profit Affordable Housing Developers State Agency Other Non-Profit Organizations For-profit Consultant, Planning For-profit Consultant, Engineering For-profit Consultant, Construction Private For-profit Affordable Housing Consultant Landlords *
Federal Employer I.D. Number:
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Access Requested for RFP/Program
Acacia Youth Center Affordable Housing Trust Fund Affordable Housing Trust Fund - Innovation Projects Bright Side Manor Community and Cultural Community Services Block Grant-Special Initiatives Edison Memorial Tower First Tee Heating Improvement Hinchliffe Neighborhood HOME Community Housing Development Organizations HOME Housing Production Investment Fund Hudson County Housing First Hudson County Re-entry LIHEAP CWA Administration LIHEAP Weatherization Mercer County Reentry National Aviation Research National Housing Trust Fund Neighborhood Revitalization Tax Credit Planning Reentry Coalition Transitional Re-entry Universal Service Fund - CWA Administration Volunteer Emergency Service Organization WAP Training and Technical Assistance Weequahic Park Youth Center Paterson NRTC Center *
Date Created
Certificate of Corporation
Federal Congressional District
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 *
DUNS Number (Obtain a DUNS number )
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NJ Department of Treasure Corporate Number (Entity ID)
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1. If your organization received U.S. Federal Revenues in your preceding completed fiscal year, was the sum of those revenues: A. $25,000,000 or more in annual gross revenues?
Yes No *
B. 80% or more of the agency's annual gross revenues?
Yes No *
2. If you answered 'yes' to both questions 1a and 1b, does the public have accesss to information about the compensation of the excutives in your organization through periodic reports filed under section 13(a) or 15(d) or the Securities Exchange Act of 1934 (15U.S.C 78o(d) or section 6140 of the Internal Revenue Code of 1986?
Yes No *