Form N-Rdf - Non-Residential Development Fee Certification/exemption
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1
2STATE OF NEW JERSEY
NON-RESIDENTIAL DEVELOPMENT FEE CERTIFICATION/EXEMPTION
SECTION A (To be completed by developer):
Developer
Name of Developer:
Address:
Phone:
Fax:
E-mail:
Property Location
County:
Municipality:
Block:
Lot:
Qual.:
Street Address:
Date(s) on which Developer received preliminary and/or final site plan approval:
Construction Permit Application Number:
Date on which Developer first sought construction or demolition permit (section 37 of P.L. 2008 c.46):
Exempt From or Not Subject to Fee [Section Citation of P.L. 2008 c. 46(C. 40:55D-8.1 et seq.] Check one if appropriate
Non-profit Educational Purposes [35b]
Transit Hub [35b.(4)]
House of Worship [35b]
Transit Village [35b.(6)]
Parking lots and structures [35b.(1)]
Transit Hub-Light Rail [35b.(5)]
Non-profit hospital relocation or improvement
Public amenity (recreational, community, senior centers)
[35b.(3)]
[35b.(2)] (Attach Planning Board approval)
State, County, and local government buildings
Commercial Farm or Use Group U Buildings and Structures
Approval granted prior to July 1, 2013 [37a. (1,3-5)
Non exempt status [Section citation] Check one if appropriate
Prior payment or commitment for low and moderate income housing [37c]
Amount paid:
$
Non-residential planned development, subject to a development or redevelopment agreement entitled to a 1% fee [37a.(2)]
Full Fee Due (2.5%)
IF AN EXEMPTION OR REDUCED PAYMENT AMOUNT IS CLAIMED, THE DEVELOPER SHOULD ATTACH
SUBSTANTIATION FOR THA CLAIM.
I, the undersigned, understand that this declaration and its contents may be disclosed or provided to the State of New Jersey
and that any false statement contained herein may be punished by fine, imprisonment, or both. I further declare that I have
examined this declaration and, to the best of my knowledge and belief, it is true, correct and complete.
Signature of Developer:
Name:
Title:
Date:
SECTION B (To be completed by assessor):
Estimated
Final
Assessed Value
$
$
E1
F1
Director’s Ratio
%
%
E2
F2
Equalized Assessed Value
$
$
E3
F3
Existing Equalized Assessed Value –
$
$
E4
F4
If new construction, use $0.00/NA.
Amount on Which Fee is Calculated
$
$
E5 (E3-E4)
F5 (F3-F4)
Non-residential Development Fee
$
$
E6 (E5 X 2.5%)
F6 (F5 x 2.5%)
Signature of Assessor:
Date
Name:
Exempt:
SECTION C (To be completed by municipality)
Payment Amount:
$
Amount should equal E6 or F6
Payment received by ( name):
Signature:
Name:
Title:
Date:
(N-RDF- rev. 10/24/13)
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