New Jersey Administrative Code
Title 13 - LAW AND PUBLIC SAFETY
Chapter 69A - APPLICATIONS
Subchapter 5 - FORMS
Section 13:69A-5.13 - Labor Organization Registration Statement

1. The name of the registrant as shown on its charter or in its constitution;

2. The current business addresses of the registrant, including the address, telephone and fax numbers of any office where matters pertaining to employees of a casino licensee will be conducted;

3. The name, title, telephone and fax numbers of a person to be contacted in reference to the statement;

4. Whether the submission is an initial or biennial renewal registration;

5. The names of the registrant's parent organization and all affiliates of the registrant or its parent organization, whether chartered by the parent organization or governed by the same constitution or bylaws;

6. The name and nature of the actual or probable involvement of any affiliate which represents or is seeking to represent employees who are employed in a casino hotel, casino or casino simulcasting facility by a casino licensee, or which is involved or seeking to be involved in the control or direction of such representation;

7. Financial data, including information concerning any financial interests held in a casino hotel, casino, casino simulcasting facility or casino licensee; and

8. The name, address and, where applicable, date of birth, title or position and authority or responsibility, of the following persons or entities:

1. A notarized affidavit of truth, which shall be dated and signed by the registrant's president or other authorized officer;

2. A Release Authorization directing all courts, probation departments, selective service boards, employers, educational institutions, banks, financial and other institutions and all governmental agencies, Federal, state and local, both foreign and domestic, to release any and all information pertaining to the registrant as requested by the Division;

3. A waiver of liability as to the State and its instrumentalities and agents for any damages resulting to the registrant from any disclosure or publication of information acquired during the investigation process, in accordance with N.J.S.A. 5:12-80b; and

4. Consent to inspection, searches and seizures and the supplying of handwriting exemplars, in accordance with N.J.S.A. 5:12-80c.