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Domestic Partnership Certificates

To obtain a domestic partnership certificate you must follow the process below. There is a fee of $28.00 due and payable at time of application.Application should be made at the Piscataway Township Health Department, 455 Hoes Lane between the hours of 8:30 a.m. and 4:00 p.m.

An Affidavit of Domestic Partnership must be completed and signed by both applicants at the same time, in the presence of a notary public, and notarized.

Applicants must appear together and each supply valid identification that establishes name, age and date of birth. This may be supplied by one or more documents issued by a government agency, such as a certified copy of a birth certificate, driver’s license, military identification or state / county identification card.`

Applicants must bring with them proof of residency. If the residence is outside the State of New Jersey, at least one of the applicants must provide proof of membership in a New Jersey State-administered Retirement System by providing one of the following documents issued by the Division of Pension and Benefits:

  • Personal Benefits Statement from the current or previous year 1099R from the current or previous year, or Certificate of Pension Membership
  • Applicants must provide proof of joint financial responsibility, evidenced by at least one of the following documents:
  • Joint deed, mortgage agreement or lease;
  • Joint bank account;
  • Designation of one of the persons as primary beneficiary in the other person’s will;
  • Designation of one of the persons as primary beneficiary in the other person’s insurance policy or retirement plan;or:
  • Joint ownership of a motor vehicle

Department affiliation: Health Department

 

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