NJDOBI | Third Party Administrator - Certificate of Compliance

Third Party Administrator - Certificate of Compliance

In order to issue a Certificate of Compliance the Department will need the following information:

	Name of Third Party Administrator (TPA)
	Home Address of the TPA
	Date of Formation
	Domestic State
	Number of Certificates needed
	Name of the person requesting the Certificate
	Phone number or e-mail of requestor in case the Department needs to contact you
	Address or e-mail where the Certificate(s) should be sent (If Certificate is e-mailed, there will not be a raised Seal)
	Do you want the Certificate mailed, e-mailed or both?

There is no fee for a Certificate(s) of Compliance.

The request can be sent in by e-mail to Tim.Stroud@dobi.nj.gov or requested by phone at 609-940-7452.



	OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey.			You will need to download the latest version of Adobe Acrobat Reader in order to correctly view and print PDF (Portable Document Format) files from this web site.

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