Annual Manufacturer Report and Certification

This form is needed to collect annual reports from manufacturers of a covered product subject to the law containing the following information:

Manufacturer's Information

Manufacturer Name(Required)
Manufacturer's Address(Required)

Certifier's Information

The name, title, telephone number, and email address of the responsible official certifying the information contained in the Annual Manufacturer Report and Certification
Certifier's Name(Required)
Certifier's Email Address(Required)

Product Information

A list of each covered applicable product offered for sale, by product category as set forth the manufacturer in New Jersey, including, for each category of applicable product listed in the Guidance, along with the following information for each covered product.
Type(s) of Products (Select Product)(Required)
0 of 250 max characters
Max. file size: 500 MB.
Upload an image of the label, mark, and/or tag on the product and packaging [upload of jpg, png, pdf)
All listed products comply with the requirements of the law(Required)
All listed products are certified through SASD or other certification platform as described in the Appliance Standards FAQ(Required)
Any product that has undergone modifications that may affect compliance with this subchapter have been recertified prior to sale of the modified product in New Jersey(Required)

Certification Statement

Certification Statement(Required)
Electronic Signature(Required)

Questions?

For additional questions or comments regarding New Jersey’s Appliance Standards, please send an email to appliancestandards@dep.nj.gov.