New Jersey Statutes Title 34. Labor and Workmen's Compensation 34 § 11-56.90

a. The name, principal business address and telephone number of the waterfront employer;

b. Whether the waterfront employer is a corporation, partnership, sole proprietorship, or other form of business entity;

c. If the waterfront employer's principal business address is not within the State, the name and address of the waterfront employer's custodian of records and agent for service of process in this State;

d. The name and address of each person with a financial interest in the waterfront employer and the percentage interest, except that if the waterfront employer is a publicly-traded corporation, the waterfront employer shall supply the names and addresses of the corporation's officers;

e. The waterfront employer's tax identification number and unemployment insurance registration number;

f. A certification form provided by the commissioner, with documentation satisfactory to the commissioner, that the waterfront employer has all valid and effective licenses, registrations or certificates required by State law, including registrations or certifications required to do business in the State of New Jersey; and

g. Other relevant and appropriate information as determined by the commissioner.

At the time of registration, and subsequently upon request, the waterfront employer shall submit to the commissioner documentation demonstrating that the waterfront employer has workers' compensation insurance coverage for all workers as required by law.