Donation Box Registration

Donation Box Annual Registration

  1. donation box
  2. donation box 2
  3. donation box 3
  4. Annual Fee

    $50.00 Can be paid over phone with a credit card or mail in a check. 

  5. PROPOSED PROPERTY ADDRESS WHERE BOX TO BE LOCATED: (ONLY ONE BOX PER PARCEL)
  6. ORGANIZATION INFO/BOX OWNER:
  7. Regulations Set by City of Brooklyn Codified Ordinance Chapter 731 Donation Boxes. A permit is valid from the date of issuance through December 31 of each year, is not transferable, and does not automatically renew. Any donation box placed or maintained in the City that is not permitted by the City, and any donated items left outside a donation box, shall be subject to impoundment by the City.  If impounded, a donation box and donated items may be released to the owner upon the payment of an impound fee established by Council.  If impounded for more than thirty days, a donation box and donated items may be sold for scrap or otherwise disposed of by the City. The permit issued for any donation box may be revoked, after reasonable notice is attempted to be given to the donation box owner, if the donation box is placed or maintained in violation of this chapter. Whoever violates any provision of this chapter is guilty of a minor misdemeanor for a first offense, and for a second or subsequent offense, shall be guilty of a misdemeanor of the fourth degree.

  8. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that:

     1) your application will not be signed in the sense of a traditional paper document.

    2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature.

    3)You may still be required to provide a traditional signature at a later date.

    4) you understand the regulations stated above.

  9. Leave This Blank:

  10. This field is not part of the form submission.