Fillable NEW JERSEY DIVISION OF FISH AND WILDLIFE Bureau

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NEW JERSEY DIVISION OF FISH AND WILDLIFE Bureau

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NEW JERSEY DIVISION OF FISH AND WILDLIFE
Bureau of Marine Fisheries
PO Box 418
Port Republic, New Jersey 08241
Phone: (609) 748-2020
Visit our Division Website: www.njfishandwildlife.com
MENHADEN LICENSE APPLICATION – RESIDENT YEAR______
OWNER/COMPANY_______________________________ CONTACT PERSON_________________________
ADDRESS________________________________________ DATE OF BIRTH____________________________
CITY, STATE & ZIP_______________________________ TELEPHONE # _____________________________
CID#_____________________________________ GEAR/BMFID#________ CELL PHONE #______________
E-MAIL ADDRESS-**REQUIRED**_________________________________EIN OR SS# ____________________
HEIGHT: __________ WEIGHT: ___________ EYE COLOR: ___________ HAIR COLOR: ______________
VESSEL NAME__________________________________ HOME PORT_______________________________
VESSEL DOC/STATE REGISTRATION #____________ NMFS PERMIT #____________________________
Please include the following information for Menhaden Purse Seine Licences (MLPS & MFVL):
VESSEL LENGTH_________________________________ VESSEL HORSEPOWER_____________________
VESSEL HOLD CAPACITY
(NOT REQUIRED FOR MFVL)_______________________________________________________________________
New Jersey Residents License # Gear Type Fee
Menhaden Dealer License MD- n/a $102.00
Menhaden Purse Seine Fishing Vessel Operator’s License
(Gives permission to operate the vessel of ANY MFVL license holder)
MOPR- n/a $52.00
Limited entry programs have been established for the licenses listed below. If you did not purchase this license in the
previous year or if you do not meet eligibility criteria you may NOT purchase this license type.
Menhaden Landing License (bait net/gill net/pound net/otter trawl) ML- $52.00
Menhaden Landing License (bait net/gill net/pound net/otter trawl) ML- $52.00
Menhaden Personal Use and Limited Sale (gill nets only) MLLS- Gill Nets $52.00
Menhaden Landing License with Purse Seine MLPS- Purse Seine $152.00
SELECT: CATCH CARRY BOTH
Menhaden Purse Seine Fishing Vessel License (max length – 90 ft) MFVL- Purse Seine $
SELECT: CATCH CARRY BOTH See below for flat fee per gross ton
Less than 30 gross tons $22.00
30 – 100 gross tons $127.00
101- 150 gross tons $252.00
151-175 gross tons $402.00
176 – 200 gross tons $552.00
More than 200 gross tons $902.00
TOTAL $
I certify under penalty of law that the information provided in this document is true, accurate and complete. I am aware that there are significant
civil penalties for knowingly submitting false, inaccurate or incomplete information and that I am committing a crime of the fourth degree if I make
a written false statement which I do not believe to be true.
SIGNATURE _________________________________________________________ DATE______________________
Please include copy of Driver License and a current state Motor Vehicle Boat Registration, or USCG Documentation (No Doc/Reg needed for Menhaden
Dealer License and Menhaden Landing License with a Bait Net). Make checks payable to the State of New Jersey. See complete regulations pertaining to the
taking of Atlantic Menhaden at N.J.S.A. 23:3-51 and 23:3-52. The New Jersey Commercial Marine Gear License associated with these landing licenses (except
MFVL) must be purchased separately. Reporting forms must be up to date to be eligible to renew a menhaden license.
R: 6/5/19
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SUPPLEMENTAL LICENSE APPLICATION
Child Support Certification Form
* Social Security Number _____ _____ _____ Calendar Year 20_____
Please certify, under penalty of perjury, the following:
a. Do you currently have a child-support obligation? ☐yes ☐no
(1)
If “Yes,” are you in arrears in payment of said obligation? ☐yes ☐no
(2)
If “Yes,” does the arrearage match or exceed the total amount payable for the past six months
? ☐yes
☐no
b.
Have you failed to provide any court-ordered health insurance coverage during the past six months
? ☐yes
☐no
c. Have you failed to respond to a subpoena related to either paternity or child-support proceeding? ☐yes ☐no
d.
Are you the subject of a child-support related arrest warrant? ☐yes ☐no
In accordance with N.J.S.A. 2A:17-56,44d,
an answer “Yes” to any of the questions (2) through d will result in a denial of licensure or
certification. Furthermore, any false certification of the above may subject you to a penalty, including but not limited to, immediate
revocation or suspension of licensure or certification.
______________ __________________________________ ___________________________________
Date Applicant’s Name (Please Print) Applicant’s Signature
Agency Use:
License Type ______________________________
Number_____________________________________
* P
ursuant to N.J.S.A. 2A17-56.44e. of the New Jersey Child Support Enforcement Law, the Division of Fish and Wildlife is require
d
to
obtain your Social Security Number. The Division is further obligated to provide your Social Security Number to the Probation
Division or other agency responsible for child support enforcem
ent.
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NEW JERSEY DIVISION OF FISH AND WILDLIFE Bureau

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Completed 13 May 2021

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