NJ Department of Environmental Protection
Division of Fish and Wildlife
Captive Game Permits
1 Eldridge Road
Robbinsville, NJ 08691
SEMI-WILD SHOOTING PRESERVE ANNUAL REPORT FOR THE REPORTING YEAR 20_____ - 20 _____
DATE: __________________ PERMIT NO: ________________________
CLUB NAME: ________________________________________________________________________________
Contact Name: _______________________________________________________________________________
Address: ____________________________________________________________________________________
City: ______________________________________ State: ________ Zip Code: _____________
Daytime Phone Number: _________________________ Home Phone Number: __________________________
Email: ______________________________________________________________________________________
Preserve Location: ____________________________________________________ Acreage: ________________
Township: _____________________________________________ County: ______________________________
NJ Captive Game Propagation & Sales Permit # (if you raised and/or transferred birds to this permit): ________
The following is the total number of birds released during the reporting year: 20_____ - 20 _____
Pheasant: _________________ Hungarian Partridge: _________________
Quail: _________________ Chukar Partridge: _________________
TOTAL BIRDS STOCKED: ________________ Supplier Permit Number: __________________________
Total Tags Purchased: _______________
Subtract Total Birds Tagged: _______________
Balance of Tags (Now Expired): _______________
I hereby submit this certification as a record of activities conducted under the license shown above. Completion
and submission of this report is required by N.J.S.A. 23:3-37.
Date: __________________ Signature: ________________________________________________________
NJ Division of Fish and Wildlife HARVEST REPORT FOR THE RPORTING YEAR 20_______ - 20_______
Permit #: ________________________________ Check one: Semi-Wild Preserve
Commercial Preserve
Club Name: __________________________________________________________________________________
Pheasants
Quail
Chukar
Partridge
Hungarian
Partridge
Mallards
Total Birds
Purchased
Total Birds Lost
Prior to Purchase
Total Birds
Harvested
The NJ Division of Fish and Wildlifes Bureau of Wildlife Management reviews and analyzes harvest statistics for
various upland species, including bobwhite quail and pheasant. A significant portion of the annual game bird
harvest comes from the Commercial and Semi-Wild Shooting Preserves.
Therefore, in addition to the normal annual report and to further this research effort, the Division is requesting
all Commercial and Semi-Wild permit holders to complete this form at the end of each season. This information
will be used to better estimate the harvest of native versus stocked game birds in the State. We strongly feel this
is an important issue and the results will enable the Division to better serve the citizens of our State.
Please note, failure to submit the Harvest Report with the Annual Report will delay the authorization and/or
issuance of a Commercial and Semi-Wild Permit for the upcoming season.
If you have any further questions, please feel free to contact the Wildlife Permitting Unit at (609) 984-6213 or
Andrew Burnett, Principal Biologist, at (609) 748-2058.
Semi-Wild Preserve Annual Report & Harvest Report Instructions
1. The Semi-Wild Preserve Permit Annual Report and Harvest Report are due April 15th.
2. IF you cannot provide the appropriate information to complete the form, you should include a written
explanation with the pertinent reasons why the information is not available.
3. A summary statement from your supplier(s) indicating the total number of each species purchased for
the season and full payment of such must be submitted with this report form.
4. If you raise your own birds under a Captive Game - Propagation and Sales Permit, you must include a
copy of your Captive Game Permit Annual Report or documentation indicating the transfer of these
birds to your Semi-Wild Preserve.
5. Daily kill and liberation records must be kept on the premises during the season and be readily available
for inspection upon request.
6. Records must be retained and available for three (3) years.
7. Licenses will not be renewed until the Annual Report and Harvest Report have been received, reviewed,
and approved.
8. Failure to file your annual and harvest reports in a timely manner may cause a delay in obtaining your
new permit.
MAIL THE FOLLOWING BY APRIL 15TH:
- Completed Annual Report
- Summary Statement from Supplier
- Completed Harvest Report
- Captive Game - Propagation and Sales Permit or other supporting documents (if applicable)
TO:
NJ Division of Fish and Wildlife
Captive Game Permits, Semi-Wild Permits
1 Eldridge Road
Robbinsville, NJ 08691
Or by email to:
Kate Szostak at Katherine.Szostak@dep.nj.gov
If you have any questions or need further information, please call (609) 984-6213 or visit our website at:
www.njfishandwildlife.com/semiwild_preserves.htm.