REISSUANCE APPLICATION $2.00 Application Fee
V:SFMF Admin/app/species rev 4/29/20
REISSUANCE NEW JERSEY LANDING PERMIT APPLICATION
The last issued New Jersey Landing Permit must be surrendered before your new permit is issued. If you cannot locate your last
issued New Jersey Landing Permit, please call 609-748-2020.
REPLACEMENT VESSEL
CHANGE OF ADDRESS
OTHER ____________________________________
The last issued New Jersey Landing Permit must be surrendered before a new permit is issued. If you cannot locate your last
issued New Jersey Landing Permit please call 609-748-2020.
Is the NJ permit(s) being transferred currently revoked, suspended or have violations pending? Yes No
CURRENT VESSEL BEING REPLACED
VESSEL NAME_____________________________________________ VESSEL DOC/REGISTRATION #_________________________
REPLACEMENT VESSEL (***INCLUDE DOCUMENTATION/REGISTRATION AND PROOF OF HORSEPOWER***)
VESSEL NAME__________________________________________ NMFS VESSEL PERMIT #_______________ (Include NMFS Permit)
VESSEL DOC/REGISTRATION #_____________________ VESSEL LENGTH_____________ VESSEL HORSEPOWER__________
HOME PORT ___________________________________________
Black Sea Bass Permit #_________________________ Gear Type __________________
Summer Flounder Permit #_______________________ Gear Type __________________
Shad Permit # _______________________________ (ONLY TRANSFERRABLE BETWEEN IMMEDIATE FAMILY MEMBERS)
Tautog Permit # ______________________________ Gear Type __________________
Lobster Permit #_____________________________
*Do you hold a Federal Limited Access American Lobster Permit? Yes No
*Will vessel be harvesting lobster in State waters? Yes No
*If yes, who is the individual possessing the New Jersey Commercial Lobster License? __________________________________
OWNER/COMPANY_______________________________________________ CID#___________________ GEAR ID#________________
CONTACT PARTY _____________________________________ PHONE #____________________ DATE OF BIRTH ________________
ADDRESS__________________________________________ CITY, STATE & ZIP____________________________________________
EIN and/or SS#__________________________ E-MAIL ADDRESS _________________________________________________________
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______________________
Owner/Agent
Approval _________________________________________________________________ Date______________________________
NOTARY (if not signed in front of NJ Fish and Wildlife staff) : ________________________________________________
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