Form SLAP22.87 "Live Bait Dealer Permit Application" - Nevada

What Is Form SLAP22.87?

This is a legal form that was released by the Nevada Department of Wildlife - a government authority operating within Nevada. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on September 1, 2019;
  • The latest edition provided by the Nevada Department of Wildlife;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form SLAP22.87 by clicking the link below or browse more documents and templates provided by the Nevada Department of Wildlife.

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Download Form SLAP22.87 "Live Bait Dealer Permit Application" - Nevada

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____________________________________________________________________________________________________________
APPLICATION
LIVE BAIT DEALER PERMIT
Fee: $44
(22.87)
Please PRINT all information except for your signature. Incomplete or illegible applications will be
returned. PROCESSING TIME: Allow thirty (30) days.
SLAP Entity ID (Special Permit and License ID) - New applicants SLAP ID will be assigned when the
permit is issued.
Federal Tax ID or SSN only required for new applicants.
I
B
E
I
-
NSTITUTION OR
USINESS
NTITY
NFORMATION
(Institution or business entity the permit is for.)
I
B
E
:
(If same as responsible party indicate SAME)
SLAP Entity ID
NSTITUTION OR
USINESS
NTITY NAME
MAILING ADDRESS:
FEDERAL TAX ID:
CITY:
STATE:
ZIP:
E-MAIL ADDRESS:
PHYSICAL ADDRESS:
CITY:
STATE:
ZIP:
TELEPHONE:
– Person responsible for permit
R
P
ESPONSIBLE
ARTY
NAME [LAST]
[FIRST]
[MIDDLE]
SLAP Entity ID
MAILING ADDRESS:
SSN
CITY:
STATE:
ZIP:
E-MAIL ADDRESS:
PHYSICAL ADDRESS:
CITY:
STATE:
ZIP:
TELEPHONE:
HEIGHT:
WEIGHT:
HAIR:
EYES:
GENDER:
DRIVER’S LICENSE NUMBER
STATE:
DATE ISSUED:
1. Location or address of additional holding facilities used in conjunction with the above business.
2. List the source or installation from which you will be obtaining the live bait or aquatic bait to be offered for
sale, held or transported:
__________________________________________________________________________________
____________________________________________________________________________________________________________
STATE OF NEVADA – Department of Wildlife
SLAP 22.87
Rev. Sept. 2019 A.M.
Page 1 of 2
____________________________________________________________________________________________________________
APPLICATION
LIVE BAIT DEALER PERMIT
Fee: $44
(22.87)
Please PRINT all information except for your signature. Incomplete or illegible applications will be
returned. PROCESSING TIME: Allow thirty (30) days.
SLAP Entity ID (Special Permit and License ID) - New applicants SLAP ID will be assigned when the
permit is issued.
Federal Tax ID or SSN only required for new applicants.
I
B
E
I
-
NSTITUTION OR
USINESS
NTITY
NFORMATION
(Institution or business entity the permit is for.)
I
B
E
:
(If same as responsible party indicate SAME)
SLAP Entity ID
NSTITUTION OR
USINESS
NTITY NAME
MAILING ADDRESS:
FEDERAL TAX ID:
CITY:
STATE:
ZIP:
E-MAIL ADDRESS:
PHYSICAL ADDRESS:
CITY:
STATE:
ZIP:
TELEPHONE:
– Person responsible for permit
R
P
ESPONSIBLE
ARTY
NAME [LAST]
[FIRST]
[MIDDLE]
SLAP Entity ID
MAILING ADDRESS:
SSN
CITY:
STATE:
ZIP:
E-MAIL ADDRESS:
PHYSICAL ADDRESS:
CITY:
STATE:
ZIP:
TELEPHONE:
HEIGHT:
WEIGHT:
HAIR:
EYES:
GENDER:
DRIVER’S LICENSE NUMBER
STATE:
DATE ISSUED:
1. Location or address of additional holding facilities used in conjunction with the above business.
2. List the source or installation from which you will be obtaining the live bait or aquatic bait to be offered for
sale, held or transported:
__________________________________________________________________________________
____________________________________________________________________________________________________________
STATE OF NEVADA – Department of Wildlife
SLAP 22.87
Rev. Sept. 2019 A.M.
Page 1 of 2
NOTICE:
Any person receiving, bringing, having brought or shipped into the State of Nevada any live fish,
live bait or aquatic life, shall notify the Department at least five (5) days in advance of each shipment.
It is unlawful for any person to import fish or aquatic life in the State of Nevada from an installation or source
that has not been approved by the Department.
I, the signator, in signing this application, hereby state that I am entitled to this license under the laws of the
State of Nevada and that no false information or false statement has been made by me to obtain this license.
_____________________________________________________________
__________________________________
Signature of Applicant
Date
Submit your completed application and fee to the appropriate office below:
Western Region
Southern Region
Nevada Department of Wildlife
Nevada Department of Wildlife
Special Licenses and Permits
3373 Pepper Ln.; Las Vegas, NV 89120
1100 Valley Rd, Reno, NV 89512
Telephone: (702) 486-5127
Telephone: (775) 688-1500
Counties: Clark, Esmeralda, Lincoln, Nye
Counties: Carson City, Churchill, Douglas,
Humboldt, Lyon, Mineral, Pershing, Storey,
Washoe
Eastern Region
Nevada Department of Wildlife
60 Youth Center Road; Elko, NV 89801
Telephone: (775) 777-2300
Counties: Elko, Eureka, Lander, White Pine
FOR DEPARTMENT USE ONLY
Department Representative:
Date Received: _______________
Date Approved: _______________
Date Returned for Additional Information: _______________
Date Disapproved: _______________
Letter Sent:
REASON FOR DISAPPROVAL:
____________________________________________________________________________________________________________
STATE OF NEVADA – Department of Wildlife
SLAP 22.87
Rev. Sept. 2019 A.M.
Page 2 of 2
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