Form SFN6087 "Application for Retail or Wholesale Vendor License" - North Dakota

What Is Form SFN6087?

This is a legal form that was released by the North Dakota Game and Fish Department - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2019;
  • The latest edition provided by the North Dakota Game and Fish Department;
  • 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 SFN6087 by clicking the link below or browse more documents and templates provided by the North Dakota Game and Fish Department.

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Download Form SFN6087 "Application for Retail or Wholesale Vendor License" - North Dakota

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APPLICATION FOR RETAIL OR WHOLESALE VENDOR LICENSE
N
D
G
F
D
ORTH
AKOTA
AME AND
ISH
EPARTMENT (701) 328-6349
100 N
B
E
~ B
, ND 58501-5095
ORTH
ISMARCK
XPRESSWAY
ISMARCK
SFN 6087 (R
11/2020)
EVISED
Name of Business:
Name of Applicant:
Date of Birth:
Social Security Number:
Driver’s License No. or NonDriver Photo ID No:
CHECK BOX (✓) TO INDICATE PREFERRED MAILING ADDRESS
Mailing Address of Applicant:
Physical Address of Business (if different than Mailing Address):
Business Phone:
Cellular Phone:
(
)
(
)
Application for Calendar Year: _________
By signing below, I certify that all information provided is true. Further (for those applying for a resident wholesale bait vendor license), I acknowledge
that I am eligible and have met all residency requirements including living and maintaining a residence within the State of North Dakota for the
immediate six months prior to the date of this application.
Applicant Signature:
Date:
License(s) Requested (✓ ) *
See Below for License Definitions
□ Retail Bait Vendor
$ 15.00
□ Non Resident Wholesale Class A with ten tags
$ 500.00
□ Retail with White Sucker
$ 75.00
additional tags @ $5.00/tag
$
□ Resident Wholesale Bait Vendor with ten tags
$ 50.00
□ Non Resident Wholesale Class B
$ 250.00
additional tags @ $5.00/tag
$
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*L
D
ICENSE
EFINITIONS
Retail Bait Vendors License ($15) is an annual license to sell legal live aquatic bait (excluding white sucker) at retail only at one specified selling location. A licensee may not import live
aquatic bait into the state without first obtaining a permit from the director (issued monthly; free of charge).
Retail Bait Vendors License with white sucker ($75) is an annual license to sell legal live aquatic bait, to include white sucker, at retail only at one specified selling location. A licensee may
not import live aquatic bait into the state without first obtaining a permit from the director (issued monthly; free of charge).
Resident Wholesale Bait Vendors License ($50) is an annual license to sell and/or trap legal live aquatic bait at wholesale. A licensee may trap North Dakota waters with Department
approval. This license includes ten tags to mark bait-trapping equipment. A tag must be affixed to each trap used by the licensee. Upon request (by application), the department shall issue
additional tags to a licensee at a cost of five dollars per tag. A licensee may not import or export live aquatic bait without first obtaining a permit from the director (issued monthly; free of
charge).
Non-Resident Class A Wholesale Bait Vendors License ($500) is an annual license to sell and/or trap legal live aquatic bait at wholesale. The license includes ten tags to mark bait-
trapping equipment. A tag must be affixed to each trap used by the licensee. Upon request (by application), the department shall issue additional tags to a licensee at a cost of five dollars per
tag. The annual Class A license also allows the licensee to trap in North Dakota waters upon Department approval. The Class A license allows the import and export of approved aquatic bait,
with a permit from the director (issued monthly; free of charge). A non-resident may hold a Class A license if the Non-Resident’s state of residence provides the same privilege for residents of
North Dakota.
Non-Resident Class B Wholesale Bait Vendors License ($250) is an annual license to sell legal live aquatic bait at wholesale. The Class B license allows a nonresident to transport
aquatic bait with appropriate import or export permits (issued monthly; free of charge). A non-resident holding an annual Class B license to sell minnows or other live aquatic bait at
wholesale may not trap bait.
*In compliance with the Federal Privacy Act of 1974, the disclosure of the individual’s social security number on this form is mandatory pursuant to North Dakota Century Code 43-50-
02. The individual’s social security number is used for identification purposes and the national database to determine eligibility for licensure and detect violations of law or regulations.
Penalty for the applicant not including the Social Security Number on their application will cause the application to not be processed.
APPLICATION FOR RETAIL OR WHOLESALE VENDOR LICENSE
N
D
G
F
D
ORTH
AKOTA
AME AND
ISH
EPARTMENT (701) 328-6349
100 N
B
E
~ B
, ND 58501-5095
ORTH
ISMARCK
XPRESSWAY
ISMARCK
SFN 6087 (R
11/2020)
EVISED
Name of Business:
Name of Applicant:
Date of Birth:
Social Security Number:
Driver’s License No. or NonDriver Photo ID No:
CHECK BOX (✓) TO INDICATE PREFERRED MAILING ADDRESS
Mailing Address of Applicant:
Physical Address of Business (if different than Mailing Address):
Business Phone:
Cellular Phone:
(
)
(
)
Application for Calendar Year: _________
By signing below, I certify that all information provided is true. Further (for those applying for a resident wholesale bait vendor license), I acknowledge
that I am eligible and have met all residency requirements including living and maintaining a residence within the State of North Dakota for the
immediate six months prior to the date of this application.
Applicant Signature:
Date:
License(s) Requested (✓ ) *
See Below for License Definitions
□ Retail Bait Vendor
$ 15.00
□ Non Resident Wholesale Class A with ten tags
$ 500.00
□ Retail with White Sucker
$ 75.00
additional tags @ $5.00/tag
$
□ Resident Wholesale Bait Vendor with ten tags
$ 50.00
□ Non Resident Wholesale Class B
$ 250.00
additional tags @ $5.00/tag
$
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*L
D
ICENSE
EFINITIONS
Retail Bait Vendors License ($15) is an annual license to sell legal live aquatic bait (excluding white sucker) at retail only at one specified selling location. A licensee may not import live
aquatic bait into the state without first obtaining a permit from the director (issued monthly; free of charge).
Retail Bait Vendors License with white sucker ($75) is an annual license to sell legal live aquatic bait, to include white sucker, at retail only at one specified selling location. A licensee may
not import live aquatic bait into the state without first obtaining a permit from the director (issued monthly; free of charge).
Resident Wholesale Bait Vendors License ($50) is an annual license to sell and/or trap legal live aquatic bait at wholesale. A licensee may trap North Dakota waters with Department
approval. This license includes ten tags to mark bait-trapping equipment. A tag must be affixed to each trap used by the licensee. Upon request (by application), the department shall issue
additional tags to a licensee at a cost of five dollars per tag. A licensee may not import or export live aquatic bait without first obtaining a permit from the director (issued monthly; free of
charge).
Non-Resident Class A Wholesale Bait Vendors License ($500) is an annual license to sell and/or trap legal live aquatic bait at wholesale. The license includes ten tags to mark bait-
trapping equipment. A tag must be affixed to each trap used by the licensee. Upon request (by application), the department shall issue additional tags to a licensee at a cost of five dollars per
tag. The annual Class A license also allows the licensee to trap in North Dakota waters upon Department approval. The Class A license allows the import and export of approved aquatic bait,
with a permit from the director (issued monthly; free of charge). A non-resident may hold a Class A license if the Non-Resident’s state of residence provides the same privilege for residents of
North Dakota.
Non-Resident Class B Wholesale Bait Vendors License ($250) is an annual license to sell legal live aquatic bait at wholesale. The Class B license allows a nonresident to transport
aquatic bait with appropriate import or export permits (issued monthly; free of charge). A non-resident holding an annual Class B license to sell minnows or other live aquatic bait at
wholesale may not trap bait.
*In compliance with the Federal Privacy Act of 1974, the disclosure of the individual’s social security number on this form is mandatory pursuant to North Dakota Century Code 43-50-
02. The individual’s social security number is used for identification purposes and the national database to determine eligibility for licensure and detect violations of law or regulations.
Penalty for the applicant not including the Social Security Number on their application will cause the application to not be processed.
APPLICATION (C
)
ONTINUED
F
W
TRAPPING
OR
HOLESALE
:
:
A licensed wholesale bait vendor may employ the assistance of up to six other persons to capture or sell and transport live
A
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aquatic bait. No individual who has been convicted of a state or federal criminal game or fish violation in the last three years or whose
license to hunt or fish is under suspension or revocation may not act as an assistant. Assistant information must be provided below for
Department approval.
N
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: Equipment for taking legal live aquatic bait for trapping shall be used
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only in areas approved by the department, and the equipment must have attached at all times the valid tags issued with and
corresponding to the permit. Legal descriptions are limited to 50 ponds annually and must be recorded to the quarter section on this
application form. If pond spans in more than one quarter, record legal description of your access point. All ponds must be approved by
the director prior to trapping.
I
S
,
F REQUESTING TO TRAP MULTIPLE PONDS IN A
ECTION
(
)
RECORD EACH POND INDIVIDUALLY
ONE POND PER ENTRY
County
Township
Range
Section
Target Specie(s)
Brief Description of Where Pond is Located
For Dept Use
(include Qtr.)
Y
fatheads, creek chubs,
Burleigh
138
080
02 SE ¼
Example: Access point at section line west of farmstead
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
For Department Use:
Reviewed by:
APPLICATION (C
)
ONTINUED
F
W
TRAPPING
OR
HOLESALE
L
D
L
D
E
G
A
L
E
S
C
R
I
P
T
I
O
N
S
I
W
T
A
: Equipment for taking legal live aquatic bait for trapping shall be
E
G
A
L
E
S
C
R
I
P
T
I
O
N
S
I
W
T
A
:
O
O
F
F
N
N
T
T
E
E
N
N
D
D
E
E
D
D
H
H
O
O
L
L
E
E
S
S
A
A
L
L
E
E
R
R
A
A
P
P
P
P
I
I
N
N
G
G
R
R
E
E
A
A
S
S
used only in areas approved by the department, and the equipment must have attached at all times the valid tags issued with and
corresponding to the permit. Legal descriptions are limited to 50 ponds annually and must be recorded to the quarter section on this
application form. If pond spans in more than one quarter, record legal description of your access point. All ponds must be approved by
the director prior to trapping.
I
S
,
F REQUESTING TO TRAP MULTIPLE PONDS IN A
ECTION
(
)
RECORD EACH POND INDIVIDUALLY
ONE POND PER ENTRY
County
Township
Range
Section
Target Specie(s)
For Dept Use
(include Qtr.)
Brief Description of Where Pond is Located
Y
fatheads, creek chubs,
Burleigh
138
080
02 SE ¼
Example: Access point at section line west of farmstead
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
County
Twp.
Rge.
Sec. (include Qtr.)
fatheads, creek chubs,
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
County
Twp.
Rge.
Sec. (include Qtr.)
fatheads, creek chubs,
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
County
Twp.
Rge.
Sec. (include Qtr.)
fatheads, creek chubs,
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
fatheads, creek chubs,
County
Twp.
Rge.
Sec. (include Qtr.)
white sucker, frogs, leeches
For Department Use:
Reviewed by:
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