PFBC-168R (03/13) Pennsylvania Fish & Boat Commission Division Licensing & Registration P.O. Box 68900 Harrisburg, PA 17106-8900 1-877-707-4085  Fax: 717-705-7931 www.fishandboat.com NET PERMIT/THROW NET RENEWAL APPLICATION You must currently have a valid fishing license to purchase a net permit. Cast Nets can be purchased on line - www.pa.wildlifelicense.com Or complete this form and include $10.70 *for each location with application – make check payable to PFBC (Do not Send Cash or Money Order). Submit application form and payment to the address listed above. st Cast Net permit s expire on December 31 The use of a cast net or throw net in any other Commonwealth waters is a violation of the Fish and Boat Code and is punishable by a fine and may result in the loss of fishing privileges. Cast nets or throw nets shall not exceed 10 feet in radius or 20 feet in diameter and possess a mesh size of at least 3/8- inch. The holder of the cast net or throw net permit may take, catch, kill or possess a daily creel limit of 100 gizzard shad and alewife (combined species). The holder of the permit shall carry the permit on his/her person while using the net or while possessing more than 50 gizzard shad or alewife (combined species). APPLICANT INFORMATION DATE OF BIRTH (CID) CUSTOMER IDENTIFICATION NUMBER PREFIX FIRST M.I. LAST SUFFIX TELEPHONE (inc. area code) STREET ADDRESS CITY STATE ZIP MAILING ADDRESS CITY STATE ZIP EMAIL ADDRESS DRIVER’S LICENSE NUMBER DRIVER’S LICENSE STATE BUSINESS INFORMATION BUSINESS NAME TELEPHONE BUSINESS ADDRESS Select Location CITY Permit Fee $10.70* Lake Lake Raystown Lake Arthur Blue Marsh Lake Shenango River Lake Beltzville Lake Nockamixon Lake Lake Wallenpaupack STATE County Huntingdon Butler Berks Mercer Carbon Bucks Wayne/Pike ZIP FAX NUMBER Region Southcentral Northwest Southeast Northwest Northeast Southeast Northeast I certify that the information contained in the application is true and correct to the best of my knowledge, information and belief. This certification is made subject to the penalty of Section 4904 of Crimes Code (18 Pa. C.S.A. § 4904) (relating to Unsworn Falsification to Authorities) and Section 908 of the Fish and Boat Code (30 Pa. C.S. § 908) (relating to False Identification or False or Fraudulent Statements on Reports). SIGNATURE *$10.00 renewal fee and $.70 electronic processing fee. DATE