Motor Vehicle Commission Business Licensing Services Bureau P.O. Box 168 Trenton, New Jersey 08666-0168 Phone: (609) 292-6500 ext.5095 APPLICATION FOR RED LIGHT FOR SEARCH & RESCUE Date: I, (print name and address of applicant) hereby apply for a Red Light Permit for the following vehicle: N.J. Driver License Number Name and of Registered Owner/Lessee Street Address City, County, State, Zip Vehicle Make, Model, Year Registration Plate Number VIN Describe use of vehicle Applicant's Signature Title Organization Corp Code THIS SECTION TO BE COMPLETED BY THE COUNTY EMERGENCY MANAGEMENT COORDINATOR I, , the County Emergency Management Coordinator of County, affix my signature of approval of the above applicant to be granted a permit for the use of a red light on the vehicle described above. County Emergency Management Coordinator's Signature THIS SECTION TO BE COMPLETED BY THE DIRECTOR OF THE STATE OFFICE OF EMERGENCY MANAGEMENT I affix my signature in agreement to the approval by the County Emergency Management Coordinator of the permit for the use of a red light on the vehicle described above. Director, State Office of Emergency Management ATTACH THE FOLLOWING: A copy of the registration of the vehicle described above; if the vehicle is leased, a copy of the lease agreement/contrac t . BLC-56A (12/08) MVC Web Site http://www.njmvc.gov American LegalNet, Inc. www.FormsWorkFlow.com RED LIGHT SEARCH AND RESCUE Period of validity; cancellation of permit A permit is valid only during the term of office of the holder or for a period of two years, whichever period is shorter, and is non-transferable. Upon the expiration or termination of the term of office of a chief, a first assistant chief, a principal, or a principal assistant of a search and rescue team, or upon the sale, transfer, disposal or termination of lease of any vehicles for which the permit was issued, the permit shall automatically and immediately be deemed cancelled and shall be surrendered to the State Office of Emergency Management. The State Office of Emergency Management shall forward a surrendered permit to the Motor Vehicle Commission. Mounting; specifications Any siren permitted by this subchapter shall be mounted on the vehicle in accordance with the manufacturer's recommendation and be audible from a distance of not less than 500 feet. Any red emergency light shall be affixed to the vehicle by means of a non-permanent mounting system unless the vehicle is identified, by function and by either county or municipality, by means of a placard or sign which is attached to the vehicle and which contains letters in contrasting colors with a minimum height of two and onehalf inches. Non-permanent red emergency lights shall be displayed on the vehicle only when it is being operated In response to an emergency and shall be removed at the conclusion of the emergency. Red emergency lights displayed on a vehicle shall not be used in place of the vehicle's regular headlights and shall not be mounted on the interior front dashboard of the vehicle. Alternately flashing or strobe headlights are prohibited and shall not be incorporated into the housing of any lighting permitted by this subchapter. The red emergency light and siren permitted pursuant to this subchapter may be used only under the following conditions: The vehicle is being operated by, or under the direct supervision of, the search and rescue team personnel listed on the permit response to an actual emergency. Possession and exhibition of permit; The permit must be in the possession of the operator at all times when the vehicle is being operated and the red emergency light and siren are displayed on the vehicle and must be exhibited upon the request of any law enforcement official or authorized representative of the Commission. MVC Web Site http://www.njmvc.gov American LegalNet, Inc. www.FormsWorkFlow.com