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Leaseholder Annual Report Form

In order to retain a lease in the Suffolk County Shellfish Aquaculture Lease Program. Each year, thirty (30) days before the lease anniversary date (start of term); leaseholders must submit a complete Leaseholder Annual Report Form along with the payment of the annual lease rental fee.

Leaseholders may complete the Leaseholder Annual Report Form either by submitting the online form or completing the paper copy of the Leaseholder Annual Report Form and mailing it to the Department of Economic Development and Planning. Below are hyperlinks to each ver-sion of the Leaseholder Annual Report Form:

If a leaseholder wishes to mail in the Leaseholder Annual Report Form please use the following mailing address:

County of Suffolk
Dept. of Economic Development and Planning
Aquaculture Lease Program
H. Lee Dennison Building 2nd Floor
P.O. Box 6100
Hauppauge, NY 11788-0099
Attention: Mr. Thomas Ralicky

Each year, leaseholders must also submit the Suffolk County Form 22 (Contractor’s/Vendor’s Public Disclosure Statement) year along with the annual report form. This is the standard public disclosure form for Suffolk County. All persons or business entities that have leases or contracts with Suffolk County are required to complete this form to the County each year they retain their lease. This form must be notarized prior to submittal to Suffolk County Leaseholder Annual Report Form.

Suffolk County Government

H. Lee Dennison Bldg

100 Veterans Memorial Hwy
P.O. Box 6100
Hauppauge, NY 11788

Riverhead County Center

County Road 51
Riverhead, NY 11901