Request For Duplicate Licenses Form - Commercial Fisheries Entry Commission

Commercial Fisheries Entry Commission

P.O. Box 110302

Juneau, Alaska 99811-0302

Request for Duplicate Licenses

Phone: (907)789-6150/Fax: (907)789-6170

This form may be used to request a replacement permit card, vessel license sticker, vessel license, vessel triangle plate or a permit certiﬁ cate when the original

has been lost or not received in the mail. This form must be signed and notarized and mailed or faxed to the Entry Commission with the appropriate fees. When

the duplicate is approved the original license becomes VOID and is ILLEGAL for use. The permit number/alpha letter, the D and/or Y, and the

year/sequence/alpha letter, all of which are listed below on this form, must be written on each ﬁ sh ticket.

Submit a check or money order made payable to the State of Alaska or if paying with a credit card complete the attached

credit card authorization.

Please indicate what happened to the license(s)

__ Lost

__ Stolen __ Damaged

__ Never received in mail

Check the spaces as to which license you need

FEE

____ Permit card

__________________

___________________ D

______________________

$20

CFEC Fishery

Permit Number/Alpha

Year/Sequence/Alpha

____ Permit card

______________

___________________ D

______________________

$20

CFEC Fishery

Permit Number/Alpha

Year/Sequence/Alph

____ Permit certiﬁ cate _______________________________________

No fee

____ Vessel ADF&G triangle plate _______________________________

$20

____ ADF&G vessel license receipt ______________________________

$20*

____ ADF&G vessel license sticker_______________________________

$20*

*Only one $20.00 fee is required for a vessel sticker and/or receipt

____ ADF&G vessel license salmon net gear area tab ________________

No fee

____ Check here if the vessel ownership has changed since the current license was issued.

Indicate the date of the ownership change and provide new owner information below. ________________________________

Date of ownership change

CERTIFICATION OF APPLICANT

I swear under penalty of perjury that all information supplied by me on this form and in all supporting documents is true and complete to the best of my knowledge.

I further certify that I am the: ____ Permit holder ____ Vessel owner ____ Agent or representative ____ Other (explain) _____________________________________

___________________________________________

_______________________________

____________________

Name of permit holder or vessel owner

CFEC ID number

Year of birth

ADF&G number

___________________________________________________________________________________________________________________________________________

Permanent mailing address

City

State

Zip