New License Opportunities Non-Resident Marine License Application Form - Rhode Island Department Of Environmental Management

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Rhode Island Department of Environmental Management
Office of Boat Registration & Licensing
235 Promenade Street Room 360
Providence RI 02908-5767
(401) 222-6647 RI Relay 711
2016 New License Opportunities Non-Resident Marine License Application
Applicant ID:_____________________
Office Use only
Applicant Mailing Address
Residence Address
(Cannot be a PO Box)
Name:______________________________
Street:______________________________
Street:____________________________
City:________________State___ Zip_____
City:_____________State___ Zip ______
DOB:_________________________
Height:_______________Weight:________
Hair Color:____________ Eye Color:______
Drivers License #:__________________
Occupation:__________________________
Has your commercial fishing license and/or permit been revoked or suspended in any state or jurisdiction?
Yes
No (Check One)
(APPLICATION MUST BE RECEIVED NO LATER THEN 02/29/2016)
***
***
Reporting
Available Licenses
Method -
Check Method
Mandatory
Logbook $25.00
Principal Effort License
$400.
VTR
Endorsements
Please Check
Electronic
Description
applicable
Restricted Finfish (6)
Logbook
$25.00
Total
A total of 33 new quahog endorsements (resident only) and 12 soft shell clam (resident only) endorsements will be
issued on the CFL license in 2016 & 6 restricted finfish endorsements will be issued on the PEL license. All
determinations on the available endorsements will be made after the application deadline date of 2/29/2016. Do
NOT mail a check along with this application. The license/endorsement fee will be charged only if you are a
successful applicant. You must submit justification as to your eligibility for this endorsement per criteria set forth in
the Commercial Fishing Licensing Regulations. Prior paperwork submissions do not apply. Please read all
guidance document material prior to submission of this application.
Note: Every vessel engaged in Commercial Fishing must be declared on a Commercial Vessel Declaration
Application
You must complete requirements of Taxation Certification & submit along with this application for marine
License or have SS# on file with DEM
Applicants must be 18 years of age or older to qualify for a non resident license
Under penalty of perjury, I declare I the information contained herein is true and accurate.
Applicant‘s Signature: __________________________
Date: ________________
Notary Public: _________________________________ Comm. Exp. ___________
Applicant’s Telephone #: ________________________
Note: Licensed fishers are obligated to comply with possession limits for finfish as provided in the Marine
Fisheries listserve, dedicated phone line at (401) 423-1920, or webpage at
Licensed shellfishers are obligated to
comply with conditional closure areas as provided on DEM’s dedicated phone line at (401) 222-2900

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