Species: _______________________
Certified Weight: ____lb. ___oz.
(Does not apply to Catch & Release)
Length: ______________________inches
Caught
in: ____ Marine OR ____ Freshwater?
Date caught: _______________________
Location Caught:
______________________
Sport Fish license #: _________________
Age (if entrant
under 16 years old): ________
Entrant's name (please print)
____________________________________________________
Mailing Address
_____________________________________________________________ City/State
______________________________________ Zip Code
__________________
The undersigned Trophy Official does hereby verify the identity
of the described fish:
Official's name (please print) ____________________________
Scales certification date: ______
Official's mailing address
_________________________________________________________
We the undersigned witnessed the weighing and measuring of the
fish described above, and verify the weight and measurements
recorded:
Witness 1. (signature/address)
_______________________________________________
Witness 2. (signature/address)
_______________________________________________
I hereby swear that in taking this fish I complied with all
the rules and regulations in the location the fish was caught, and
that the witnesses actually witnessed the weighing and measuring of
this fish. I further declare that all the above information is true
and correct.
Entrant's signature
_____________________________________________________
Official's signature
_____________________________________________________ Certified
by me this (date) _______________________________________________
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