Florida Freshwater Fish & Frog Dealers License – Residents Home » Florida » Commercial Freshwater » Freshwater Fish & Frog Dealers License – Residents A brief description of the form or Application to be filled out here. Vessel Name Vessel Use / Endorsement* Pleasure Commercial Official Number (If Applicable) Confirm Official Number Type* New Applicant Renewal License # Applicant Name* First Last Ethnicity White African American Asian Hispanic Other Florida Resident* Yes No US Citizen Yes No Gender Male Female Date of Birth MM slash DD slash YYYY Social Security Number Drivers License number Primary Phone #Alternate/Cell Phone #Fax #Mailing Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Would you like to be notified of updates via email and text? Yes No Cell Phone Service Provider Corporation InformationDo you wish to apply as a Corporation? Yes No Business Name and/or Fictitious Name(As filed with the Florida Department of State, Division of Corporations) Federal Employee Identification Number Division of Corporation Registration # Fictitious Name Registration # License TypeResident License Types Freshwater Commercial Fishing (FCL) Resident Freshwater Fish Dealer (RFD) Resident Freshwater Fish & Frog Dealer Non-Resident License Types Non- Resident Freshwater Commercial Fishing (FCL) Non-Resident Freshwater Wholesale Buyer (FWB) Non-Resident Freshwater Wholesale Dealer (FWD) Non-Resident Freshwater Fish Dealer (FRD) Store Number Physical Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code orVehicle Year, Make and Tag Number Contact InformationName First Last Email* Enter Email Confirm Email Phone*Freshwater Commercial Fishing (FCL) Application Fee Price: Freshwater Resident Fish & Frog Dealer's Fee Price: Resident Freshwater Fish Dealer (RFD) Application Fee Price: Non- Resident Freshwater Commercial Fishing (FCL) Application Fee Price: Non-Resident Freshwater Wholesale Buyer (FWB) Application Fee Price: Non-Resident Freshwater Wholesale Dealer (FWD) Application Fee Price: Non-Resident Freshwater Fish Dealer (FRD) Application Fee Price: RENEWAL ADVANCED PAYMENT OPTION No Additional Years 2 year renewal 3 year renewal 4 year renewal 5 year renewal Total $0.00 Consent*I CERTIFY THAT THE RECITATIONS CONCERNING THE VESSEL: NAME, TONNAGE, DIMENSIONS, PROPULSION, OWNERSHIP, HAILING PORT, RESTRICTIONS, ENTITLEMENTS, REMARKS AND ENDORSEMENTS CONTAINED IN THE CERTIFICATE OF DOCUMENTATION REMAIN ABSOLUTELY THE SAME. I agreeNAME:*Type your full name to sign this secure webform Signature*CAPACITY OF PERSON SIGNING (E.G., OWNER, AGENT, TRUSTEE, GENERAL PARTNER, CORPORATE OFFICER, MEMBER) Date MM slash DD slash YYYY Authorization*I agree to pay the above total amount according to the card issuer agreement and hereby authorize the charge for the total amount above for the processing of selected permits. I understand that my application will be processed in the order in which it is received by Commercial Fishing Permits Center, a private fee-for-service documentation company, not owned or operated by any governmental agency. I understand that application and processing fees are non-refundable as per Commercial Fishing Permits Center's no refund policy. I understand that submitting another application for a license or permit will supersede the current/pending application for that license or permit. I understand that Commercial Fishing Permits Center does not issue or sell any licenses or permits. 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