Maine Dealer Wholesale Seafood with Lobster Home » Maine » Dealer License Application Forms » Dealer Wholesale Seafood with Lobster Apply for Dealer Wholesale Seafood (with Lobster) A brief description of the form or Application to be filled out here. Vessel NameVessel Use / Endorsement* Pleasure Commercial Official Number*Confirm Official Number*Part A: Applicant InformationLandings#Business NameFed Employer ID or SS#Mailing Address of Business 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 Is your physical address different from your mailing address? Yes No Physical 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 LandlineCell PhoneContact PersonFaxPart B: Fishery InformationCheck licenses that apply Wholesale Seafood W/Lobster Lobster Transportation Lobster Processor Less than 1,000,000 lbs raw Lobster Processor Greater than 1,000,000 lbs raw Lobster Meat Permit Lobster Tails Only Retail Seafood Enhanced Retail Seafood Certificate Number of Wholesale Seafood Vehicles and FacilitiesNumber of Lobster Transportation VehiclesNumber of Marine Worm Dealer Vehicles and FacilitiesDo you buy or intend to buy any marine species from harvesters (fishermen)? Yes No Part C: Additional InformationRegistration/DocumentationVessel NameBoat LengthPrimary Town of AnchorageStateIs this vehicle: owned leased rented State of RegistrationRegistration Plate#MakeVehicle ID No.ModelYearColorDo you buy or intend to buy any marine species from harvesters (fishermen)? Yes No Do you have a Lobster Import/Export Permit? Yes No If you are a harvester using your own product under the dealer license, you must select yes: Yes No In the wholesale trade, do you buy, sell, process or transport shrimp? Yes No In the wholesale trade, do you buy, sell, process or transport herring? Yes No In the wholesale trade, do you buy, sell, process or transport dogfish? Yes No In the wholesale trade, do you buy, sell, process or transport scallop? Yes No In the wholesale trade, do you buy, sell, process or transport black sea bass? Yes No Do you sell lobster bait? Yes No Supplemental VehiclesSupplemental Vehicles Supplementals are for: Is this vehicle State Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Supplemental Facilities(if different from mailing address)Supplemental Facilities Address Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Vessel InformationRegistration/documentation#Vessel NameBoat LengthPrimary Town of AnchorageState Part EFor Corporations or LLC's with six or fewer shareholders, please fill out the highest percentage.Last NameFirst NameDOBSS#% Name First Last 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 PhoneNumber of Plastic Truck Seals Requested (sealing outside of the truck)Number of Plastic Zip Tie Crate Seals Requested (sealing lobster crates)Number of Orange Waterproof paper seals (Shipping tags-for alternative boxes, i.e., Styrofoam)Shellfish Certificates and PermitsQuantity of Shellstock Shipper PermitsQuantity of Shucker Packer PermitsQuantity of Reshipper PermitsQuantity of Depuration PermitsQuantity of Enhanced Retail PermitsQuantity of Wet Storage, Flow Through PermitsQuantity of Wet Storage, Off Shore PermitsQuantity of Wet Storage, Recirculating PermitsQuantity of Wet Storage, Recirculating. Non-DMR Testing PermitsQuantity of Buying Station PermitsQuantity of Bulk Tagging PermitsQuantity of Buying Station Permits for other species (Mussels, Oysters, Quahogs)List the license numbers of those that you are renewing:Depuration Tags: Number seals requestedContact InformationName First Last Email* Enter Email Confirm Email Phone*This field is hidden when viewing the formnumber of suplementsWholesale Seafood W/Lobster Price: Wholesale Seafood Supp Price: $0.00 for each vehicle & facility: $87Lobster Transportation Price: Lobster Trans Supp. Price: $312.00 for each vehicle: $63.Lobster / Wholesale Surcharge Price: If NOT applying for Wholesale Seafood with Lobster you must pay $312 fee with $1,200 extra surcharge. Up to 2 Supplementals Surcharge Costs Price: These must be added to ALL wholesale supplemental AND Lobster Transportation Supplemental Licenses: Up to 2: $600. 3-5: $1,200. 6 or more: $1,800;3 - 5 Supplementals Surcharge Costs Price: These must be added to ALL wholesale supplemental AND Lobster Transportation Supplemental Licenses: Up to 2: $600. 3-5: $1,200. 6 or more: $1,800;6+ Supplementals Surcharge Costs Price: These must be added to ALL wholesale supplemental AND Lobster Transportation Supplemental Licenses: Up to 2: $600. 3-5: $1,200. 6 or more: $1,800;Lobster Processor Price: Surcharge of $1,000 if < 1,000,000 lbs. raw product processedLobster Processor Price: Surcharge of $4,000 if > 1,000,000 lbs. raw product processedLobster Meat Permit Price: Lobster Transportation Price: Retail Seafood Price: Enhanced Retail Seaf. Certificate Price: Processing 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 agreeI 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.NAME:*Type your full name to sign this secure webformSignature*CAPACITY OF PERSON SIGNING (E.G., OWNER, AGENT, TRUSTEE, GENERAL PARTNER, CORPORATE OFFICER, MEMBER)Date MM slash DD slash YYYY Authorization* I agreeI 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.Credit CardCard Details Cardholder Name Having Trouble with your card? My card information is not workingCheck this box to move forward without your Credit Card.BILLING ADDRESS Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country By clicking submit you agree to these Terms and Conditions and the above authorization of payment.