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 Name Vessel Use / Endorsement* Pleasure Commercial Official Number* Confirm Official Number* Part A: Applicant InformationLandings# Business Name Fed 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 Person FaxPart 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/Documentation Vessel Name Boat Length Primary Town of Anchorage State Is this vehicle: owned leased rented State of Registration Registration Plate# Make Vehicle ID No. Model Year Color Do 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 requested Contact InformationName First Last Email* Enter Email Confirm Email Phone*Hiddennumber 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? 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