MASSACHUSETTS – REQUESTFOR VERIFICATION OF FISHING EXPERIENCE Home » Massachusetts » MASSACHUSETTS – REQUESTFOR VERIFICATION OF FISHING EXPERIENCE A brief description of the form or Application to be filled out here. Name First Last 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 PhoneDate of Birth MM slash DD slash YYYY DMF Permit ID# (if applicable)Federal Permit # (if applicable)Vessel Information (Name, MS/DOC#, length)Type of permit you are interested in obtaining Coastal Lobster Fish-Pot Conch Fish-Pot Scup Fish-Pot Seabass Ocean Quahog Surf Clam Quahog Dredge Mobile Gear Coastal Access Permit List your commercial POT FISHING experienceVessel NameName of Permit HolderDMF Permit ID#YearMonths FishedEstimated # of trips List your commercial FISHING experienceVessel NameName of Permit HolderDMF Permit ID#YearMonths FishedEstimated # of trips Do you currently hold or have you ever held a Massachusetts commercial permit? Yes No DMF Permit ID #Year(s)Do you currently hold or own a vessel that holds any NMFS Federal Permits? Yes No NMFS #Has there been any state or federal enforcement actions against you, the permit or the vessel you were fishing under prior to this transfer request? Yes No Describe violation or enforcement actionContact InformationName First Last Email* Enter Email Confirm Email Phone*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 webformSignature*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. I agreeCredit CardCard Details Cardholder Name Having Trouble with your card?Check this box to move forward without your Credit Card. 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