Eligibility Pool Application - Commercial Fishing Permits Center

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Apply for the Standard Commercial Fishing License (SCFL) through the eligibility pool process.

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
Participant Information
Participant I.D. if available
Name
First Middle Last Suffix
Check one
- Driver’s License No.
- State I.D. No.
- Military I.D. No.
- Resident Alien I.D. No.
- Passport No.
Provide number and expiration date
No. Expire Date
Date of Birth
MM slash DD slash YYYY
Race:
Gender
Height
Weight
Eye Color
Hair Color
Primary Residence (State)
Email
Enter Email Confirm Email
Physical Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
County:
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
County
Home Phone
Business Phone
Fax
Cellular Phone
ELIGIBILITY APPLICATION PAGE 2
1. ELIGIBILITY CRITERIA: In order for the SCFL Eligibility Board to determine if you are qualified to be placed in the License Eligibility Pool, please select one or more of the criteria listed below that describes your involvement in commercial fishing. PROVIDE SUPPORTING DOCUMENTATION FOR EACH OF THE CRITERIA SELECTED. All supporting documentation must be signed by the provider and notarized (Instructions on Attachment 1).
- Significant involvement in the commercial fishing industry three of the last five years; or
- Significant involvement in commercial fishing or in the commercial fishing industry prior to the last five years; or
- In the case of an applicant who is under 16 years of age, significant involvement in commercial fishing for two out of the last five years with a parent, legal guardian, grandparent or other adult; or
- Significant Involvement of the applicant's family in commercial fishing. For the purpose of this Sub-item, family shall include mother, father, brother, sister, spouse, children, grandparents, or legal guardian.
2. COMPLIANCE WITH LAWS AND REGULATIONS List all fishing, environmental, and natural resource warnings, violations, convictions, and license suspensions or revocations, issued by any federal or state agency in the previous 10 years. If there are no violations put “NONE”, do not leave blank.** Please put down STATE AND FEDERAL VIOLATIONS, CONVICTIONS, WARNINGS, SUSPENSIONS, REVOCATIONS
STATE/FEDERAL AGENCY LICENSE NO. TYPE OF OFFENSE DESCRIPTION

**NC Marine Fisheries Commission Rule 15A NCAC 03O .0405(5)(6) Applications shall be legible and complete or they will be returned. It is unlawful to submit false statements on applications or supporting documents. If eligibility is based on false information provided by the applicant, this eligibility is automatically revoked.
3. COMMERCIAL FISHING INCOME Please submit tax records (1099, W2, Schedule C, tax return, etc.) as proof of commercial fishing income if available.
Certification Statement (This section must be completed by Applicant)
I, ______________ certify that:
1. All the information provided on this application and any supporting documentation provided is true, accurate, and complete. And further, for renewals, any changes in information or supporting documents have been provided at the time of renewal.
I am a resident of the State of:
If claiming resident status in North Carolina, I certify further that (check one):
- I have been a legal resident for more than six months, or
- If domiciled in North Carolina between 60 days and six months, I have completed and submitted with this application a notarized Certificate of Eligibility for North Carolina Residency.
3. If applying for a Standard or Retired Standard Commercial Fishing License as a North Carolina Resident, I also certify that:
I filed a North Carolina State Income Tax Return for the previous calendar or tax year.
Please initial
I was not required to file a North Carolina State Income Tax Return for the previous calendar or tax year
Please initial
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 agree
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.
NAME:
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
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.
Credit Card
Card Details
Cardholder Name
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STATE/FEDERAL AGENCY	LICENSE NO.	TYPE OF OFFENSE	DESCRIPTION

Participant Information

ELIGIBILITY APPLICATION PAGE 2

Certification Statement (This section must be completed by Applicant)