Fish Dealer License Application - Commercial Fishing Permits Center

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Application for Fish Dealer’s License in the State of North Carolina.

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
Check one:
- New Application
- Renew
- Replace
Existing License Number

(License number is printed on license)
Individual or Business Agent Participant Information
Participant I.D.
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
- Check if same as physical address
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
County
Home Phone
Business Phone
Fax
Cellular Phone
Type of Business Entity (circle one):
- Corporation
- Partnership
- Sole Proprietorship
- LLC
Business Participant Information (This section must be completed for the application of a license for use by a business)
Participant I.D.
Business Name:
State of Incorporation:
Charter State:
Business Phone
Cellular Phone
Home Phone
Fax
Email
Enter Email Confirm Email
Business Owner Name (F, M, L)
Physical Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
County
Mailing Address
- Check if same as physical address
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
County
Dealer Location (physical address)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Location Phone No.
Business Fax Phone No.
Records location
- Check if same as physical address
Records location (Location or site where records pertaining to fish dealers are maintained)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Fax
Shipping Address
- Check if same as physical address
Shipping Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Fax
Categories (must indicate which categories you will be dealing in) Check ALL that apply (Fees - See Commercial License and Permit Fee Sheet. If you need assistance please contact any NC DMF License Office or call (252) 726-7021 or (800) 682-2632.)
- New Dealer
- Consolidated License (all categories) (Requires Shellfish Certification prior to the purchase of this license. Call the Shellfish Sanitation Section at the number below for questions.)
- Oysters (Requires Shellfish Certification prior to the purchase of this license. Call the Shellfish Sanitation Section at the number below for questions.)
- Clams (Requires Shellfish Certification prior to the purchase of this license. Call the Shellfish Sanitation Section at the number below for questions.)
- Hard and Soft Crabs
- Scallops
- Shrimp, including bait
- Finfish, including bait
Hidden
Each license listed above costs $100, please state how many licenses you checked to add total cost.
Please enter a number from 1 to 6.
Max: 6
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:
Oysters Fee
Application Fee
Price:
Oysters Fee
Application Fee
Price:
Clams Fee
Application Fee
Price:
Clams Fee
Application Fee
Price:
Scallops Fee
Application Fee
Price:
Scallops Fee
Application Fee
Price:
Hard or Soft Crabs Fee
Application Fee
Price:
Hard or Soft Crabs Fee
Application Fee
Price:
Shrimp Fee
Application Fee
Price:
Shrimp Fee
Application Fee
Price:
Finfish Fee
Application Fee
Price:
Finfish Fee
Application Fee
Price:
New Dealer Fee
Application Fee
Price:
New Dealer Fee
Application Fee
Price:
Consolidated Dealers Fee
Application Fee
Price:
Consolidated Dealers Fee
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
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Business Owner Name (F, M, L)

Individual or Business Agent Participant Information

Business Participant Information (This section must be completed for the application of a license for use by a business)

Certification Statement (This section must be completed by Applicant)