Claim Form

Before you fill in this form please click here to read the application form guide

 

1. Boat Shore(please tick appropriate)

2. Species (common name)

Species (Scientific)

3. Weight

lb   oz kg

4. Length
record.gif (13552 bytes)
Measure as indicated below taking X to X from tip of nose to fork of tail and XX to XX from tip of nose to tip of tail. For round fish take girth measurement Y to Y around the widest part of the body. For skates, rays or flatfish take widest measurement Z to Z across widest part

inches X to X    XX to XX

cm X to X XX to XX

5. Girth or Width (see measurements diagrams)

inches Y to Y    Z to Z

cm Y to Y Z to Z

6. Date of Catch
/ /

7. Place of Catch

Port Place Country

8. Method of Catch

9. Angler

Mr  Mrs  Ms Miss

Surname

Forename

10. Permanent Address

11. Membership or Angling Clubs

12. Tackle Used (every item in this section must be completed. A sample of the actual line must accompany the claim)

ROD

Make

Tip Length (centre of reel to end of tip)

Butt Length (centre of reel to butt cap)

REEL

Make & Model

Size

LINE

Make

Manufacturer’s breaking strain

Length of double line

Length of trace

Type of gaff

Length

Number & type of hooks

Type of lure or bait

13. Boat (if used)

Name    Length

Skippers name     Skippers Address

Skippers Signature

14. Line Class Entered (see acceptable classes)

2lb*/1kg 4/2 8/4 12/6 16/8 20/10 30/15
50/24 80/37 130/60 AT**/AT** SH**/SH**
**European only / *LTC only

15. Scales

Location

Type

Manufacturer

Serial

Date Last Certified

Person or agency certifying scales

Weighmaster

Address

Signature
(A copy of the scale certificate valid within one year of the date of weighing must accompany the claim)

16. Witness (to weighing other than angler)

Name Address

Witness to catch other than skipper (two names & address if possible)

Name

Address

Name

Address

Declaration of angler
(note signature of angler required for all claimants. Oath and notary seal only required in the event of no witnesses to the catch)

I, the undersigned, hereby take oath and attest that the fish described in the application was hooked, fought and bought to the gaff by me without assistance from anyone, except as specifically provided in the regulations; and that it was caught in accordance with EUROPEAN LINE CLASS RULES; and that the line submitted with this application is the actual line used to catch the fish. I further declare that all information is true and correct to the best of my knowledge.

Signature of Angler   Date

Sworn  by me this day of 19

Notary Signature and seal

PLEASE DO NOT WRITE BELOW THIS LINE
(for official use only)
—————————————————————-

Line strength test

Fish identified by

Registered under line class

Signature

Data Ratified

Data identified

Signature of fish recorder

Record category

A copy of this form may be taken in order to complete a record claim. The copyright remains the property of the The European Federation of Sea Anglers (EFSA) and the Light Tackle Club (LTC)