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Multi-Purpose License Renewal Application Form - Rhode Island Department Of Environmental Management

HODE

SLAND

EPARTMENT OF

NVIRONMENTAL

ANAGEMENT

235 Promenade Street, Providence, RI 02908-5767

TDD 401-831-5508

Office of Boat Registration & Licensing 3

Floor Room 360 (401) 222-6647

2016 MULTI-PURPOSE LICENSE RENEWAL APPLICATION

Mailing Address

Residence Address (Cannot be a PO Box)

Name: ______________________________

Street: ______________________________

Street: _____________________________

City,State,ZIP:________________________

City,State,ZIP:_______________________

Applicant ID: _________________________

DOB: ______________________________

Current License Information

New License Information:

License Type: MPURP

License Number: _____________________

Expiration Date: 12/31/2015

Expiration Date: 12/31/2016

Occupation: _________________________

*** (MUST BE RENEWED NO LATER THEN 02/29/2016) ***

Renewal Grace Period with $200.00 Late Fee March 1, 2016 – April 29, 2016

It is unlawful to fish or sell fishery products without a current 2016 license

The information below is REQUIRED in order to renew your license

Multi-Purpose License

$ 300.00

Reporting Method –

Endorsements

Mandatory

Gill Net- Renewal Only

$ 20.00

Logbook –

$25.00

Purse Seine

$ 20.00

Endorsement

Mid Water/Pair Trawl

$ 20.00

VTR

Dockside

$ 25.00

Electronic

Logbook

$ 25.00

Total Due:

NOTES

Fishery Sector(s)

Non-binding

Please make check or money order

For Informational purposes

Please check all

payable to: State of RI-DEM & mail or

ONLY

that apply

deliver to address above

Finfish

Every vessel engaged in Commercial

Shellfish

Fishing must be declared on a Commercial

Crustacean

Vessel Declaration Application

Rules & Regulations are available at

or Office of Boat Registration & Licensing

Social Security Number must be on file with the Dept or applicant must submit Letter of Good

Standing from RI Division of Taxation prior to renewal of marine license

Resident RIGL20-1-3(8) Resident means an individual who has had his or her actual place of residence and

has lived in the state of RI for a continuous period of not less than six (6) months:

I hereby certify that I am a RI resident and the information contained herein is true and correct:

Signature: ____________________________ Date: ____________ RIDL # ____________

Telephone Number: _____________________ (Optional)

Note: Licensed fishers are obligated to comply with possession limits for finfish as provided in the Marine

Fisheries listserve, dedicated phone line at (401) 423-1920, or webpage at

Licensed shellfishers are obligated to

comply with conditional closure areas as provided on DEM’s dedicated phone line at (401) 222-2900.

Multi-Purpose License Renewal Application Form - Rhode Island Department Of Environmental Management

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